This document summarizes information about the Nipah virus (NiV) including outbreaks in India and Bangladesh. It discusses the morphology and transmission of NiV, noting it can spread from bats to humans and pigs. Symptoms include influenza-like illness that can progress to encephalitis and coma. Diagnosis involves PCR and antibody detection. There is no vaccine and treatment focuses on supportive care. Prevention emphasizes reducing bat access to food sources and protecting health workers caring for patients.

1. Dr.V.Pragadeesh Raja
Assistant Professor
Department of Community Medicine
Shri Sathya Sai Medical College and Research Institute
Ammapettai-603108
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Nipah Virus (NiV)

2. Plan of
presentation
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Nipah in Kerala
History of Nipah
Morphology
Mode of transmission
Symptoms and signs
Treatment
Prevention
Reference

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4. Nipah in Kerala
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Kerala ---Kozhikode district –
Changaroth village
May to 5 to 19 - 2018
 Death of Mohammed
Saliah(28), Mohammed
sadiq(26) , Mariumma
(50),Moosa (62), Atifa (19) .
‘‘Mystery disease’’- Sample
sent to NIV-pune –diagnosed

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9. What is Nipah
Virus
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Nipah virus-Zoonotic virus
Transmitted from animals to human(Bats and Pigs).
 Nipah virus causes from a range of illness from
asymptomatic infection to acute respiratory illness and fatal
encephalitis.
It infects a wide range of animals and causes severe disease
and death in people.

10. Where was Nipah virus
started?
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Nipah virus was first recongnized in sep 1998 to April 1999 during an
outbreak among pig farmers in Kampung Sungaim Nipah.
Acute encephalitis in pigs and humans.
There is no new outbreaks have been reported in Malaysia and Singapore.
Subsequent outbreaks in India and Bangladesh have occurred with high
case fatality.
Case fatality rate-75%-100%

11. Bangladesh
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The first identification of Nipah virus as a cause of an outbreak of
encephalitis was reported in 2001 in Meherpur district of Bangladesh.
 Nipah virus encephalitis have been reported almost every year in
Bangladesh.
Sporadic cases of Nipah virus encephalitis have been reported, mostly
from the west and north-western regions of Bangladesh almost every year,
with high mortality.
Till March 31, 2012 a total of 209 human cases of NiV infection in
Bangladesh were reported- 161 (77%) of them died.

12. India
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India reported two outbreaks of Nipah virus encephalitis in the eastern
state of West Bengal, bordering Bangladesh, in 2001 and 2007.
Seventy one cases with 50 deaths (70% of the cases) were reported in two
outbreaks.
Outbreaks occurred during winter and spring (December-May).
This could be associated with several factors like the breeding season of
the bats, increased shedding of virus by the bats and the date palm sap

13. Nipah in India and Bangladesh
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Year / Month Location No.of Cases No.of
.Deaths
Case
fatality rate
Jan-Feb 2001 Siliguri (India) 66 45 68%
Apr-May 2001 Meherpur (Bangladesh) 13 9 69%
Jan-03 Naogaon (Bangladesh) 12 8 67%
Jan 2004 Rajbari( Bangladesh) 31 23 74%
Apr-04 Faridpur (Bangladesh) 36 27 75%
Jan-Mar 2005 Tangail (Bangladesh) 12 11 92%
Jan-Feb 2007 Thakurgaon (Bangladesh) 7 3 43%
Mar-07 Kushtia,Pabna,Natore (Bangladesh) 8 5 63%

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Apr-07 Naogaon (Bangladesh) 3 1 33%
Apr-07 Nadia (India) 5 5 100%
Feb-08 Manikgonj (Bangladesh) 4 4 100%
Apr-08
Rajbari and Faridpur
(Bangladesh)
7 5 71%
Jan-09
Gaibandha, Rangpur and
Nilphamari (Bangladesh)
3 0 0%
Rajbari (Bangladesh) 1 1 100%
Feb-Mar 2010
Faridpur,
Rajbari,Gopalganj,Madarip
ur (Bangladesh)
16 14 87.50%
Jan-Feb 2011
Lalmohirhat, Dinajpur,
Comilla, Nilphamari and
Rangpur (Bangladesh)
44 40 91%
Feb-12
Joypurhat, Rajshahi,
Natore, Rajbari and
Gopalganj (Bangladesh)
12 10 83%
Total 280 211 75%

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16. Morphology-Virus
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Enveloped
Non Segmented
40 to 600 nm in diameter
RNA virus
Virus belonging to the genus Henipavirus of the Paramyxoviridae family.

17. Modes of Transmission
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Virus transmitted to humans from animals.
NiV infection has been found in 5 of 14 fruit bat species, with the highest
being Pteropus hypomelanus .
Primarily transmitted via body secretions or partially eaten fruit.
Pigs are primarily infected directly from fruit bats or other pigs.
Humans have been found to be infected by three different pathways, fruit
bat to human, pig to human, and or human to human.

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Most recent transmission of NiV has been a result of human to human
transmission through close contact through respiratory secretions or urine.
Pigs transmit NiV differently than bats in that they shed the virus primarily
by coughing and the expulsion of respiratory secretions and saliva.

21. Clinical
Features
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Incubation period - Range between from 4-14 days.
 Influenza-like symptoms of fever, headaches, myalgia (muscle pain),
vomiting and sore throat.
Dizziness, drowsiness, altered consciousness, and neurological signs that
indicate acute encephalitis
Encephalitis and seizures occur in severe cases, progressing to coma
within 24 to 48 hours.

22. Diagnosi
s
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Real time polymerase chain reaction (RT-PCR) from bodily fluids as well
as antibody detection via ELISA.
Enzyme-linked immunosorbent assay (ELISA)
Polymerase chain reaction (PCR) assay
Virus isolation by cell culture.

23. Treatment
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There are currently no drugs or vaccines specific for NiV infection.
 Intensive supportive care is recommended to treat severe respiratory
and neurologic complications.

24. Prevention
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 There are no vaccines available against Nipah virus.
 Routine and thorough cleaning and disinfection of pig farms may be effective
in preventing infection.
 Culling of infected animals – with close supervision of burial or incineration
of carcasses.
 To prevent transmission should first focus on decreasing bat access to date
palm sap and to other fresh food products

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 Gloves and other protective clothing should be worn while handling sick
animals or their tissues, and during slaughtering and culling procedures.
 Close unprotected physical contact with Nipah virus-infected people
should be avoided.
 Health-care workers caring for patients with suspected or confirmed NiV
infection, or handling specimens from them, should implement standard
infection control precautions for all patients at all times
 Samples taken from people and animals with suspected NiV infection
should be handled by trained staff working in suitably equipped
laboratories.

26. Reference
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 Reports of World Health Organization

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