Nipah Virus: A Zoonotic Threat That Spans Species
The Nipah virus (NiV), classified as a zoonotic virus, possesses the capacity to transfer from humans to animals and vice versa. Among the creatures that serve as natural hosts for NiV, fruit bats, commonly referred to as flying foxes, top the list. Notably, both pigs and humans have fallen victim to Nipah virus infection, a condition often associated with encephalitis, which leads to brain swelling. This viral infection can range from mild to severe, sometimes resulting in fatalities. In several parts of Asia, primarily Bangladesh and India, outbreaks happen virtually every year.
Avoiding contact with sick bats and pigs in places where the virus is present, as well as not consuming raw date palm sap that has been tainted by an infected bat, can help prevent nipah virus infection. Standard infection control procedures can reduce the risk of patient-to-patient transmission during an outbreak.
What is Nipah Virus ?
In 1999, an epidemic that caused concern led to a health catastrophe that affected Malaysia and Singapore. The nipah virus (NiV) was solely to blame for this terrible incident. Over 1 million pigs were slaughtered as part of an extreme action to stop the spread of the disease. Although this action was required to stop the outbreak, it was quite expensive. Over 100 people had already died as a result of the virus, which had infected over 300 people. The economic effects of this outbreak were as severe and had a long-lasting effect on the affected areas.
NiV outbreaks have been reported almost yearly in several regions of Asia since 1999, notably in Bangladesh and India, despite the fact that there haven’t been any other known outbreaks in Malaysia or Singapore. Concerns regarding the possibility that NiV could start a worldwide pandemic have been raised as a result of evidence that the virus can move from person to person in these outbreaks.
NiV belongs to the genus Henipavirus in the family Paramyxoviridae. Since it is a zoonotic virus, it initially travels between people and animals.The fruit bat, commonly known as the flying fox, is an animal reservoir for the NiV virus and belongs to the Pteropus genus.
Due to NiV’s genetic resemblance to the Hendra virus, another henipavirus that is known to be carried by bats, it was quickly selected as a subject for investigation.
Flying foxes were later shown to be the reservoir for NiV.
Humans and other animals, including pigs, can catch the illness from infected fruit bats.Close contact with an infected animal or its bodily fluids, such as saliva or urine, can result in human infection; this initial transmission from an animal to a person is referred to as a spillover incident. NiV can also transmit from person to person once it has infected humans.
Transmission
The Nipah virus (NiV) can be transmitted among people by:
- Direct contact with diseased animals, like pigs or bats, or their bodily fluids (such blood, urine, or saliva).
- Consuming food items that have been tainted with an infected animal’s bodily fluids (such as fruit tainted with an infected bat’s juice or palm sap).
- Close contact with a NiV-positive individual or their bodily fluids (such as blood, urine, or droplets from the nose or mouth)
People likely contracted the virus during the first recorded NiV outbreak through close contact with sick pigs. The NiV strain found in that outbreak appeared to have been propagated first among bats before moving on to pigs and then pig populations. Then, those who had regular contact with the diseased pigs started getting sick. In that outbreak, there was no information on person-to-person transmission.
NiV transmission from person to person is, nevertheless, frequently documented in Bangladesh and India. Healthcare facilities and the families and carers of NiV-infected patients are where this is most frequently observed. Additionally, exposure to food products tainted by sick animals can result in transmission. Examples include eating fruit tainted with bat saliva or urine or raw date palm sap. People that climb trees where bats frequently roost have also been documented to contract the NiV virus in some situations.
Signs and Symptoms
Nipah virus (NiV) infection can result in mild to severe illness, including brain swelling (encephalitis), and even death.
Typically, 4–14 days after a virus exposure, symptoms start to manifest. The illness usually includes symptoms of a respiratory illness, such as coughing, sore throat, and difficulty breathing, and typically begins with 3–14 days of fever and headache. Drowsiness, disorientation, and mental confusion are common symptoms of the ensuing phase of brain swelling (encephalitis), which can quickly develop to coma within 24-48 hours.
Read : Ministry of Ayush
Initial symptoms could involve one or more of the following:
- Fever
- Headache
- Cough
- throat discomfort breathing issues
- Vomiting
Severe signs and symptoms, such as:
- confusion sleepiness, or disorientation
- Seizures
- Coma
- An enflamed brain (encephalitis)
In 40–75% of instances, death may occur. Survivors of Nipah virus infection have reported long-term negative effects such as chronic convulsions and behavioural abnormalities.
Dormant or latent infections, which manifest symptoms and can result in death much later after exposure, have also been documented months or even years later.
Diagnosis
An infection with the Nipah virus (NiV) may be discovered either during or after recovery. There are numerous tests available to identify NiV infection. Real-time polymerase chain reaction (RT-PCR) laboratory testing from blood, urine, cerebrospinal fluid, and throat and nasal swabs can be done in the early stages of the illness. An enzyme-linked immunosorbent assay (ELISA) is used to test for antibodies later in the course of the illness and after recovery.
Due to the non-specific nature of the illness’s early symptoms, detecting NiV infection in its early stages can be difficult. However, to improve the odds of survival for those who are sick, to stop transmission to others, and to manage outbreak response operations, early detection and diagnosis are essential.People who have travelled to nations where Nipah is more common who show symptoms that are consistent with NiV infection should be tested for NiV—especially if they have a history of exposure.
Treatment
There are no approved medications on the market right now to treat Nipah virus (NiV) infection. Only supportive care, such as rest, hydration, and symptom management, is used as a kind of treatment.
However, there are currently being developed and tested immunotherapeutic drugs (monoclonal antibody therapy) to treat NiV infections. A phase 1 clinical trial for one of these monoclonal antibodies, m102.4, was completed and it has been applied on a compassionate use basis. Remdesivir, an antiviral medication, has also shown promise in nonhuman primates as a post-exposure preventative and may be used in conjunction with immunotherapeutic therapies. In the initial Malaysian NiV outbreak, the medication ribavirin was used to treat a small number of patients, although it is unknown whether it is effective in humans.
In places where Nipah virus (NiV) outbreaks have occurred, people should:
- Regularly wash your hands with soap and water.
- Stay away from sick pigs or bats.
- Prevent going to places where bats are known to roost.
- Avoid consuming or consuming products that could be contaminated by bats, such as raw date palm sap, raw fruit,or fruit that has fallen to the ground. Also, avoid coming into contact with someone who has been known to have the
- NiV virus by contact with their blood or body fluids.
Standard infection control procedures and effective barrier nursing techniques are crucial in preventing hospital-acquired infections (nosocomial transmission) in settings where a patient has a confirmed or suspected NiV infection since NiV can be passed from person to person.
Future NiV outbreaks may occur in other areas, such as those where flying foxes (of the bat genus Pteropus) are found. Currently, these bats can be found in Thailand, the Philippines, Madagascar, Indonesia, Cambodia, and Indonesia. Consider taking the same safety measures as those who live in places where outbreaks have already happened if you live in or visit these locations.
Consider taking the same safety measures as those who live in places where outbreaks have already happened if you live in or visit these locations.
Along with precautions that people can take to reduce their chance of contracting NiV, it will be crucial for scientists, researchers, and communities at risk to keep learning about NiV in order to stop further outbreaks. Additional preventative initiatives include:
- Increasing animal and human surveillance in places where NiV is suspected to be present.
- More study is being done on the ecology of fruit bats to learn where they live and how they transmit the virus to other living things and humans.
- Evaluation of cutting-edge techniques or technology to reduce viral spread among bat populations.
- enhancing instruments for early viral detection in people and livestock.
- To stop the spread of infection from person to person, regular infection control procedures are being reinforced in healthcare settings.
- Educating people in high-risk groups about the symptoms, risks, and indicators of the NiV among populations at higher risk due to:
- geographical area
- fruit bat-contaminated objects or coming into contact with fruit bats
- Animals that could come into touch with fruit bats, such as pigs, should not be handled
- Work in healthcare or as a carer for NiV-infected individuals
