Even as thousands of COVID-19 cases are still being reported daily in India, despite the fact that the worst peaks of coronavirus disease spread have abated since the first wave last year from April to September 2020 and the second wave between April to June 2021, yet another viral ailment has been identified recently. The Nipah Virus disease was confirmed in a 12-year-old boy in Kozhikode, Kerala and the youngster who had suffered from encephalitis – swelling in the brain and myocarditis – inflammation in the heart muscles, eventually succumbed to the disease on September 5, 2021, Sunday.
Immediate action has been taken since then lead by the efforts of the Kerala State Health Minister Veena George, to contain the spread of this infectious virus. Rigorous contact tracing has identified 11 more people displaying typical symptoms who have been admitted to the hospital for close monitoring and appropriate treatment. Moreover, the Central Health Ministry has advocated a list of stringent measures, including marking containment areas to spot possible cases early on, besides instructing local officials to alert the districts neighbouring Kozhikode, Kerala, namely Malappuram, Kannur, Wayanad, among others.
What Is Nipah Virus?
The Nipah virus is a communicable disease that is transmitted to humans from animals, mainly bats, besides dogs, pigs, cats, goats, sheep and already infected people. It is named after a Malaysian village – Sungai Nipah, where it was first reported in the year 1998.
Subsequent outbreaks of Nipah have been recorded since, predominantly in the South-East Asian countries of Singapore, Bangladesh and India, aside from Malaysia.
Causes Of Nipah Virus Disease:
The causative microorganism of Nipah virus disease is the pathogenic specimen Nipah virus, scientifically referred to as Nipah henipavirus. It belongs to the Henipavirus genus of viral strains and is categorised in the Paramyxoviridae family of viruses, also termed paramyxoviruses. Transmission of the Nipah virus among humans occurs directly through contact with infected bats, other infested animals or sick individuals afflicted with the disease.
The Nipah virus, abbreviated as NiV, is thus a zoonotic virus, implying that it spreads from animals to humans, with fruit bats – otherwise known as flying foxes being the primary hosts harbouring considerable reservoirs of the viral strains. The Nipah virus disease also afflicts humans by transmission from infected cats, goats, dogs, sheep, pigs that have encountered diseased fruit bats, apart from already sick persons.
History Of Nipah Virus:
The origins of the Nipah virus are in the village of Sungai Nipah in Malaysia, where it was first reported in 1998, amongst a group of pigs and farmers rearing the infected animals, which had, in turn, contracted the virus from bats. Hundred of cases were identified in Malaysia and a few instances were reported from the neighbouring country of Singapore as well, making it the world’s first Nipah virus outbreak, that took place in 1998-1999.
Following this, numerous outbreaks have been reported from the nation of Bangladesh, usually in the winter season, in the years 2001, 2003, 2004, 2005, 2007, 2008, 2010 and 2011. Nipah virus disease seemed to have been curtailed for a phase since 2011 when it was once again reported in India in 2018.
Incidence Of Nipah Virus In India:
Nipah virus was first reported in India in the year 2001 in West Bengal, which was followed by another outbreak in 2007, again in the state.
In recent times, Nipah virus cases have been recorded in India in Kerala, in the years 2018, 2019 and 2021.
Symptoms Of Nipah Virus Disease:
Infection with the Nipah virus often results in inflammation of the brain - encephalitis, severe respiratory illness and even death can occur. Following an exposure and incubation period of 5 to 14 days with this virus, several signs and symptoms can be noticed in different time scales. Subsequently, in 3 to 14 days after the incubation period, the infected person displays some flu-like symptoms such as:
- Muscle pain
- Stomach pain
- Respiratory illness
- Blurred vision
However, these symptoms can intensify rapidly, resulting in mental confusion, seizures, encephalitis, myocarditis and even progress to coma within 24 to 48 hours.
How Is Nipah Virus Diagnosed?
Once the patient showcases symptoms of Nipah virus, an extract is collected from their nasal and throat swabs, besides blood, urine and cerebrospinal fluid if encephalitis i.e. swelling in the brain arises. These samples are analysed in the diagnostic laboratory facility using an RT-PCR test, which looks for genetic fragments of the Nipah virus in the tissue/fluid samples and amplifies, highlights the portions in case they are present, which confirms the instance of Nipah virus disease in the patient.
Apart from RT-PCR, few other analytical tests including serology, histopathology are carried out, which investigate blood, tissue extracts from patients employing microscopes, to probe for the presence of the Nipah virus.
Treatment For Nipah Virus Disease:
According to the World Health Organization (WHO), there is presently no treatment available for Nipah virus disease. Furthermore, no preventive vaccine exists up till now to avert Nipah virus infection, which makes it essential for patients with symptoms to be taken to the hospital at once for timely diagnosis and remedial measures.
The only methods to treat Nipah virus disease currently are supportive care, with the patient being admitted in the hospital, observing their vitals, ensuring they get ample rest, hydration to recuperate from sickness. Furthermore, antiviral drugs are prescribed to alleviate nausea, vomiting, convulsions and other accompanying symptoms as they develop.
Are Patients With COVID-19 At Higher Risk Of Contracting Nipah Virus?
While COVID-19 and Nipah Virus are both infectious viral ailments presenting with symptoms resembling the flu, like dry cough, fever, cold, headache, fatigue, the RT-PCR test is the gold standard utilised in diagnosing the disorders and clearly distinguishes the two. Also, COVID-19 triggers only mild to moderate symptoms in the majority of people which can be managed at home, while the Nipah virus is far more lethal requiring advanced medical care in the hospital. Hence doctors state that COVID-19 patients do not face a high risk of acquiring the Nipah virus.
The only situation that poses a hazard is hospital transmissions, wherein patients admitted for Nipah virus could come in contact with those having severe symptoms of COVID-19 with subsequent spread of Nipah virus infection. However, the chances of this instance taking place in hospitals are very rare, owing to the strict protective measures of PPE kits, sanitisers as well as clearly demarcating the wards where Nipah cases and COVID-19 cases are being treated.