Deadly Nipah Virus : Is Another Pandemic On Its Way?

The third wave of Nipah virus [NiV] was confirmed in Kerala after the death of a 12-year-old who has been tested for Nipah virus in Kozhikode. Around 118 were identified as primary contact among them 20 are high-risk contacts including 2 health workers.

Nipah virus (Nipah henipavirus) is a zoonotic virus that comes under paramyxovirus. Fruit bats commonly known as flying fox are the animal reservoir of Nipah. This disease has a high mortality rate due to the lack of effective vaccines or therapies. Infection can cause in humans from other animals also by human-human interaction. It is observed that Nipah outbreaks occur almost annually in parts of Asia primarily in India and Bangladesh.

HISTORY OF NIPAH VIRUS

Nipah virus first recognized in 1998 among pig farmers in Malaysia led to the killing of about a million pigs. No new outbreaks reported in Malaysia since then. Due to the movement of infected pigs the virus subsequently spread to various regions of Singapore. Later between 2001 and 2005, Bangladesh witnessed consecutive five outbreaks. The disease also has been identified periodically in India. The infected virus has been found in bats in Cambodia, Ghana, Indonesia, etc but no cases reported yet in these countries.

SYMPTOMS OF NIPAH VIRUS

Nipah symptoms can range from asymptomatic to severe febrile encephalitis and respiratory diseases which are very fatal. The case fatality is about 40-75%. According to WHO, the infected people initially show fever, shivering, and dizzies. Later symptoms progressing into acute encephalitis and seizures. The incubation period of the virus is believed to be 4- 14 days so the onset of the symptoms can be between these days.

CAUSE AND TRANSMISSION

The disease can cause most likely through contaminated saliva, urine, or the tissue of the infected natural host. The subsequent outbreaks in India and Bangladesh are most commonly thought bats of the Pteropodidae family. Transmission of the diseases vigorously happened by the movement of infected animals and Human
to human transmission.

RE-EMERGENCE OF NiV IN INDIA

Evidence suggested that climatic and anthropogenic factors including agricultural expansions are one of the underlying causes of its emergence.

The possible reason for the re-emergence of NiV in Kerala can be planting fruits including plantains which will attract bats and will allow the spillover of this novel paramyxovirus. Various research has been initiated since 2018 to know the re-occurrence of the diseases particularly in certain parts of India.

No successful vaccine, therapies, or proper treatment protocol discovered yet for the Nipah virus for animals and humans as well. NiV can be effectively treated by some antiviral drugs which are used for Hendra virus (close relative to Nipah virus).

PREVENTION

As we are already in the middle of a novel coronavirus pandemic all the precautions that are needed for covid-19 are enough for Nipah as well. The situation in Kerala is under control the close contact with the 12-year old has been quarantined with close supervision.