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Nipah UPSC NOTE

 

Nipah

  • Nipah virus (NiV) is a zoonotic virus (it is transmitted from animals to humans) and can also be transmitted through contaminated food or directly between people. 

  • In infected people, it causes a range of illnesses from asymptomatic (subclinical) infection to acute respiratory illness and fatal encephalitis.

  • The virus can also cause severe disease in animals such as pigs, resulting in significant economic losses for farmers. 

Transmission:

Nipah virus (NiV) can spread to people from:

  • Direct contact with infected animals, such as bats or pigs, or their body fluids (such as blood, urine or saliva)

  • Consuming food products that have been contaminated by body fluids of infected animals (such as palm sap or fruit contaminated by an infected bat)

  • Close contact with a person infected with NiV or their body fluids (including nasal or respiratory droplets, urine, or blood).

Signs and Symptoms:

  • Infection with Nipah virus (NiV) can cause mild to severe disease, including swelling of the brain (encephalitis) and potentially death.

  • Symptoms typically appear in 4-14 days following exposure to the virus. 

  • The illness initially presents as 3-14 days of fever and headache, and often includes signs of respiratory illness, such as cough, sore throat, and difficulty breathing. 

  • A phase of brain swelling (encephalitis) may follow, where symptoms can include drowsiness, disorientation, and mental confusion, which can rapidly progress to coma within 24-48 hours.

  • Symptoms may initially include one or several of the following:

    • Fever

    • Headache

    • Cough

    • Sore throat

    • Difficulty breathing

    • Vomiting

  • Severe symptoms may follow, such as:

    • Disorientation, drowsiness, or confusion

    • Seizures

    • Coma

    • Brain swelling (encephalitis)

  • Death may occur in 40-75% of cases. 

  • Long-term side effects in survivors of Nipah virus infection have been noted, including persistent convulsions and personality changes.

  • Infections that lead to symptoms and sometimes death much later after exposure (known as dormant or latent infections) have also been reported months and even years after exposure.

Diagnosis:

  • Nipah virus (NiV) infection can be diagnosed during illness or after recovery. 

  • During early stages of the illness, laboratory testing can be conducted using real time polymerase chain reaction (RT-PCR) from throat and nasal swabs, cerebrospinal fluid, urine, and blood. 

  • Later in the course of illness and after recovery, testing for antibodies is conducted using an enzyme-linked immunosorbent assay (ELISA).

  • Early diagnosis of NiV infection can be challenging due to the non-specific early symptoms of the illness. 

  • However, early detection and diagnosis are critical to increase chances of survival among infected individuals, to prevent transmission to other people, and to manage outbreak response efforts. 

Treatment:

  • Currently there are no licensed treatments available for Nipah virus (NiV) infection.

  • Treatment is limited to supportive care, including rest, hydration, and treatment of symptoms as they occur.

  • There are, however, immunotherapeutic treatments (monoclonal antibody therapies) that are currently under development and evaluation for treatment of NiV infections. 

  • One such monoclonal antibody, m102.4, has completed phase 1 clinical trials and has been used on a compassionate use basis. 

  • In addition, the antiviral treatment remdesivir has been effective in nonhuman primates when given as post-exposure prophylaxis, and may be complementary to immunotherapeutic treatments. 

Prevention:

  • In areas where Nipah virus (NiV) outbreaks have occurred (Bangladesh, Malaysia, India, and Singapore), people should:

  • Practice hand washing regularly with soap and water

  • Avoid contact with sick bats or pigs

  • Avoid areas where bats are known to roost

  • Avoid eating or drinking products that could be contaminated by bats, such as raw date palm sap, raw fruit, or fruit that is found on the ground

  • Avoid contact with the blood or body fluids of any person known to be infected with NiV.

  • Because NiV can be spread from person-to-person, standard infection control practices and proper barrier nursing techniques are important in preventing hospital-acquired infections (nosocomial transmission) in settings where a patient has confirmed or suspected NiV infection.

  • Increasing surveillance of animals and people in areas where NiV is known to exist.

  • Increasing research on the ecology of fruit bats to understand where they live and how they spread the virus to other animals and people.

  • Improving tools to detect the virus early in communities and livestock.

  • Reinforcing protocols for healthcare settings on standard infection control practices to prevent person-to-person spread.

  • Raising awareness about the signs, symptoms, and risk of NiV among populations.

Outbreaks:

  • So far, NiV outbreaks have only been described in Asia. 

  • The first reported outbreak occurred in 1998–1999 and involved pig farmers in the village of Sungai Nipah (Malaysia).

  • Since then, outbreaks have been documented in Bangladesh, India, the Philippines & Singapore.

Nipah outbreaks in India:

  • In 2001 and 2007, both in West Bengal.

  • In Kozhikode and Malappuram districts of Kerala in May 2018.

  • In 2019 Ernakulam district of Kerala (Zero death).

  • In 2021 Kozhikode district of Kerala.

  • In Kozhikode districts of Kerala in September 2023.

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Learnerz IAS | Concept oriented UPSC Classes in Malayalam: Nipah UPSC NOTE
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