Brenda S. P.

Ang,
Tchoyoson C. C. Lim, Linfa
Wang

Nipah Virus
Infection
 Epidemiolog
y
• Nipah virus (NiV)
outbreak – 1998 to
1999; Kampung Sungai
Nipah, Malaysia
• Initially ascribed
to Japanese B
Encephalitis (JE)
• Fogging and
stepping-up of
immunization was
started
 Epidemiolog
y
• NiV-infected pigs →
“Barking Pig
Syndrome”
• Relatedness of NiV to
Hendra virus (HeV)
• Health education were
given; pig-culling
operations were
conducted
• Fruit bats (Pteropus
spp.) – natural
reservoir hosts
Epidemiolog
y
 Histor
y
• Febrile encephalitis
with or without acute
respiratory infection
(ARI)
• (+) JE-specific IgM;
presence of JE
nucleic acids
• Adult males (pig
farmers, abattoir
workers)
• No reported cases
from the Malay
 Transmissio
n
Food
Direct
Consumption
Contact
Infected Fruits
Bats
Infected Fruit
Pigs Products
Infected
People
 Clinical
Presentation
Fever Headache Dizzines Vomiting
s

Encephalit
is with
Neurologic Respirato
al Signs ry
Symptoms*
 Clinical
Presentation
The Classic
Case al
Respirato Fever Respiratory
Fever Symptoms
ry Headache
Symptoms Sore
Headache Altered
Dizziness Throat
Level of Myalgia
Consciousnes
Vomiting
Dizzines Encephalit
s
Encephalit
is with Drowsiness is with
s
Neurologic Neurologic
Vomiting al signs Altered
Level of al signs
Consciousnes
 Clinical
Presentation
The Classic
Case al
Respirato Fever Respiratory
Fever Symptoms
ry Headache
Symptoms Sore
Headache Altered
Dizziness Throat
Level of Myalgia
Consciousnes
Vomiting
Dizzines Encephalit
s
Encephalit
is with Drowsiness is with
s
Neurologic Neurologic
Vomiting al signs Altered
Level of al signs
Consciousnes
 Diagnosi
s
Clinical
History NAATs

Physical Antibody
Examinatio Detection
n
Virus
Immunohistochemistr
Isolation
y
 Diagnosi
s
Clinical
History NipahNAATs

Physical virus
Antibody
Examinatio Detection
n (NiV)
Virus
Isolation Infectio
Immunohistochemistr
y
n
 Etiologic
Agent
family Nipah
Paramyxovirid virus
ae (NiV)
genus
Henipavirus

Closely
related to
HeV
NiV Malaysia (NiV-
MY)
NiV Bangladesh
(NiV-BD)
 Etiologic
Agent
family Nipah
Paramyxovirid virus
ae (NiV)
genus
Henipavirus

Closely
related to
HeV
NiV Malaysia (NiV-
MY)
NiV Bangladesh
(NiV-BD)
 Management

Drugs
Intensive
Supportive
Care
Vaccines
 Preventi
on

Avoidance Vaccine
of Candidates
Exposure
Surveillan Cleaning
ce & &
Awareness Disinfecti
on
 Preventi
on

Avoidance Vaccine
of Candidates
Exposure
Surveillan Cleaning
ce & &
Awareness Disinfecti
on
fo
r MERCY