Is Nipah virus the next pandemic

Nipah virus, serious infectious disease that periodically causes outbreaks in parts of Asia.

Case fatality rate 40 to 75%

During outbreaks, 10 to 92%

Person to person transmission is possible

Close care home or hospital environments

Overcrowded, poorly ventilated environments

Transmission via droplets is suspected, (Boston Uni)

WHO has listed Nipah virus as an epidemic threat requiring urgent research and development action, including vaccine development.

Potential risks

Environmental encroachment

Viral mutation

Gain of function ‘research’

Weaponisation

Risk from transmission during flights

References

UK Government, UKHSA ‘Blog’

WHO official communication

Reference from Government of Indian

Official US CDC site

Australian CDC

Boston University, Office of Research

No cases have ever been found in the UK, US or Australia

Nipah virus is zoonotic virus, it can be spread from animals to humans.

It can also be transmitted through contaminated food or directly from human to human.

First identified in 1998/9 during an outbreak among pig farmers in Malaysia and Singapore.

Evidence that Nipah virus can infect dogs, cats, goats, horses and sheep.

Natural hosts of the virus

Fruit bats, (flying foxes) particularly those of the Pteropus genus.

Symptoms

Incubation period, typically 4 to 21 days, (or longer)

Sudden onset of non-specific flu-like illness or fever.

Pneumonia and other respiratory problems develop.

Encephalitis (inflammation of the brain) or meningitis, typically develops 3 to 21 days after initial symptoms.

Severe headache, drowsiness, blurred vision, cough, abdominal pain, myalgia

Case fatality rate, 40 to 75%

Some survivors may be left with lasting neurology difficulties, persistent seizures, personality changes.

In rare cases, the virus can reactivate months or even years after the initial infection.

Diagnosis

Real time polymerase chain reaction (RT-PCR) of respiratory samples, blood or cerebrospinal fluid.

Blood antibody detection.

Where is Nipah virus found

Human outbreaks, only in been South and South-East Asia, primarily in rural or semi-rural locations.

Bangladesh (where cases have occurred almost annually since 2001)

India (outbreaks in Kerala since 2018, current outbreak in West Bengal)

Malaysia

The Philippines

Singapore

How is Nipah virus transmitted?

Direct contact with an infected animal and their secretions

Consumption of fruits or fruit products

(raw or partially fermented date palm juice),

contaminated with the poo, urine or saliva of infected fruit bats.

Person-to-person spread

Is possible through close contact with an infected person or their body fluids.

This has been documented in Bangladesh and India, most commonly among family members and close contacts caring for infected patients.

Those with respiratory symptoms may pose a transmission risk.

Nipah virus treatment

No proven specific treatment for Nipah virus infection

No preventative vaccine is licensed for use.

Prevention in endemic areas

Avoid contact with bats and their environments

Avoid contact with sick animals

Don't consume raw or partially fermented date palm sap - if consuming date palm juice, ensure it has been boiled first

Wash all fruit thoroughly with clean water and peel before eating

Avoid fruit found on the ground or fruit that appears to have been partially eaten by animals

Good hand hygiene, particularly after caring for or visiting sick people

Avoid close, unprotected contact with anyone infected with Nipah virus, including contact with their blood or body fluids

In healthcare settings

Strict infection prevention and control measures are essential,

including contact, droplet and airborne precautions for both suspected and confirmed patients.