Nipah virus

Nipah virus
• Where was the virus discovered first?
• How did it get its name?
• Which animal is/ are the natural reservoir/s?
• How do humans get infection
• Which are the high risk zones in India
• How do the cases present?
• Who should be under scanner?
• How do we look for the agent
• 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

Name comes from Sungai Nipah, a village in Malaysia where

first cases were reported
Agent
• Genus Henipavirus
• Virus discovered, 1999
• Related to Hendra virus
• Negative sense RNA virus
• Grows in cell cultures (Vero cells – 7 – 10 days) and embryonated eggs
Transmission
• Bats of genus “Pteropus”, fruit eating bats
• Bats may transmit disease to pigs
• First reports of human disease with NiV was attributed to close contact with
sick pigs
• Consumption of palm sap contaminated with bat saliva
• Bat urine
• NOSOCOMIAL – Human – Human transmission
Is entire India at risk?

There are approximately 7

species of bats which are
known to be seropositive
for NiV antibodies

Plowright RK, Becker DJ, Crowley DE, Washburne AD,

Huang T, et al. (2019) Prioritizing surveillance of Nipah
virus in India. PLOS Neglected Tropical Diseases 13(6):
e0007393.
https://doi.org/10.1371/journal.pntd.0007393
https://journals.plos.org/plosntds/article?id=10.1371/j
ournal.pntd.0007393
 Fig 2. Phylogeny of Indian bats and Nipah virus detections.

Plowright RK, Becker DJ, Crowley DE, Washburne AD, Huang T, et al. (2019) Prioritizing surveillance of Nipah virus in India. PLOS Neglected
Tropical Diseases 13(6): e0007393. https://doi.org/10.1371/journal.pntd.0007393
https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0007393
 Fig 4. Range of predicted bat species.

Plowright RK, Becker DJ, Crowley DE, Washburne AD, Huang T, et al. (2019) Prioritizing surveillance of Nipah virus in India. PLOS Neglected
Tropical Diseases 13(6): e0007393. https://doi.org/10.1371/journal.pntd.0007393
https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0007393
Human Illness
• Incubation period: 4 to 20 days
• Fever and headache
• Encephalitis (Malaysian cases)
• Dizziness, drowsiness, vomiting
• Seizures
• Progresses to coma in 24-48 hours
• Influenza like Illness (Indian cases)
• Relapsing neurologic symptoms

Center for Food Security and Public Health, Iowa State University, 2011
Human Illness
• Complications (Malaysian outbreak)
• Septicemia (24%)
• GI bleeding (5%)
• Renal impairment (4%)
• Asymptomatic
• Relapse or late-onset encephalitis
• Residual neurological deficits
• Treatment: Supportive, ribavirin

Center for Food Security and Public Health, Iowa State University, 2011
Laboratory diagnosis
• Sample
• Blood – for serology
• Respiratory sample
• Throat swab
• Nasopharyngeal swab
• CSF – in case of encephalitis like presentation
• Urine
Laboratory diagnosis
• Transportation
• Triple layer container
Laboratory diagnosis
Laboratory diagnosis
Laboratory diagnosis
Prevention in a healthcare setting
Prevention in community
• Prevention of bat to human
• Avoid consumption of raw date palm sap
• Avoid close contact with bats (bat communities – caves)
• Avoid consumption of fruits with animal bites

• Prevention of pig to human

• Avoid close contact with sick animals
• Proper protective gear to be worn while examining animals
Summary of viral infections
affecting the CNS