The Nipah virus – What you need to know?
Nipah is a virus that causes the Nipah disease. The virus is part of the family Paramyxoviridae and was first identified in 1999. The outbreak back then began as a mild disease in pigs but spread to over 300 human cases. Out of these, 100 deaths occurred which resulted in the euthanization of more than a million pigs.
Since 2001, the outbreak has regularly been occurring in countries such as Bangladesh and have also been reported many times in India. Off late, around the beginning of 2018, there have been cases of the Nipah virus happening several times in India as well.
Nipah virus is transferred to humans after direct contact with infected bats, pigs, and other NiV-affected individuals. Initially, people were affected after contact with pigs and bats.
Soon, person-to-person transmission of the virus occurred in India and Bangladesh and had often been occurring ever since. It occurs commonly in the family as well as caregivers of those affected by the virus. The transmission also occurs from the direct exposure to bats as well. One way in which it is transmitted is when a human consumes the raw data palm sap which is contaminated by the excretions of infected bats.
Signs and symptoms:
Nipah virus infection is directly associated with the encephalitis, which is the inflammation of the brain. After being exposed to the virus, within an incubation period of 5 to 14 days, patients will feel 3-14 days of a headache and fever along with disorientation, drowsiness as well as mental confusion. If not treated, this can lead to a coma within 24-48 hours.
During the early part of the infections, some patients also feel a respiratory illness and more than half the patients show neurological and pulmonary signs that are severe. A general health checkup can help in identifying the presence of the virus in a person’s system.
About 40% of the patients who entered the hospitals back in 1999 were diagnosed with serious nervous diseases that led to their deaths.
A combination of tests can determine whether a patient has the disease or not. A general health checkup might not bring up the signs, but other tests that can determine whether the Nipah virus is in the body include real-time polymerase chain reactions from both nasal and throat swabs, urine, cerebrospinal fluid and blood tests undertaken in the early stages of the disease.
If the case is fatal, immunohistochemistry done on tissues collected during the autopsy period is another way to confirm the presence of the virus.
A preventive health care checkup could help identify the virus in the early stages of its presence.
Most of the other treatment is generally limited to just supportive care. The virus, transferred from person-to-person requires proper control practices, as well as barrier nursing techniques, are crucial during this stage.
Ribavirin is one drug that has been effective against the viruses, in-vitro, but there has been inconclusive evidence over its effectiveness of the medicine itself.
Another method that has proved to be beneficial includes the immunization using a monoclonal antibody that targets the Nipah G glycoprotein.
The virus can be prevented by ensuring there is no exposure to sick pigs as well as bats in some of the endemic areas. Also, avoiding raw date palm sap can help in preventing the disease.
Other efforts that are mainly centered around awareness and surveillance will ensure that future outbreaks do not occur. There is still a lot of research that needs to be done to understand bat ecology as well as the Nipah virus.
The other surveillance tools that are available are laboratory assays that will help detect the disease at an early stage. Raising awareness of the symptoms and having standard infection control practices can ensure that the disease does not spread.
A vaccine subunit that is created using the Hendra G protein helps in producing cross-protective antibodies against both the NIPV and the HENV. These methods have been employed in Australia against the Hendra virus, and it offers a lot of potential for the henipavirus protection in humans too.