By While Kerala struggles under the weight of mounting Covid-19 cases, a new public health threat has emerged in the state. A 12-year-old boy died early Sunday morning from a Nipah virus infection in Kerala’s Kozhikode district.
The Centre immediately dispatched a team to provide technical assistance, and state health minister Veena George confirmed that teams had been formed to deal with the situation. “There is no reason to panic at the moment, but we must exercise caution,” she said.
This is not the first time Kerala has encountered the Nipah virus. In 2018, the state’s Kozhikode and Malappuram districts experienced an outbreak of the disease. The outbreak claimed the lives of 17 people and infected another 18.
HOW IS THE NIPAH VIRUS DETECTED?
Nipah is a zoonotic virus, meaning it can be transmitted from animals to humans. The Nipah virus is spread by flying foxes (fruit bats) to animals and humans. In general, it affects animals such as pigs, dogs, and horses. If the Nipah virus spreads among humans, it can cause severe illness and death.
The World Health Organization reports that the Nipah virus infects various animals and can result in severe disease and death in humans. As a result, it raises concerns about public health.
“It causes a variety of illnesses in infected individuals, ranging from asymptomatic (subclinical) infection to acute respiratory illness and fatal encephalitis,” the WHO states in its Nipah virus guidelines.
SYMPTOMS OF INFECTION WITH THE NIPAH VIRUS
The symptoms of Nipa virus infection include the following:
- Fever of the brain
- High fever accompanied by a persistent cough and difficulty breathing
- Respiratory infection, acute (mild or severe)
- Symptoms similar to those of influenza — fever, headache, muscle pain, vomiting, sore throat, dizziness, and drowsiness
- Neurological symptoms suggestive of encephalitis
According to the WHO, in some cases, individuals may also develop pneumonia.
“In severe cases, encephalitis and seizures develop, progressing to coma within 24 to 48 hours,” the WHO guidelines state.
Nipah virus has an average incubation period of 5-14 days. However, it can be up to 45 days in some extreme cases, which leaves plenty of time for an infected person to infect others unknowingly.
HOW IS THE NIPAH VIRUS DETECTED?
The primary diagnostic tests for the Nipah virus are real-time polymerase chain reaction (RT-PCR) from bodily fluids and antibody detection using an enzyme-linked immunosorbent assay (ELISA). Additional tests include polymerase chain reaction (PCR) and virus isolation via cell culture.
These tests are frequently unsuitable for use in remote and rural areas, where most outbreaks occur, with limited containment capabilities.
HOW IS THE NIPAH VIRUS TRANSMITTED AMONG HUMAN BEINGS?
Humans can contract the Nipah virus through close contact with Nipah-infected people, bats, or pigs. As a result, paramedical personnel and close relatives of infected individuals are at risk.
“Virus-infected bat secretions can infect humans during fruit tree climbing, eating/handling contaminated fallen fruits, or consuming raw date palm sap/juice or toddy,” the National Center for Disease Control’s Nipah virus guidelines state.
Another possible source of infection is the bodies of Nipah virus victims. The National Center for Disease Control (NCDC) recommends that bodies be handled strictly by government guidelines.
“During this emotionally charged time period, traditional rituals and practices may need to be modified to avoid infecting family members,” the NCDC stated.
HOW TO PREVENT THE SPREAD OF THE NIPAH VIRUS
To help prevent and minimize the spread of the Nipah virus, individuals should regularly wash their hands with soap and water, especially after coming into contact with a potentially infected person or animal.
Additionally, individuals should abstain from raw date palm sap or toddy.
The bodies of those who died due to the Nipah virus should be handled according to health officials’ guidelines. Any lapse in this regard could exacerbate the situation.
Fruits should be consumed only after they have been thoroughly cleaned. Avoid fruits that are half-eaten and lying on the ground. These fruits may have been consumed by infected animals, particularly the flying fox, the primary vector of the Nipah virus.
Care should be exercised when handling sick animals. Gloves and other protective clothing should be worn during the slaughter and culling of infected animals, and as much contact with infected pigs as possible should be avoided.
HOW IS THE NIPAH VIRUS TREATMENT PERFORMED?
According to the World Health Organization, there are no licensed drugs available to treat the Nipah virus at the moment. Ribavirin has been shown in laboratory studies to be effective against Nipah viruses. However, human studies have been inconclusive, and the WHO notes that Ribavirin’s clinical utility remains uncertain.
Without a licensed drug to treat Nipah infection, the WHO recommends intensive supportive care for severe respiratory and neurologic complications.
The majority of people who survive acute encephalitis recover completely. Those who have survived the disease, on the other hand, have reported long-term neurologic complications.
“Around 20% of patients experience residual neurological symptoms such as seizure disorder and personality changes. After demonstrating signs of recovery, a small percentage of people experience a relapse or develop delayed onset encephalitis “According to the WHO.
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