Only a few years after battling the COVID-19 pandemic, Kerala faces a new outbreak called Nipah. This isn’t the first time Kerala has dealt with these situations, having experienced outbreaks in 2018, 2019, and 2021. Fortunately, each time, the state’s public health system responded effectively. Although two deaths have been reported in the current outbreak, more than 200 samples from high-risk contacts have tested negative. As of September 18, Kerala’s health minister, Veena George, stated that the outbreak was under control[1].
What is Nipah?
Nipah is a zoonotic virus known as NiV, which can spread from animals to humans. Human infection can occur through close contact with an infected animal or its body fluids. It is contagious and can then spread from person to person.
The name ‘Nipah’ originates from a Malaysian village, where the first outbreak occurred in 1998-1999, involving over 250 cases of febrile encephalitis. Between 1998 and 2018, documented outbreaks saw a 40% to 70% fatality rate among those infected[2].
Signs and Symptoms
Nipah virus (NiV) infection in humans can manifest in various ways, ranging from no noticeable symptoms (subclinical) to severe acute respiratory disease and fatal encephalitis. Symptoms typically appear about 4-14 days after exposure to the virus, with the illness initially characterized by a period of 3-14 days marked by fever and headache. Encephalitis or brain swelling, a severe form of the disease, includes symptoms such as fever, headache, drowsiness, confusion, mental disorientation, coma, and, in severe cases, even death.
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Disease Prevention
Detecting the virus through laboratory testing is possible during the early stages of the disease, using methods like real-time polymerase chain reaction (RT-PCR) from throat and nasal swabs, cerebrospinal fluid, urine, and blood. Later, after recovery, testing for antibodies is conducted using an enzyme-linked immunosorbent assay (ELISA). However, with nonspecific early signs and symptoms, it is challenging to diagnose Nipah early on.
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Therefore, early detection and diagnosis are vital for increasing the chances of survival among infected individuals, preventing further transmission, and effectively managing outbreaks. This is particularly important for individuals with symptoms consistent with NiV infection who have been in areas where Nipah is more common.
Prevention is paramount with the non-availability of treatments or vaccines for people and animals affected by the Nipah virus, and supportive care is the main approach for human treatment.
Here are some preventive measures that can be taken to prevent the transmission of Nipah Virus[3]:
1. Practice Proper Hand Hygiene: Wash your hands with soap and water or alcohol-based hand rub frequently[1].
2. Avoid Contact with Sick Pigs or Bats: People who are handling animals like pigs should disinfect burial sites with chlorinated lime and use sodium hypochlorite (bleach) to disinfect contaminated areas and equipment.
3. Safe Eating and Drinking Practices: Avoid consuming potentially contaminated items, like palm sap, or fruits like guava and lychee. Before eating, wash and peel all fruits and get rid of any fruit showing signs of bat bites or having touched the ground.
4. Avoid Contact with Infected Individuals: Prevent contact with the saliva, blood, or other bodily fluids of a person infected with the virus using PPE (personal protective equipment) that includes mask, gloves, etc.
5. Educate for Improved Biosecurity Practices: Encourage using protective equipment, implementing sanitation measures, and restricting access to affected areas.
6. Encourage Nature Conservation: Preserving habitats and tackling climate change by limiting animal-human contact while restoring forests for bats can reduce spillover risk and prevent outbreaks.
If you experience symptoms of the Nipah virus, especially after being in an outbreak-prone region or having contact with an infected person or animal, don’t hesitate to contact a healthcare provider promptly.
Consult a doctor today to protect yourself and those around you.
While there’s no specific treatment, early diagnosis, and supportive care can prevent further transmission.
(The article is written by Dr.Subita Alagh, Senior Executive, and reviewed by Monalisa Deka, Senior Health Content Editor)
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