Brenda S. P. Ang, Tchoyoson C. C.

Lim, Linfa Wang

Nipah Virus
Infection
 Epidemiology
• 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
 Epidemiology
• 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
Epidemiology
 History
• 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 villages
 Transmission
Food
Direct Contact
Consumption
Infected Bats Fruits

Infected Pigs Fruit

Products
Infected People
 Clinical Presentation

Fever Headache Dizziness Vomiting

Encephalitis
with
Neurological Respiratory
Signs Symptoms*
 Clinical Presentation
The Case Classical
Respiratory Fever Respiratory
Fever Symptoms
Symptoms Headache
Sore Throat
Headache Altered Level of
Dizziness
Consciousness
Myalgia
Vomiting
Dizziness Encephalitis Encephalitis
with Drowsiness with
Neurological Neurological
Vomiting signs Altered Level of
Consciousness signs
 Clinical Presentation
The Case Classical
Respiratory Fever Respiratory
Fever Symptoms
Symptoms Headache
Sore Throat
Headache Altered Level of
Dizziness
Consciousness
Myalgia
Vomiting
Dizziness Encephalitis Encephalitis
with Drowsiness with
Neurological Neurological
Vomiting signs Altered Level of
Consciousness signs
 Diagnosis

Clinical
History NAATs

Physical Antibody
Examination Detection

Virus
Immunohistochemistry
Isolation
 Diagnosis

Clinical
History Nipah virus
NAATs

Physical
Examination
(NiV)
Antibody
Detection

Virus
Infection
Immunohistochemistry
Isolation
 Etiologic Agent
family Nipah virus
Paramyxoviridae (NiV)

genus Henipavirus

Closely related to
HeV

NiV Malaysia (NiV-MY)

NiV Bangladesh
(NiV-BD)
 Etiologic Agent
family Nipah virus
Paramyxoviridae (NiV)

genus Henipavirus

Closely related to
HeV

NiV Malaysia (NiV-MY)

NiV Bangladesh
(NiV-BD)
 Management

Drugs
Intensive
Supportive
Care
Vaccines
 Prevention

Avoidance of Vaccine
Exposure Candidates

Surveillance Cleaning
& Awareness & Disinfection
 Prevention

Avoidance of Vaccine
Exposure Candidates

Surveillance Cleaning
& Awareness & Disinfection
Barks
for
MER