What
is
Nipah
virus
infection
(NiV)?

NiV
is
a
zoonotic
virus
(a
disease
that
animals
can
transmit
to
humans,
known
as
a
zoonosis);
the
virus
often
infects
animals
such
as
pigs
and
fruit
bats
(Pteropodidae),
but
they
may
be
asymptomatic.

Nipah
virus
infection
is
a
zoonosis
transferred
by
contact
with
a
NiV-infected
animal
or
person
or
their
secretions
that
has
a
high
fatality
rate
in
infected
humans.

The
cause
of
a
Nipah
virus
infection
is
the
Nipah
virus
(NiV).
The
virus
can
cause
a
range
of
symptoms
in
people,
and
cases
can
range
from
mild
to
deadly.
Nipah
virus
(NiV)
is
a
member
of
the
family

Paramyxoviridae,
genus

Henipavirus
and
is
related
to
Hendra
virus
that
infects
horses.
NiV
is
a
zoonotic
virus
(a
disease
that
animals
can
transmit
to
humans,
known
as
a
zoonosis);
the
virus
often
infects
animals
such
as
pigs
and
fruit
bats
(Pteropodidae),
but
they
may
be
asymptomatic
(not
show
any
symptoms).
In
addition,
flying
foxes
of
the
genus

Pteropus
in
the
Malaysian
peninsula
can
carry
NiV.

People
first
discovered
NiV
in
a
village
named
Kampung
Sungai
Nipah
in
1999
in
Malaysia;
the
virus
was
named
after
the
village.
This
first
recorded
outbreak
began
in
1998-1999
and
reached
Singapore.
A
new
strain
occurred
in
2001
in
Bangladesh
and
India.
Small
outbreaks
of
NiV
have
happened
in
these
countries
since
2001.
An
outbreak
in
India
(state
of
Kerala)
occurred
in
May
2018.
Fruit
bats
and
rabbits
are
the
likely
sources
of
NiV
that
infected
people.
The
Indian
government
sources
say
that
the
situation
is
currently
under
control.
During
this
outbreak,
at
least
11
people
have
died
and
another
14
people
contracted
the
virus,
while
another
22
are
awaiting
test
results.

What
causes
Nipah
virus
infection?

Humans
who
have
direct
contact
with
infected
fruit
bats
or
infected
pigs
are
the
usual
way
an
outbreak
begins.
However,
the
consumption
of
raw
date
palm
sap
contaminated
with
bat
feces
is
another
common
way
to
get
the
disease.
Human-to-human
transmission
occurs
during
close
contact
between
family
members
and/or
medical
caregivers.

The
risk
factors
for
this
infection
include

• having
  close
  contact
  with
  infected
  animals
  such
  as
  pigs,
  bats,
  and/or
  humans
  infected
  with
  the
  virus.
• In
  addition,
  the
  consumption
  of
  raw
  date
  palm
  sap
  is
  a
  significant
  risk
  factor
  since
  bat
  excrement
  often
  contaminates
  this
  substance.

The
virus
is
moderately
contagious
as
it
needs
close
contact
and
usually
infects
the
family
members
and/or
medical
caregivers
of
NiV-infected
individuals.

The
incubation
period
(time
from
initial
exposure
to
virus
to
when
symptoms
begin)
for
NiV
usually
varies
from
about
five
to
14
days.
There
have
been
a
few
cases
with
much
longer
incubation
periods,
as
long
as
45
days.

Doctors
do
not
completely
understand
the
contagious
period
for
infection,
but
it
likely
begins
during
the
incubation
period
(proven
in
pigs)
and
continues
until
the
patient
stops
shedding
virus.
In
most
patients,
this
occurs
when
the
symptoms
and
signs
of
the
infection
are
diminished
or
gone.

What
are
the
symptoms
of
Nipah
virus
infection?

The
signs
and
symptoms
of
Nipah
virus
infection
begin
with

Encephalitis
follows
and
those
infected
may
exhibit

• drowsiness,
• disorientation,
• mental
  confusion,
• altered
  consciousness,
  and
• 
  seizures
  that
  can
  progress,
  within
  24-48
  hours,
  to
  
  coma
  and
  eventually
  death.

Diagnosis
of
Nipah
virus
infection

A
combination
of
tests
that
diagnoses
NiV
includes
the
following.

• Viral
  isolation,
• RT-PCR,
  and
• antibody
  detection
  by
  the
  
  ELISA
  tests is
  the
  test that
  health
  care
  professionals
  use
  most
  often
  to
  diagnose
  Nipah
  virus
  infection.

What
are
the
treatments
for
Nipah
virus
infection?

• According
  to
  the
  U.S.
  Centers
  for
  Disease
  Control
  and
  
  Prevention
  (CDC),
  supportive
  care
  is
  the
  only
  current
  treatment
  for
  this
  viral
  infection.
• There
  is
  no
  
  vaccine
  specifically
  available
  to
  protect
  humans.
• However,
  some
  researchers
  suggest
  that
  the
  antiviral
  drug
  
  ribavirin
  may
  be
  useful,
  but
  there
  is
  little
  or
  no
  data
  to
  support
  this.
• A
  human
  monoclonal
  antibody
  that
  targets
  the
  G
  glycoprotein
  of
  NiV
  has
  shown
  benefit
  in
  a
  ferret
  animal
  model
  of
  this
  disease,
  but
  researchers
  have
  not
  studied
  the
  effects
  of
  the
  antibody
  in
  humans.

What
is
the
prognosis
for
Nipah
virus
infection?

• The
  prognosis
  of
  NiV
  infections
  is
  fair
  to
  poor.
• The
  fatality
  rate
  is
  estimated
  by
  the
  World
  Health
  Organization
  (WHO)
  to
  range
  from
  40%-75%,
  depending
  upon
  the
  local
  capabilities
  for
  surveillance
  and
  clinical
  management
  (supportive
  care).
• Survivors
  may
  have
  residual
  neurological
  problems
  such
  as
  seizures
  and/or
  personality
  changes.
• A
  few
  survivors
  who
  recover
  may
  subsequently
  relapse
  or
  develop
  delayed
  onset
  encephalitis.

Is
it
possible
to
prevent
Nipah
virus
infection?

There
are
ways
to
reduce
the
risk
of
developing
NiV
infections.

• For
  example,
  individuals
  should
  avoid
  date
  palm
  sap
  and
  any
  bats
  or
  potentially
  infected
  domestic
  animals
  such
  as
  infected
  pigs.
• The
  WHO
  suggests
  that
  health
  care
  professionals
  wear
  gloves
  and
  other
  protective
  clothing
  during
  any
  pig
  slaughtering
  and
  culling
  procedures.
• Avoid
  contagion,
  the
  communication
  of
  disease
  from
  one
  person
  to
  another
  by
  close
  contact.
• Medical
  caregivers
  should
  employ
  quarantine
  methods
  and
  use
  barrier
  methods
  such
  as
  gloves,
  masks,
  and
  disposable
  gowns,
  as
  they
  are
  at
  high
  risk
  of
  person-to-person
  transmission
  of
  NiV.
• Boiling
  freshly
  collected
  date
  palm
  juice
• Thoroughly
  washing
  and
  peeling
  all
  fruits
  before
  you
  eat
  them
• Throwing
  away
  any
  fruit
  with
  signs
  of
  bat
  bites
• Considering
  the
  presence
  of
  fruit
  bats
  when
  establishing
  a
  farm
• Keeping
  pig
  feed
  and
  pig
  sheds
  protected
  from
  bats