Dr. Naveen D. Kini

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Nipah Virus infection

Posted by Naveen Kini on June 5, 2018 at 1:20 PM

Nipah virus infection is a new disease that is causing fear and panic in our country, and along with it has come the usual chain of misconceptions, and useless remedies. Here are the up-to-date facts about the disease, and the preventive measures that are recommended by the World Health Organisation (WHO)


Transmission


Nipah virus (NiV) is a zoonotic virus (it is transmitted from animals to humans) and can be transmitted through:

  • Contaminated food i.e. fruits or fruit products (such as raw date palm juice) contaminated with the urine or saliva from infected fruit bats
  • Directly between people (human to human transmission)
  • Transmission can occur via unprotected exposure to secretions or unprotected contact with the tissue of infected animals (such as pigs).

NiV was first identified during an outbreak that took place in Kampung Sungai Nipah, Malaysia in 1998 (and hence the name). The natural host of the virus are fruit bats of the Pteropodidae Family, Pteropus genus.


Signs and symptoms


Human infections range from infection with no symptoms, acute respiratory infection (mild or severe), to fatal encephalitis (inflammation of the brain).

  • The incubation period (interval from infection to the onset of symptoms) is believed to range from 4 to 14 days
  • Infected people initially develop influenza-like symptoms (fever, headaches, muscle pain, vomiting and sore throat)
  • This can be followed by dizziness, drowsiness, altered consciousness, and neurological signs that indicate acute encephalitis
  • Some people can also experience severe respiratory problems, including acute respiratory distress (breathing difficulty), suggestive of pneumonia
  • Disorientation and seizures (fits) occur in severe cases, progressing to coma within 24 to 48 hours of onset.


Diagnosis


Initial signs and symptoms of Nipah virus infection are nonspecific, and the diagnosis is often not suspected at the time of presentation. The main diagnostic tests used are:

  • Real time polymerase chain reaction (RT-PCR) from bodily fluids
  • Antibody detection via enzyme-linked immunosorbent assay (ELISA)


Treatment


There are currently no drugs or vaccines specific for Nipah virus infection. Intensive supportive (ICU) care is recommended to treat severe respiratory and neurologic complications.


Prevention


  • Keeping bats away from sap collection sites with protective coverings (such as bamboo sap skirts)
  • Freshly collected date palm juice should be boiled, and fruits should be thoroughly washed and peeled before consumption (there is no need to stop consumption of all fruits!)
  • Fruits with sign of bat bites should be discarded
  • Close unprotected physical contact with Nipah virus-infected people should be avoided
  • Regular hand washing should be carried out after caring for or visiting infected people
  • Health-care workers should implement standard infection control precautions at all times, like wearing gloves, face masks and protective clothing.
  • Samples taken from people and animals with suspected Nipah virus infection should be handled by trained staff working in suitably equipped laboratories.


I would like to reiterate that none of the concoctions that you read about on social media will have any role in prevention of this illness. Till medications and vaccinations are available, resorting to the above measures, and not giving in to rumours and panic, will help us doctors and the government bring this disease under control.

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