All you need to know about Nipah virus infection

Nipah virus Infection is a newly emerged zoonosis (disease transmitted from animals to humans) affecting South-East Asia. The current endemic epidemic in Kerala is an infectious outcome of a similar severe Nipah outbreak in several districts of West Bengal from 2001 to 2008. The infectious virus was named after the Malaysian village Nipah, as the virus was first identified in the year 1998.
You must know about the re-emerged Nipah virus infection in Kerala. Although the disease may not be an immediate threat to states other than Kerala, it is still important for all of us to be aware of Nipah virus infection and ways to prevent and manage its symptoms.

Nipah virus (NiV) is a zoonotic virus (animal to human) that can spread through contaminated food or directly between people. NiV belongs to the Henipaviral genus in the Paramyxoviridae family. Fruit bats, commonly known as flying foxes, are the natural animal host reservoir of NiV. Nipah virus is also reported to infect pigs and humans. If an infected animal or its bodily fluids (such as saliva or urine) meet a human, they may also become infected. This initial spread from animal to human is called a spillover event. Once it infects humans, NiV can also spread from person to person. NiV infection is associated with encephalitis or swelling of the brain, and can cause mild or severe illness and sometimes death.

What are the Symptoms of Nipah Virus Infection:

Typically, symptoms begin 4-14 days after exposure to the virus. The illness usually includes symptoms of a respiratory illness, such as cough, sore throat, and difficulty breathing, and typically begins with fever and headache 3-14 days later. Drowsiness, disorientation, and mental confusion are common symptoms of the next stage of brain inflammation (encephalitis), which can rapidly progress to a coma within 24-48 hours. Death may occur in 40-75% of cases. Survivors of Nipah virus infection have reported long-term side effects such as chronic convulsions and behavioural abnormalities.

Initial symptoms may include one or more of the following:

Fever
Headache
Difficulty breathing
Cough
Diarrhea
Vomiting
Muscle pain and severe weakness.
Also, infections have been reported that show symptoms and can cause death months or even years after infection. These diseases are called dormant or latent infections.

Reason of Nipah Virus Infection:

People who met infected pigs began to fall seriously ill and this was the first case of Nipah virus. Researchers found that bats were the initial source of the virus, which carried it to pigs.
An infected bat or pig can infect another animal by spreading its body fluids. This happens when people meet an animal’s body fluids. This can happen through saliva, blood, faces or urine. Once a person is infected, he or she can transmit the virus to others through contact with bodily fluids. Food products contaminated with secretions from infected animals can potentially spread the disease. This includes raw date palm fruits and juices. The Nipah virus has also infected people who frequently climb trees where bats rest and sleep.

Diagnosis of Nipah Virus Infection:

A medical professional can identify Nipah virus by reviewing your symptoms and asking about recent travel to places where this virus is common. RT-PCR (real-time polymerase chain reaction) testing can be used by a medical professional to identify Nipah virus in the early stages of the disease. The following bodily fluids are analyzed during this test to diagnose the condition:

Urine samples.

Blood samples.

Throat or nasal swabs.

CSF, or cerebrospinal fluid.

By analyzing your blood for specific antibodies, health care professionals can detect the infection in the later stages or after you have recovered. This is called an ELISA (enzyme-linked immunosorbent assay). Polymerase chain reaction (PCR) assays and virus isolation by cell culture are further tests that are used.

What are the Risk Factors for Nipah Virus:

Lack of proper hygiene and cleaning practices.

Health workers are at risk of nosocomial infection.

Handling contaminated materials without proper protection.

Limited access to health facilities in affected areas.

Close contact with infected fruit bats or their contaminated saliva, urine, or faeces.

Consumption of food or water contaminated with bat secretions, such as raw date palm sap.

Person-to-person transmission through respiratory droplets.

Direct contact with infected animals, especially pigs.

Living in or visiting areas with a history of Nipah virus outbreaks.

Treatment of Nipah virus infection:

Nipah virus infection is treated primarily with intensive supportive care. There is no approved anti-Nipah virus vaccine against Nipah virus. Treatment is aimed at managing fever and other respiratory and neurological symptoms.

Dextromethorphan, dexamethasone, ipratropium, or salbutamol inhalers or nebulizers for treatment of respiratory symptoms;

Dimenhydrinate and/or ondansetron for treatment of nausea and vomiting.

Anti-seizure medications such as benzodiazepines, levetiracetam, and/or phenytoin may be used to treat seizures caused by acute encephalitis and to control neurological symptoms.

Acetaminophen and/or ibuprofen for treatment of pain and fever;

Dimenhydrinate and/or ondansetron for treatment of motion sickness;

Although there is currently no approved drug treatment for NiV infection, immunotherapy treatments such as monoclonal antibody therapy are being developed and evaluated for NiV infection treatment. The monoclonal antibody M102.4 is in clinical studies and is being used on an individual basis. Antiviral drugs, such as remdesivir, have been found to be effective after NiV exposure in investigations on non-human primates. Ribavirin was also used to treat some patients during the initial NiV outbreak, although its efficacy in humans is unknown.

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