Nipah virus : New emerging disease with high mortality

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NIPAH VIRUS
By:
Dr Harivansh Chopra
Dr Abhishek Agarwal

Introduction
• Nipah virus (NiV) infection is a newly
emerging zoonosis that causes severe
disease in both animals and hum...

Introduction
• Nipah virus causes a range of
illnesses from asymptomatic
(subclinical) infection to acute
respiratory illn...

Introduction
• Nipah virus is closely related to Hendra
virus.
• Both are members of the
genus Henipavirus, a new class of...

NIPAH Virus : A public Health Problem
• Though Nipah virus has caused
only a few outbreaks, it infects a
wide range of ani...

Distribution

Problem
• 1st Case reported from Malaysia in 1998
• 1st Outbreak in south east asia was in Bangladesh in 2001
• 1st Outbre...

Agent: Nipah Virus
Paramyxovirus
Highly pathogenic
Closely related to Hendra virus
Epidemiology

Incubation Period
4 – 18 days

Host
• Reservoir Host: Fruit Bats
• Amplifier Hosts: Pig and Horses
• Dead End Host: Humans
Epidemiology

Epidemiology
ENVIRONMENT
• Cases are more in Winter and Spring (December–May).
– Breeding Season of bats
– Date palm sap h...

Transmission cycle of Nipah Virus

Direct Transmission: Pig to Human
• Direct human contact with infected
pigs was identified as the
predominant mode of tran...

Direct Transmission: Human to Human
• The evidence of human to human
transmission of Nipah Virus was first
reported from I...

Body fluids responsible for human to human
transmission of Nipah Virus
Cerebrospinal Fluid
Respiratory Secretions
Saliva
U...

Direct Transmission: Bat to
Human
• Direct transmission of Nipah
Virus from fruit bats to
humans has been reported
during ...

Indirect Transmission: Fruit Bat
• The natural host of the virus are
fruit bats of the Pteropodidae
Family, Pteropus genus...

Fluids from bats transmitting the disease
• Virus present in its excretions and secretions
– Urine
– Semen
– Saliva
– Excr...

Indirect Transmission: Date palm sap
• Drinking of date palm sap,
possibly contaminated by fruit
bats may have been respon...

Indirect Transmission: Date palm sap
• Fruit bats also consume date
palm sap and can contaminate it
with saliva, urine fec...

Case Definition : Suspected Nipah Case
High Grade Fever with :-
• acute onset of altered mental status, or
• Seizure, or
•...

Case Definition : Probable Nipah Case
• Suspect cases, and/or who
died before complete
diagnostic specimens could
be colle...

Case Definition : Confirmed Nipah Case
i) IgM antibody
ii) RNA identified by RT-PCR
iii) isolation of Nipah Virus
Confirme...

Clinical Features
• The classical form is an acute and
rapidly progressive encephalitis with or
without respiratory involv...

Clinical Features
• The Nipah encephalitis presents with 3–14 days of
fever and headache, followed by drowsiness,
disorien...

Clinical Features
• The respiratory involvement consists of non-productive
cough during the early part of the disease, whi...

Clinical Features
• Post-encephalitis sequelae have been commonly
observed in NiV infection.
• One third of Nipah survivor...

Lab Diagnosis
Serology
PCR
ELISA
Virus Isolation
Neutralization test

Treatment : Supportive
• Fluid maintenance and electrolyte balance.
• Nutrition
• Anticonvulsant
• Oropharyngeal suction i...

Treatment : Supportive
• Oxygen inhalation using disposable cannula.
• Bronchodilators through large spacer
devices.
• Sev...

Treatment: Drug
• Ribavirin:
• Monoclonal Antibodies (Post exposure therapy)

Prevention
• hand hygiene
• injection safety
• facial protection
• glove and gown wearing
• waste disposal,

Prevention
• Linen cleaning
• Environmental cleaning
• Patient care equipment and
• Respiratory Hygiene

Prevention
# Avoid intake of
fruits bitten by
animals

Prevention
# Proper handling of
specimen

Prevention
# Strong Disease
Surveillance

Prevention
Alvac Canary Pox Vaccine
(Presently for cat)
Human trials are underway

Reach us at:
Dr Harivansh Chopra: harichop@gmail.com
Dr Abhishek Agarwal: abhishek3april@gmail.com

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