1. PRESENTED BY Dr. ATTINDER PAL SINGH
H.O.D. - Dr. ARVIND ARYA SIR
DEPARTMENT OF NEUROANESTHESIA (IHBAS)
(NiV)
2. EMERGING ZOONOSIS
RNA VIRUS
GENUS :- Henipavirus
FAMILY:- Paramyxoviridae
RELATED TO Hendravirus
NATURAL HOST BATS
INTERMEDIATE HOST PIGS
3. Barking Pig Syndrome
Porcine Respiratory and Encephalitis
Syndrome
Porcine Respiratory and Neurologic
Syndrome
4. first identified during an outbreak of disease in
Kampung Sungai Nipah, Malaysia in 1998. infected
pigs were considered source of infection.
In Bangladesh in 2004, humans became infected with
NiV as a result of consuming date palm sap
contaminated by infected fruit bats.
On 19 May 2018, a Nipah virus disease (NiV) outbreak
was reported from Kozhikode district of Kerala, India.
There have been 17 deaths and 18 confirmed cases
as of 1 June 2018. source uncertain
5.
6. Direct contact with:
infected bats, infected pigs,
Other NiV infected people
Transmission through respiratory droplets, saliva,
contact with infected tissues, other bodily secretions
Consumption of fruit or fruit products contaminated
with urine or saliva of infected bats- Indirect
transmission
The secondary wave of transmission occurs from
human-human contact and is most challenging for
health authorities to combat
Nipah virus infection generally has a stuttering chain of
transmission- Once the virus moves from bats to
humans; it generally spreads to people in close contact
with the patients
7. The virion binds and fuses to the surface of a host
cell via the F and G proteins.
The lipid bi-layers are then melted and the viral
nucleocapsid is released into the host cell.
The negative sense viral RNA is transcribed to mRNA
which acts as a template for more negative sense
viral RNA.
The viral RNA is used to make the necessary proteins
(N,P,M,F,G,L,C,V,W) which congregate near the cell
membrane.
Once all the necessary proteins are assembled a new
viral cell will bud off and infect other host cells.
The new viral cells are able to fuse together and
create a huge multinucleated cell called syncytia.
8.
9. After exposure and an incubation period of 5 to
14 days
presents with 3-14 days of fever and headache,
followed by drowsiness, disorientation and
mental confusion.
can progress to coma within 24-48 hours.
Some patients have a respiratory illness during
the early part of their infections, and half of the
patients showing severe neurological signs
showed also pulmonary signs.
10. • Virus isolation attempts and real time polymerase
chain reaction (RT-PCR) from throat and nasal
swabs, cerebrospinal fluid, urine, and blood should
be performed in the early stages of disease
DETECTION BY ELISA METHODOLOGY Antibody
detection by ELISA (IgG and IgM) can be used later
on.
In fatal cases, immunohistochemistry on tissues
collected during autopsy may be the only way to
confirm a diagnosis
11. by avoiding exposure to sick pigs and bats in
endemic areas
and not drinking raw date palm sap
Additional efforts focused on surveillance and
awareness will help prevent future outbreaks
12. Treatment is limited to intesnsive supportive
care.
standard infection control practices and
proper barrier nursing techniques are
important in preventing nosocomial
transmission.
Ribavarin shown effective in vitro test.no
clinical significance
Post exposure prophylaxis with Nipah G
glycoprotein is under evaluation
13. A subunit vaccine, using the Hendra G
protein, produces cross-protective antibodies
against HENV and NiV has been recently used
in Australia to protect horses against Hendra
virus.
This vaccine offers great potential for
henipavirus protection in humans as well.
