Nipah virus Infection

Lavina Desai
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Clinical features
Nipah virus causes an encephalitis syndrome with high mortality rate, currently reported at 75% in India. The incubation period ranges from 7-40 days. The initial presentation is non-specific with sudden onset fever, myalgia, nausea and vomiting. It is suspected in a patient who has
• Fever with new onset / altered mental status or seizure and /or
• Fever with headache and/or
• Fever with cough or shortness of breath.

Meningismus is seen in approximately in one-third of patients but marked nuchal rigidity and photophobia is uncommon. In 60% patients the disease rapidly progresses with declining consciousness and can lead to coma within 5-7 days. Generalised seizures occur in 20 % of patients. Other neurological presentations include myoclonus, cerebellar dysfunction, tremors, areflexia. Brainstem involvement leads to pinpoint pupils, unreactive pupils, abnormal doll’s eye reflex, tachycardia and hypertension which are signs of a poor prognosis. Few cases can have pulmonary involvement with atypical pneumonia and chest radiographs show diffuse interstitial infiltrates. Some cases may have non-encephalitic illness initially and have late onset neurological disease. Patients can have residual fatigue and day time somnolence after illness. One of the complications of Nipah virus infection is relapsing encephalitis presenting with multiple episodes of neurological dysfunction in survivors.

Nipah virus Infection Nipah virus Infection 05/25/2018
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