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nipah virus
- 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
- 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.
- 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.