This document summarizes research on Nipah virus contamination of hospital surfaces during outbreaks in Bangladesh from 2013-2014. Researchers tested surfaces near beds of patients with encephalitis for Nipah virus RNA. They found that surfaces near patients with respiratory symptoms were more likely to test positive, indicating these patients are more likely to spread the virus. All patients who had Nipah virus RNA detected in oral secretions died, while those without oral viral RNA survived, suggesting viral load and tissue tropism impact disease severity. The study demonstrates person-to-person transmission of Nipah virus can occur through contact with contaminated oral secretions on hospital surfaces.

1. By
M.Ummul halilunnisa
M.sc-II year
Centre for bioinformatics
Research methodology and
finishing school

2. Nipah Virus Contamination of
Hospital Surfaces during Outbreaks,
Bangladesh, 2013-2014
Journal
name
Emerging
infectious
disease
Impact
factor
7.422[2017]
publisher
Centre for
disease
control and
prevention

3. Contents
 Introduction to nipah virus
 Past outbreaks
 The outbreaks in siliguri
 Transmission
 Life cycle of virus
 Signs and symptoms
 Aim
 Methods
 Testing the samples
 Diagnosis
 Result & discussion
 Conclusion.

4.  NiV - zoonotic virus.
 Family - paraxymoviridiae
 Genus - henipavirus
 Species - petropus
Intro to nipah virus:

5. First recognized in 1999 during an outbreak among
pig farmers in Kampung Sungai Nipah, Malaysia. – No
new outbreaks since 1999.
First recognized in Bangladesh in 2001 and nearly
annual outbreaks have occurred in that country since,
with disease also identified periodically in eastern
India.
Serologic evidence for NiV has been found in the
known natural reservoir in Cambodia, Thailand,
Indonesia, Madagascar, Ghana and the Philippines.
Past outbreaks

6. The outbreak in Siliguri,
 66 were affected-2001
 60 for whom exposure was known.
 45 (75%) acquired infection during their
hospital stay (11 patients admitted for
other illness, 25 hospital staff, and 8
persons who visited an infected patient)
 In Bangladesh, during the 2010–2011
Nipah outbreak, 2 hospital staff (1
physician, 1 hospital cleaner) were infected

8. Transmission
Reservoir:
 Flying foxes (fruit bats)
◦ Carry the virus
◦ Are not affected
 Virus found in
◦ Urine
◦ Partially eaten fruit
(saliva?)
 No known secondary host

9. Transmission
Person-to-person
◦ Not reported in Malaysia
◦ Likely in Bangladesh and India
- Nosocomial infections
Bat-to-person
◦ not reported in Malaysia
◦ Common in Bangladesh and India
- Contaminated fruit, unpasteurized
date palm juice

11. Life cycle of virus

12. Signs and symptoms
• Human infections range from
asymptomatic infection, acute respiratory
infection (mild, severe), and fatal encephalitis.
• Fatality rate is estimated at 40% to 75% –
this rate can vary by outbreak depending on local
capabilities for epidemiological surveillance and
clinical management.

13. 1. Asymptomatic Infection
• The incubation period =4 -14 days
• However, 45 days of incubation have also
been reported in some case.
2. Influenza-Like Symptoms
• fever, sore throat, throat irritation,
throbbing headaches, abdominal pain, fainting,
nausea, vomiting and myalgia
Contd….

14. 3. Acute Respiratory Infection
• wheezing and breathing difficulty,
the symptoms lead to a typical pneumonia also.
4. Fatal Encephalitis
• fever, headache, vomiting, stiff neck,
lethargy, irritability, confusion, drowsiness,
hallucinations.
• Most people who survive acute encephalitis
make a full recovery – ~ 20% are left with residual
neurological consequences (seizure disorder and
personality changes).
Contd….

15. Aim
Nipah virus (NiV) has been transmitted
from patient to caregivers in Bangladesh
presumably through oral secretions. We aimed
to detect whether NiV-infected patients
contaminate hospital surfaces with the virus or
not.

16. Methods
Case identification and sample
collection:
-3 hospitals[Faridpur, Rajshahi, and
Rangpur].(dec 13-april 14)
-1 swab sample from up to 5 areas
near each patient: the wall beside patient
bed, bed rail, bed sheet, clinical
record file, and multipurpose
towel.

17. Testing the samples
 serum sample
IgM –using enzyme immunoassay.
 Oral and surface swab samples
NiV RNA by real-time reverse transcription
PCR (RT-PCR).

18. Diagnosis

19. Contd….

20. Contd…

21. Result and discussion
 332 encephalitis cases in 3 hospitals.
 Oral swab samples and blood samples were
collected[319].
 49-consuming raw date palm sap.

23. Contd….

24. Contd…

25. Treatment
 No effective drug therapies available yet.
 Ribavirin-reduces mortality
 Recent development for NiV antivirals focus
on inhibitors of fusion and receptor binding.
 No passive immunoprophylaxis, antiviral
chemoprophylaxis, or vaccine is currently
available

26. Conclusion
-Nipah patients who had respiratory
involvement (difficulty breathing and cough) were
more likely to become Nipah spreaders .
-Exposure to contaminated oral secretions
drives person-to-person transmission of NiV.
-All NiV case-patients who had evidence of
NiV RNA in their oral secretions died, and those
without NiV RNA survived, suggesting that
virulence also might be associated with tissue
tropism or viral load.

27. References