The most recent viral outbreak that has everyone on edge is caused by Nipah virus, labelled zoonotic (transmitted to humans through animals). It presents symptoms of encephalitis — severe swelling of the brain — along with acute breathing problems. There are even times when the disease doesn’t present any symptoms, only to have the patient slip into coma, and even death. The virus is named for the place it was first isolated and identified — in Sungai Nipah, Malaysia, where a bunch of pig farmers contracted the disease nearly 20 years ago.
According to a World Health Organisation (WHO) document, the disease had spread from infected pigs to the farmers. It took six months to get the first outbreak under control. The next outbreak was reported three years later in Bangladesh, but it was a different strain where the virus was directly transmitted from bats to human. The virus is one among the top priority pathogens on WHO’s R&D Blueprint list of epidemic threats.
These are some more worrisome facts about this latest epidemic, that can become a deadly pandemic if not controlled, diagnosed and treated properly.
An ‘emerging’ virus
Nipah virus (NiV) was first recognised in 1999—when there was an outbreak in Singapore among pig farmers. According to WHO, it was first isolated in Malaysia. Before being identified as Nipah virus infection, the infection was provisionally known as Japanese Encephalitis that could lead to death, too.
A yearly outbreak
The first reported outbreak of NiV in the Indian sub-continent was in 2001 in Bangladesh. Since then, the virus hits Bangladesh every year. Nipah was reported in India in 2001, too (in Siliguri, West Bengal). WHO states that the 2001 outbreak was a hospital-acquired infection, causing person-to-person transmission.
No drugs or vaccine
The Centre for Disease Control and Prevention (CDC) states that the treatment of the Nipah virus encephalitis is limited to intense supportive care. At present there is no one-drug cure for the disease. However, in certain cases ribavirin has been shown to have some effect in suppressing the infection to an extent.
Symptoms are numerous
Experts believe that the incubation period of the virus is anywhere between 4–14 days, healthcare professionals can misdiagnose the disease. In some cases, the disease doesn’t present any outward symptom apart from the infection. Symptoms when they appear, range from fever, headaches, vomiting, sore throat — or dizziness, and drowsiness. In severe cases, there are seizures which might lead to coma within 24 to 48 hours.
Fatalities are high
As there is no particular drug to cure the disease, the patients are provided intensive care to treat and ease the severe respiratory and neurological complications. In 1999, when the outbreak of Nipah virus was first recognised, there were 276 confirmed cases with 106 deaths. However, the later outbreaks in Bangladesh and India reported fatalities between 46–100 percent.
Bats are natural hosts
Fruit bats—particularly those of the species from the pteropus genus—are known to be the natural hosts of the NiV. This puts at risk large portions of human population in areas from coastal Africa and Madagascar to Indian coast, Malaysia, Indonesia, the Philippines, even part of northern coastal Australia, where these bats are largely found.
Frequency shows ignorance
A WHO analysis paper on Nipah notes that outbreaks since 2001 have been due to drinking contaminated date palm sap, or its fermented variety, especially in Bangladesh. It was then because people came in direct contact with the infected people—especially in hospital—without taking proper precautions.
Awareness is a step
Bat urine, excreta and saliva are the main contaminants; these can get into damaged fruits and unhygienic packing, especially uncovered palm saps. It is recommended to boil the palm sap before drinking it, and to thoroughly clean, and skin any fruit in areas that have higher fruit bat population.
Proper cleaning is key
Health care workers should be extra careful not to come into skin-to-skin contact with infected patients. Along with that ensuring that bats do not come in contact with any food or drinks, or with pigs and other domestic animals, helps prevent any viral transmission. But washing properly your hands and feet, and in this case, clothes, too, is essential to curb infection.