Dr. Vityala Yethindra is the world’s youngest scientist in medicine has answered the most commonly asked questions about Nipah virus (NiV) infection.
NiV infection is an emerging zoonosis that can cause severe acute respiratory disease and lethal encephalitis, for which there is currently no specific treatment or vaccines for humans or animals. NiV is one of the 10 infectious diseases of the 16 identified by the World Health Organization (WHO) as the greatest risk to public health because it has a high mortality rate (40% to 75%) depending on the origin of the outbreak.
The NIV was first detected in 1998 in Malaysia during an outbreak of the disease. According to the WHO in the first discovery, the intermediate host was the pig. Pteropus, one of the genera of fruit bats can transmit the virus through fruits. In 2004, an outbreak in Bangladesh, infected people contracted this virus after consuming date palm sap contaminated by infected fruit bats.
Symptoms of a NiV infection are similar to those associated with the common flu and influenza, including fever, sore throat, headache, and muscle pain. In some cases, the infected person can suffer from encephalitis and myocarditis (inflammation of the brain and heart muscle) which can cause permanent disability, or be fatal. Symptoms begin 5 to 14 days after exposure.
The NIV can be transmitted from animals to humans. The virus can be spread by direct contact with infected pigs, bats, or other people. Through direct unprotected contact with infected body fluids, there are person-to-person transmitted cases.
Serological tests of paired sera during the acute and convalescent stages can be used for diagnosis. RT-PCR of the throat and nasal swabs, blood, urine, and CSF can also be performed. Immunohistochemistry of brain tissue can be performed in fatal cases.
Currently, no drugs are effective in treating NiV infection. Early treatment with the antiviral drug ribavirin can reduce the duration of fever and the severity of the illness. However, the safety and efficacy of drugs for improvement in survival are still unknown.
Even though there is a safe and effective vaccine against NiV in mice, but it’s important to focus on testing the vaccine in different species and establishing the right dose to administer. Moreover, it may take time to get the vaccine approved against the NIV.
Besides outbreaks in Malaysia, Singapore, Bangladesh, and India, the NiV has reported affecting bats in countries such as Cambodia, Indonesia, Madagascar, Thailand, and Timor-Leste. Of 11 different Nipah outbreaks were identified in Bangladesh from 2001- 2011, 196 were diagnosed and 150 of them died.
The people living in areas prone to contracting the NiV should change their habits and lifestyle, especially those who live in areas with a high prevalence of fruit bats. Care should be taken during consuming fruit and already bitten fruit should be avoided.
It’s necessary to manage the infected pigs, by isolating and people dealing with them should use personal protective equipment for effective prevention.
In the case of travelers, it’s important to follow preventive measures every time. They should maintain hygiene by washing hands often, avoiding contact with sick people, bats, and other animals, and by taking safe food and beverages. Hospitals should be visited if there is a requirement for medical attention.
“The NIV is another emerging infectious disease of great concern,” Dr. Yethindra said. He further said, “NiV can explode at any moment and the next pandemic can be a drug-resistant infection.”
There is a need for a universally accepted comprehensive strategy and preparedness plan that enables rapid activation of research and development activities during epidemics. Accelerating the availability of effective tests, drugs and vaccines can save lives and prevent large-scale crises.