Nipah virus is a zoonotic virus that causes severe disease in both animals and humans. It was discovered in 1999 during an outbreak in Malaysia and Singapore. The natural host is fruit bats, and pigs and humans can be infected through contact with bat secretions or infected pigs. In humans, it causes respiratory illness and encephalitis with high mortality. There is no vaccine or treatment, so prevention focuses on avoiding contact with bats or infected animals.
Nipah virus : New emerging disease with high mortality Harivansh Chopra
Nipah Virus is one of the emerging viral infection with high mortality. Can be prevented by simply using hand washing and by good food and fruit hygiene, Still no vaccine is available for human although trials are underway. Ribavarin can be used for treatment with variable results. Prevention is still the best method for treatment. Strong IEC is required for effective prevention.
Nipah virus : New emerging disease with high mortality Harivansh Chopra
Nipah Virus is one of the emerging viral infection with high mortality. Can be prevented by simply using hand washing and by good food and fruit hygiene, Still no vaccine is available for human although trials are underway. Ribavarin can be used for treatment with variable results. Prevention is still the best method for treatment. Strong IEC is required for effective prevention.
Influenza is comonly referred to as flu is an infectious viral disease caused by RNA Virus of the family Ortho-Myxoviridae (the Influenza Virus), that affect bird and mammals.
Common symptoms are Chills, fever, sorethroat, muscle pain, severe headache, coughing, fatigue and general discomfort.
Although confused with other influenza like illnesses, especially the common cold, influenza is a more severe disease.
Monkeypox is a zoonotic disease endemic in the Democratic Republic of Congo (DRC) but prevalent also in other countries of Central and Western Africa. The clinical presentation of monkeypox closely resembles the one of smallpox. The mortality rate is officially about 11% however rates as high as 17% have been observed. The disease has been considered rare and not much attention is paid to it. Nonetheless, the incidence of monkeypox increased 20-fold from 1981-1986 to 2005-2007 (two active surveillance programs). More research, surveillance and effective interventions are needed to ensure it would not gain the potential to become the next global pandemic.
This presentation provides all up-to-date information regarding the Crimean-Congo Hemorrhagic Fever (CCHF), which is the hot topic of medical field in Pakistan nowadays.
Nipah virus (NiV) causes the deadly viral zoonotic infectious disease called Nipah, that
can transmit from animals to humans.
• Animals such as bats, most commonly the fruit bats called as flying fox and pigs were
the acting carriers of Niv.
• Nipah viral infection in humans results in range of clinical presentations such as
asymptomatic infection (subclinical) to acute respiratory infection and fatal
encephalitis.
• This infection has about 40 to 75% fatality rate, which can be varied depending on
the local capabilities for epidemiological surveillance and clinical management.
• Presently approved treatment or vaccination is unavailable for infected rather than
supportive care.
• Therefore, the disease calls out for an urgent need for an approved treatment
regimen for a proper cure of the disease. As stated by the 2018 annual review of the
WHO R&D Blueprint list of priority diseases.
Influenza is comonly referred to as flu is an infectious viral disease caused by RNA Virus of the family Ortho-Myxoviridae (the Influenza Virus), that affect bird and mammals.
Common symptoms are Chills, fever, sorethroat, muscle pain, severe headache, coughing, fatigue and general discomfort.
Although confused with other influenza like illnesses, especially the common cold, influenza is a more severe disease.
Monkeypox is a zoonotic disease endemic in the Democratic Republic of Congo (DRC) but prevalent also in other countries of Central and Western Africa. The clinical presentation of monkeypox closely resembles the one of smallpox. The mortality rate is officially about 11% however rates as high as 17% have been observed. The disease has been considered rare and not much attention is paid to it. Nonetheless, the incidence of monkeypox increased 20-fold from 1981-1986 to 2005-2007 (two active surveillance programs). More research, surveillance and effective interventions are needed to ensure it would not gain the potential to become the next global pandemic.
This presentation provides all up-to-date information regarding the Crimean-Congo Hemorrhagic Fever (CCHF), which is the hot topic of medical field in Pakistan nowadays.
Nipah virus (NiV) causes the deadly viral zoonotic infectious disease called Nipah, that
can transmit from animals to humans.
• Animals such as bats, most commonly the fruit bats called as flying fox and pigs were
the acting carriers of Niv.
• Nipah viral infection in humans results in range of clinical presentations such as
asymptomatic infection (subclinical) to acute respiratory infection and fatal
encephalitis.
• This infection has about 40 to 75% fatality rate, which can be varied depending on
the local capabilities for epidemiological surveillance and clinical management.
• Presently approved treatment or vaccination is unavailable for infected rather than
supportive care.
• Therefore, the disease calls out for an urgent need for an approved treatment
regimen for a proper cure of the disease. As stated by the 2018 annual review of the
WHO R&D Blueprint list of priority diseases.
Nipah virus (Niv) is a zoonotic virus that can spread between animals and people. Fruit bats, also called flying foxes, are the NIV reservoir among animals in nature. Spread of disease occurs from the infected fruit bats to other animals, such as pigs, and from infected animals to humans. The infection occurs through contaminated fruits by the animal's body fluids such as saliva, urine, or blood. Therefore, the initial spread is from animals to humans and then within humans.
Thus, the infection caused by Niv results in milder to severe illness ranging from acute respiratory tract infection to severe brain encephalitis (swelling of the brain). The Nipah outbreaks were most commonly observed in parts of Asia, primarily India and Bangladesh. This outbreak reported 40-75% of deaths in 1998 and 2018.
Past outbreaks
Nipah virus (NiV) was first identified in Malaysia and Singapore following an outbreak of disease in pigs and people in 1999. This outbreak resulted in more than 100 deaths and nearly 300 infected cases in people. More than a million pigs were killed to control further outbreaks of disease, and there have been no outbreaks in both countries since 1999.
In 2001, an annual outbreak of the disease was observed in Bangladesh. It was also periodically identified in India. The quick spread of the virus from animals to humans raised concern about NIV and made it a global pandemic.
Transmission
The first known outbreak in Singapore and Malaysia was through direct contact with the Nipah (Niv) infected pigs or their body fluids. It identified that the infected pigs got the Niv strain from bats, which subsequently resulted in transmission of the viral strains from pigs to humans by their unprotected exposure to infected animal species, which in turn led to a severe health issue in contact with humans that was even fatal due to unavailability of proper medications or vaccinations. There was no report of person-person transmission of disease in the outbreak.
Whereas person-person transmission was first reported in India (2001) and Bangladesh (2001-2008) by consumption of fruits and vegetables contaminated by the body fluids of infected animals caused Nipah virus infection.
The spread of the Nipah virus (NiV) from people was through the following causes:
• Direct contact with infected animals or their body fluids (such as bats or pigs).
• Consumption of fruits or vegetables contaminated by the body fluids of infected animals (such as palm sap).
• Close or direct contact with Niv infected person infected their body fluids (such as nasal droplets, blood, or urine).
Signs and Symptoms
The symptoms commonly appear 4-14 days after exposure to the virus. However, in many cases incubation period as long as 45 days has been reported.
Symptoms may initially include one or several of the following for 3-14days:
• Fever
• Headache
• Vomiting
Signs of respiratory illness:
• Sore throat
• Cough
• Difficulty breathing
Nipah virus (NiV) causes the deadly viral zoonotic infectious disease called Nipah, that can transmit from animals to humans.
Animals such as bats, most commonly the fruit bats called as flying fox and pigs were the acting carriers of Niv.
Nipah viral infection in humans results in range of clinical presentations such as asymptomatic infection (subclinical) to acute respiratory infection and fatal encephalitis.
This infection has about 40 to 75% fatality rate, which can be varied depending on the local capabilities for epidemiological surveillance and clinical management.
Presently approved treatment or vaccination is unavailable for infected rather than supportive care.
Therefore, the disease calls out for an urgent need for an approved treatment regimen for a proper cure of the disease. As stated by the 2018 annual review of the WHO R&D Blueprint list of priority diseases.
Influenza, zika, ebola in pregnancy by dr alka mukherjee nagpur m s indiaalka mukherjee
Viral infections in pregnancy are major causes of maternal and fetal morbidity and mortality. Infections can develop in the neonate transplacentally, perinatally (from vaginal secretions or blood), or postnatally (from breast milk or other sources). The clinical manifestations of neonatal infections vary depending on the viral agent and gestational age at exposure. The risk of infection is usually inversely related to gestational age at acquisition, some resulting in a congenital malformation syndrome.
Infections known to produce congenital defects have been described with the acronym TORCH (Toxoplasma, others, rubella, cytomegalovirus [CMV], herpes). The "others" category has rapidly expanded to include several viruses known to cause neonatal disease
Pregnant women, their fetuses, and infants are at a high risk of exposure to infectious diseases, especially in low-income regions of the world where vaccine-preventable diseases are prevalent. Vaccines administered during pregnancy can protect not only pregnant women against infection-related morbidity and mortality, but also their fetuses and infants against preterm delivery, perinatal death, and disability. viral infections and human rights.
Pregnant women, their fetuses, and infants are at a high risk of exposure to infectious diseases, especially in the resource-poor and low-income regions of the world where vaccine-preventable diseases are prevalent. Because of this, vaccines administered during pregnancy offer the potential to protect not only pregnant women against infection-related morbidity and mortality, but also their fetuses and infants against preterm delivery, perinatal death, and disability. The potential benefits of providing immunization to pregnant women and their infants to protect against infection are not a novel concept—even during the early development of vaccines, their usage during pregnancy was considered potentially beneficial.
Hello friends i am BSc Nursing intern.This presentation of mine covers almost each and every aspect related to swine flu.Hope it will help you to increase your knowledge regarding the topic.Looking forward to your feedback.Thank you
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1. Barking Pig Syndrome,
Porcine Respiratory and
Encephalitis Syndrome,
Porcine Respiratory and
Neurologic Syndrome
Nipah Virus
Dr. D. K. Niranjan
Infection Control Officer
Regency Healthcare Limited
2. Overview
Organism
History
Epidemiology
Transmission
Disease in Humans
Disease in Animals
Prevention and Control
Actions to Take
3. Agent
Genus Henipavirus
Virus discovered, 1999
Related to Hendra virus
Severe, rapidly progressive encephalitis in
humans
High mortality rate
Close contact with infected pigs
Severe, respiratory disease in pigs
5. History
1998-1999: Peninsular Malaysia
Human febrile encephalitis, high mortality
New virus discovered
1999: Singapore
Outbreak in abattoir workers
Pigs imported from Malaysia
● Since 2001 – Bangladesh, India
8. 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
Pigs in Malaysia
Direct contact
Contact with body fluids
Aerosolization of respiratory or
urinary secretions
Vertical transmission across the placenta?
Semen and iatrogenic spread?
10. 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. 2018 India
Closer home, in Kerala too, its being traced to a
well which had bats living in it.
It correlates well with the season when young
bats leave the nest to fly (April- June with a peak
in May)!
Once infection sets in, there is a human to human
spread.
As the virus is found in blood, urine, saliva and
CSF, the spread happens when in contact with
these secretions.
12. Photo courtesy of James Roth, DVM, PhD, ISU
These are several of the hog confinement barns that were affected
during the Malaysia Nipah virus outbreak. The reservoir fruit bats live
in these caves and feed on the fruit trees that are in close proximity to
the hog confinement barns.
13. Photo courtesy of James Roth, DVM, PhD, ISU
hog confinement barns in Malaysia. There are many fruit trees and caves
close to this location.
15. Epidemiology
1998-1999: Malaysia
265 persons hospitalized; 105 deaths
Primarily adult males with swine contact
Disease in swine
Severe respiratory disease
Transmitted by movement of infected pigs
1.1 million pigs culled
Great economic loss
Surveillance and testing
16. Epidemiology
Center for Food Security and Public Health,
Iowa State University, 2011
1999: Singapore
22 seropositive persons (1.5%)
All were male abattoir workers
12 symptomatic
Encephalitis, pneumonia, or both
10 asymptomatic
17. Epidemiology
2001: Siliguri, India
Nosocomial transmission
2004: Bangladesh
34 cases; 26 deaths
Transmission
Close contact
Exposure to common source
21. Human Illness
Incubation period: 4 to 20 days
Fever and headache
Encephalitis
Dizziness, drowsiness, vomiting
Seizures
Progresses to coma in 24-48 hours
Respiratory difficulty
Relapsing neurologic symptoms
22. Human Illness
Complications (Malaysian outbreak)
Septicemia (24%)
GI bleeding (5%)
Renal impairment (4%)
Asymptomatic
Relapse or late-onset encephalitis
Residual neurological deficits
23. Case definition
Suspected (clinical) Nipah case: Patient
coming from the community affected by an
outbreak and has: fever with acute onset of
altered mental status or seizure and/or fever with
headache and/or fever with acute onset of cough
with shortness of breath.
Probable Nipah case: Suspect cases, and/or
who died before complete diagnostic specimens
could be collected.
24. Confirmed Nipah case
Suspected/probable cases who have been
confirmed by tests from the laboratory, i.e. IgM
antibody (ELISA test) against NiV in serum or
CSF, or RT-PCR for NiV RNA from respiratory
secretions (throat swabs), urine or cerebrospinal
fluid, or Actual virus isolation from respiratory
secretions, urine or cerebrospinal fluid or other
tissue specimens.
(The tests are currently being done at National
Institute of Virology, Pune)
26. Disease in Animals
Pigs
Highly contagious
May be asymptomatic
Acute fever (>104°F)
Severe respiratory disease
Characteristic cough – harsh, “barking”
Neurological changes
Low mortality
27. Disease in Animals
Dog
Distemper-like signs
Fever, respiratory distress
Ocular and nasal discharge
Cat
Fever, depression
Severe respiratory signs
Horses
Encephalitis
28. Sampling
Before collecting or sending any samples, the
proper authorities should be contacted
Samples should only be sent under secure
conditions and to authorized laboratories to
prevent the spread of the disease
In India it is NIV Pune
29. Sample collection
The samples should be collected as early as
possible (preferably within 4-5 days on onset of
illness.
The samples may be as follows:
Throat swab to be collected in viral transport
medium
Urine approx 10 ml in universal sterile container
Blood in plain vial (at least 5ml)
CSF (at least 1 ml) in a sterile container
30. Transportation and Storage of
samples
Samples should be safely packed in triple
container packing and should be transported
under cold chain (2-8°C) to the testing laboratory
with prior intimation.
Before dispatching the sample, disinfect the outer
surface of container using 1:100 dilution of bleach
or 5% Lysol solution.
34. Prevention is the ONLY cure
Avoid exposure to infected patients and
animals (bats and pigs)
Do not consume the sap of raw date palm
or unpasteurized fruit juices
Practice hand washing and hygiene
Cover your mouth, eyes and nose when
handling the patient
Keep the patient’s items (clothes, utensils
etc.) separately
NiV has been found in blood, urine, saliva
and CSF of the patients who have died from
it. Take utmost care while dealing with any
of these.
35. ADVISORY FOR HEALTH CARE
PERSONNEL
Wash hands thoroughly with soap and water for
40 seconds after contact with a sick patient.
While handling Nipah cases (suspected/
confirmed), standard precautions for infection
control should be practiced.
For aerosol generating procedures, PPE such as
individual gowns (impermeable), gloves, masks
and goggles or face shields and shoe cover and
the procedure should be performed in airborne
isolation room.
36. ADVISORY FOR HEALTH CARE
PERSONNEL
Dedicated medical equipment should be used
(preferably disposable whenever possible).
All non-dedicated, non-disposable medical
equipment used for patient care should be
cleaned and disinfected as per manufacturer’s
instructions and hospital policies.
Use of injections and sharps should be limited.
37. ADVISORY FOR HEALTH CARE
PERSONNEL
If the use of sharp objects cannot be avoided, ensure
that the following precautions are observed:
Never replace the cap on a used needle.
Never direct the point of a used needle towards any part
of the body.
Do not remove used needles from disposable syringes by
hand, and do not bend, break or otherwise manipulate
used needles by hand.
Never re-use syringes or needles.
Dispose of syringes, needles, scalpel blades and other
sharp objects in appropriate, puncture-resistant
containers.
Ensure that containers for sharps objects are placed as
38. ADVISORY FOR HEALTH CARE
PERSONNEL
Segregate all suspected cases of Nipah patients from
all patients in the isolation ward/ facility.
Avoid unnecessary contact with suspected Nipah cases
or use barrier nursing.
Any spillage of body fluids in the OP/Ward should be
managed as per Infection control guidelines.
Mortuary staff should wear PPE while handling corpse
of Nipah.
Air sealed bag should be used for transportation of the
dead body.
39. Treatment
Limited to supportive care
There are no vaccines or medicines available
right now though trials are on for both
Animal trials are showing promise with an anti-
viral called favipiravir or ribavirin
40. Nipah as a
Biological Weapon
CDC Category C Bioterrorism Agent (BSL-4)
Emerging pathogen
Potentially high morbidity
and mortality
Major health impact
Aerosolisation potential
Economic impact
Social disruption (fear, panic)