Thursday, June 28, 2018

Nipah: The Virus that kept Entire India in Panic

NIPAH (NiV) a virus mostly carried by fruit bats is causing large-scale panic in Kerala which is under control now. Around 16 deaths were reported in the state over 15days.

Nipah was first identified in Malaysia in 1998. This infection was first reported in India in 2001 and six years later, which claimed almost 50 lives. Nipah includes flu-like symptoms that often lead to encephalitis and coma. According to WHO, fruit bats are the main carrier of NIPAH virus, for which there is no vaccination available.

Dr. Rajeev Soman, MBBS, MD and FIDSA, Consultant Physician & Infectious Diseases Specialist, Jupiter Hospital, Baner explained more about this disease and how to prevent this type of disease.

Q1. What is Nipah?
It is a Paramyxovirus (RNA virus) which has been responsible for causing disease in South and South East Asia. It was first identified during an outbreak in Malaysia/ Singapore in 1998-99, and is named after the village where it started.

Q2. How does it spread?
It is carried by fruit bats, and people consuming food or water contaminated by secretions or excretions of infected bats are at risk. The Bangladesh outbreaks were due to consumption of tree sap contaminated by bat excretion. Person to person transmission is also documented.

Q3. Are there any other animals involved?
Pigs served as intermediate hosts in the Malaysian outbreak, but do not appear important in subsequent outbreaks.

Q4. What are the symptoms?
Fever, headache, drowsiness, disorientation and delirium which can occur 3-14 days after onset of symptom. This can progress to coma in 24-48 hours. Presentation as ARDS is less common.

Q5. How is it diagnosed?
A high index of suspicion is needed, based on history of being in the area affected, and presenting with an encephalitic illness. Serology can help identify patients on recovery. PCR of blood, urine, CSF or nasopharyngeal secretions can identify active cases.

Q6. Is there a vaccine?
There is no human vaccine as yet. Passive immunoglobulins not studied.

Q7. How can we prevent disease spread?
1.Identify possible cases early- patients with travel to Malappuram and Kozhikode within 14 days of presentation who have fever should be assessed appropriately.
2.Proper contact and droplet precautions- hand hygiene mask and at least 6 feet space between the infected patient and all others mandatory.
3.Label all lab samples correctly to warn the lab personnel
4.Procedures require extra precaution.
5.Expired patients need to be wrapped and families counseled on safe disposal.
6.Notify authorities immediately.

NIPAH is thus a contagious disease. A person if gets infected by this virus has to keep isolated for further treatment.

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