Nipah virus outbreak in Kerala: All you need to know about the deadly infection

At least three people have died due to a deadly virus Nipah in northern Kerala. The outbreak was identified after three members of a family who were tested positive for the virus, including two youths in their 20s, died while undergoing treatment at the hospital. Their father, who is also infected, has been put under observation in the hospital. The entire state has been on high alert as eight others have also been hospitalized for showing similar infection-related symptoms. Basic symptoms of the Nipah virus are fever, nausea, vomiting, convulsions, choking, stomach pain, and fatigue. A person infected with the Nipah Virus can go in coma.

Nipah virus (NiV) infection is a newly emerging zoonosis, a disease which can be transmitted to humans from animals, that causes severe disease in both animals and humans. The natural hosts of the Nipah virus are fruit bats of the Pteropodidae family, Pteropus genus.

Kerala health minister KK Shylaja said a bat was found in the well of the house where the deaths occurred, and that the house has now been closed. A nursing assistant, Lini, who had treated these three patients, also died on Monday. However, it is yet to be established if she died of virus infection from bats or due to some other reasons.

Total 15 deaths have been reported due to the symptoms related to the virus in several districts of the state, reported India Today. A high-level team from the National Centre for Disease Control (NCDC) is analyzing the overall situation in Kozhikode, which is the most affected. The authorities have said there's no need to panic as the Nipah virus spreads only through direct contact with an infected person.

What is Nipah Virus (NiV)

According to the World Health Organisation, the virus was named after the Malaysian village, Kampung Sungai Nipah, where it was first identified during an outbreak of the disease in 1998. During that time, pigs were the intermediate hosts of the virus. However, in subsequent NiV outbreaks, there were no intermediate hosts. In Bangladesh in 2004, humans were infected with NiV as a result of consuming date palm sap that had been contaminated by infected fruit bats. Human-to-human transmission has also been documented in India. NiV also causes diseases in pigs and other animals. So far, there is no vaccine for either humans or animals. The primary treatment for human cases is intensive supportive care.

Causes of Nipah Virus

• Fruit bats of the genus Pteropus have been identified as natural reservoirs of NiV.
• Nipah virus has been isolated from the brain and spinal fluid of victims in Malaysia.
• Infective virus has also been isolated from bat urine and partially-eaten fruit in Malaysia.

How Nipah Virus is transmitted

• Infected bats shed virus in their excretion and secretion such as saliva, urine, semen and excreta but they are symptomless carriers.
• The NiV is highly contagious among pigs, spread by coughing. Ninety per cent of the infected people in the 1998-1999 outbreaks were pig farmers or had contact with pigs.
• WHO says emergence of bat-related viral infection communicable to humans and animals has been attributed to the loss of natural habitats of bats. As the flying fox habitat is destroyed by human activity the bats get stressed and hungry, their immune system gets weaker, their virus load goes up and a lot of virus spills out in their urine and saliva.

How to prevent Nipah virus

• There is no effective treatment for Nipah virus disease, but ribavarin may alleviate the symptoms of nausea, vomiting, and convulsions.
• Treatment is mostly focused on managing fever and the neurological symptoms.
• Severely ill individuals need to be hospitalised and may require the use of a ventilator.
• Prevent infected persons from coming in contact with others as human-to-human transmission of NiV has been reported in recent outbreaks.
• Healthcare workers caring for patients with suspected or confirmed NiV should implement standard precautions.