It’s unfortunate that Nipah virus (NiV) is grabbing headlines and our attention. The only thing deadlier than the virus is the misinformation and the rumours that are floating around. I firmly believe that knowledge is the antidote to fear and I’m here to give a low down on the virus that’s causing all the frenzy.
To begin from the beginning,
Malaysia in September 1998 was the first to report an NiV outbreak followed closely by Singapore in March 1999. In fact, the virus owes its name to a Malaysian village from where it was reported first. Bangladesh has also had outbreaks and now we have it in our backyard.
How nasty is it?
It has already claimed a dozen people and many more are suspected to be infected and are hospitalised.
How did it get here?
Malaysia and Singapore got it from pigs infected with the virus and typically the people who got infected were the ones who were around such pigs. However, in Bangladesh it’s the fruit bats who have been known to cause infection. There is a local practice of extracting sap from palm trees which are also inhabited by these bats. The sap gets contaminated with bat’s secretions (urine, faeces, saliva etc.) which causes the spread of infection. Closer home, in Kerala too, its being traced to a well which had bats living in it. It correlates well with the season when young bats leave the nest to fly (April- June with a peak in May)! Once infection sets in, there is a human to human spread. As the virus is found in blood, urine, saliva and CSF, the spread happens when in contact with these secretions.
The signs and symptoms
It starts with non-specific muscle pain and fever. The other symptoms could be
- Difficulty in breathing
- Blurred vision
- Stomach ache and vomiting
The incubation period is 5-14 days, with the patient showing rapid deterioration, severe respiratory infection, inflammation of brain tissue (encephalitis) reflecting as mental confusion, rigidity of neck and sometimes coma too.
Suspected (clinical) Nipah case: Patient coming from the community affected by an outbreak and has:
- fever with acute onset of altered mental status or seizure and/or
- fever with headache and/or
- fever with acute onset of cough with shortness of breath.
Probable Nipah case: Suspect cases, and/or who died before complete diagnostic specimens could be collected
Confirmed Nipah case: Suspected/probable cases who have been confirmed by tests from the laboratory, i.e.
- IgM antibody (ELISA test) against NiV in serum or CSF, or
- RT-PCR for NiV RNA from respiratory secretions (throat swabs), urine or cerebrospinal fluid, or
- Actual virus isolation from respiratory secretions, urine or cerebrospinal fluid or other tissue specimens.
(The tests are currently being done at National Institute of Virology, Pune)
Prevention is the ONLY cure
- Avoid exposure to infected patients and animals (bats and pigs)
- Do not consume the sap of raw date palm
- Practice hand washing and hygiene
- Cover your mouth, eyes and nose when handling the patient
- Keep the patient’s items (clothes, utensils etc.) separately
- NiV has been found in blood, urine, saliva and CSF of the patients who have died from it. Take utmost care while dealing with any of these.
A Word of caution
Remember that the virus can stay in the human bodies for months and may reactivate itself much later. Convulsions and changes in personality are expected in such patients.
Treatment for Nipah Virus
- Limited to supportive care
- There are no vaccines or medicines available right now though trials are on for both
- Animal trials are showing promise with an anti-viral called favipiravir (https://www.nature.com/articles/s41598-018-25780-3)
- Alternative medicines are claiming cure but none of it has been proven.
Hope these words help calm your nerves. As you can see that there is not much we can do when infection sets in, its increased awareness and vigilance that may help in early detection and control of it. Do not spread rumours and neither succumb to them.
P.S.: I cannot end this without paying my respects to the nurse Lini who died in the line of her duty and the brave health care workers as well, who are doing their jobs knowing fully well the risks involved.
Image Courtesy: 360Nobs.comFirst Published – https://www.momspresso.com/parenting/article/all-you-need-to-know-about-nipah-virus