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{{Use dmy dates|date=May 2018}}
{{Use dmy dates|date=May 2018}}
{{Use American English|date=May 2018}}
{{Use American English|date=May 2018}}

{{Infobox medical condition (new)
{{Infobox medical condition (new)
| name = Nipah virus infection
| name = Nipah Virus Infection
| synonyms =
| synonyms =
| image = Henipavirus structure.svg
| image = Henipavirus structure.svg
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}}
}}


'''Nipah virus infection''' ('''NiV''') is a viral [[zoonosis]] caused by Nipah virus of the genus [[Henipavirus]] in both animals and humans.<ref name="who">{{cite web |title = WHO Nipah Virus (NiV) Infection |url = http://www.who.int/csr/disease/nipah/en/ |website = www.who.int |accessdate = 21 May 2018 |deadurl = no |archiveurl = https://web.archive.org/web/20180418093759/http://www.who.int/csr/disease/nipah/en/ |archivedate = 18 April 2018 |df = dmy-all }}</ref> It was first identified in fruit bats of the [[Pteropodidae]] family, which are also the natural hosts of the virus.<ref name="cdc">{{cite web |title = Nipah Virus (NiV) CDC |url = https://www.cdc.gov/vhf/nipah/index.html |website = www.cdc.gov |publisher = CDC |accessdate = 21 May 2018 |language = en-us |deadurl = no |archiveurl = https://web.archive.org/web/20171216043000/https://www.cdc.gov/vhf/nipah/index.html |archivedate = 16 December 2017 |df = dmy-all }}</ref> Out of an estimated 582 human cases of Nipah virus, 54 percent were fatal.<ref name = christopher>{{cite journal |last1 = Broder |first1 = Christopher C. |last2 = Xu |first2 = Kai |last3 = Nikolov |first3 = Dimitar B. |last4 = Zhu |first4 = Zhongyu |last5 = Dimitrov |first5 = Dimiter S. |last6 = Middleton |first6 = Deborah |last7 = Pallister |first7 = Jackie |last8 = Geisbert |first8 = Thomas W. |last9 = Bossart |first9 = Katharine N.|last10=Wang|first10=Lin-Fa |title = A treatment for and vaccine against the deadly Hendra and Nipah viruses |journal = Antiviral Research |date = October 2013 |volume = 100 |issue = 1 |pages = 8–13 |doi = 10.1016/j.antiviral.2013.06.012 |url = https://www.sciencedirect.com/science/article/pii/S0166354213001691?via%3Dihub |accessdate = 21 May 2018 |language = en |issn = 0166-3542 }}</ref>
[http://snip.ly/hqf9d '''Nipah Virus Infection''' ('''NiV''') is a viral zoonosis caused by Nipah virus of the genus Henipavirus in both animals and humans.]<ref name="who">{{cite web |title = WHO Nipah Virus (NiV) Infection |url = http://www.who.int/csr/disease/nipah/en/ |website = www.who.int |accessdate = 21 May 2018 |deadurl = no |archiveurl = https://web.archive.org/web/20180418093759/http://www.who.int/csr/disease/nipah/en/ |archivedate = 18 April 2018 |df = dmy-all }}</ref> [http://snip.ly/hqf9d It was first identified in fruit bats of the Pteropodidae family, which are also the natural hosts of the virus.]<ref name="cdc">{{cite web |title = Nipah Virus (NiV) CDC |url = https://www.cdc.gov/vhf/nipah/index.html |website = www.cdc.gov |publisher = CDC |accessdate = 21 May 2018 |language = en-us |deadurl = no |archiveurl = https://web.archive.org/web/20171216043000/https://www.cdc.gov/vhf/nipah/index.html |archivedate = 16 December 2017 |df = dmy-all }}</ref> [http://snip.ly/hqf9d Out of an estimated 582 human cases of Nipah virus, 54 percent were fatal.]<ref name = christopher>{{cite journal |last1 = Broder |first1 = Christopher C. |last2 = Xu |first2 = Kai |last3 = Nikolov |first3 = Dimitar B. |last4 = Zhu |first4 = Zhongyu |last5 = Dimitrov |first5 = Dimiter S. |last6 = Middleton |first6 = Deborah |last7 = Pallister |first7 = Jackie |last8 = Geisbert |first8 = Thomas W. |last9 = Bossart |first9 = Katharine N.|last10=Wang|first10=Lin-Fa |title = A treatment for and vaccine against the deadly Hendra and Nipah viruses |journal = Antiviral Research |date = October 2013 |volume = 100 |issue = 1 |pages = 8–13 |doi = 10.1016/j.antiviral.2013.06.012 |url = https://www.sciencedirect.com/science/article/pii/S0166354213001691?via%3Dihub |accessdate = 21 May 2018 |language = en |issn = 0166-3542 }}</ref>


== Signs and symptoms ==
== Signs and symptoms ==
Line 52: Line 53:
== Outbreaks ==
== Outbreaks ==


Nipah virus outbreaks have been reported in [[Malaysia]], [[Singapore]], [[Bangladesh]] and [[India]]. The highest mortality due to Nipah virus infection has occurred in Bangladesh. In Bangladesh, the outbreaks are typically seen in winter season.<ref>{{cite journal |author = Chadha MS, Comer JA, Lowe L, Rota PA, Rollin PE, Bellini WJ, Ksiazek TG, Mishra A |title = Nipah virus-associated encephalitis outbreak, Siliguri, India |journal = Emerging Infectious Diseases |volume = 12 |issue = 2 |pages = 235–40 |date = February 2006 |pmid = 16494748 |url = https://www.cdc.gov/ncidod/eid/vol12no02/05-1247.htm#1 |doi = 10.3201/eid1202.051247 |pmc = 3373078 |last2 = Comer |last3 = Lowe |last4 = Rota |last5 = Rollin |last6 = Bellini |last7 = Ksiazek |last8 = Mishra }}</ref> Nipah virus first appeared in Malaysia in 1998 in peninsular Malaysia in pigs and pig farmers. By mid-1999, more than 265 human cases of encephalitis, including 105 deaths, had been reported in Malaysia, and 11 cases of either encephalitis or respiratory illness with one fatality were reported in Singapore.<ref>{{cite journal |last1 = Eaton |first1 = BT |last2 = Broder |first2 = CC |last3 = Middleton |first3 = D |last4 = Wang |first4 = LF |title = Hendra and Nipah viruses: different and dangerous. |journal = Nature reviews. Microbiology |date = January 2006 |volume = 4 |issue = 1 |pages = 23–35 |doi = 10.1038/nrmicro1323 |pmid = 16357858 |accessdate = }}</ref> In 2001, Nipah virus was reported from [[Meherpur District]], Bangladesh <ref name=chadha>{{cite journal |vauthors = Chadha MS, Comer JA, Lowe L |title = Nipah virus-associated encephalitis outbreak, Siliguri, India |journal = Emerging Infectious Diseases |volume = 12 |issue = 2 |pages = 235–40 |year = 2006 |pmid = 16494748 |url = https://www.cdc.gov/ncidod/EID/vol12no02/05-1247.htm |doi = 10.3201/eid1202.051247 |pmc = 3373078 |deadurl = no |archiveurl = https://web.archive.org/web/20110629142002/http://www.cdc.gov/ncidod/eid/vol12no02/05-1247.htm |archivedate = 29 June 2011 |df = dmy-all }}</ref><ref name=hsu>{{cite journal |vauthors = Hsu VP, Hossain MJ, Parashar UD |title = Nipah virus encephalitis reemergence, Bangladesh |journal = Emerging Infectious Diseases |volume = 10 |issue = 12 |pages = 2082–7 |year = 2004 |pmid = 15663842 |url = https://www.cdc.gov/ncidod/EID/vol10no12/04-0701.htm |doi = 10.3201/eid1012.040701 |pmc = 3323384 |deadurl = no |archiveurl = https://web.archive.org/web/20110411233331/http://www.cdc.gov/ncidod/EID/vol10no12/04-0701.htm |archivedate = 11 April 2011 |df = dmy-all }}</ref> and [[Siliguri]], India.<ref name=chadha /> The outbreak again appeared in 2003, 2004 and 2005 in [[Naogaon District]], [[Manikganj District]], [[Rajbari District]], [[Faridpur District]] and [[Tangail District]].<ref name=hsu /> In Bangladesh, there were outbreaks in subsequent years as well.<ref>{{cite news |date = 18 March 2008 |newspaper = The Daily Star |title = Arguments in Bahodderhat murder case begin |url = http://www.thedailystar.net/newDesign/latest_news.php?nid=28294 |accessdate = 21 May 2014 |deadurl = no |archiveurl = https://web.archive.org/web/20121024191333/http://www.thedailystar.net/newDesign/latest_news.php?nid=28294 |archivedate = 24 October 2012 |df = dmy-all }}</ref> For the first time in India, an outbreak has been reported in the [[Kozhikode district]] of [[Kerala]]. Ten deaths have been recorded, including one healthcare worker.<ref>{{cite web| url=http://www.bbc.com/news/world-asia-india-44207740 | title=Lini Puthussery: India's 'hero' nurse who died battling Nipah virus | publisher=BBC News | access-date=22 May 2018}}</ref> Those who have died are mainly from the districts of Kozhikode and Malappuram, including a 31-year-old nurse, who was treating patients infected with the virus.
Nipah virus outbreaks have been reported in [[Malaysia]], [[Singapore]], [[Bangladesh]] and [[India]]. The highest mortality due to Nipah virus infection has occurred in Bangladesh. In Bangladesh, the outbreaks are typically seen in winter season.<ref>{{cite journal |author = Chadha MS, Comer JA, Lowe L, Rota PA, Rollin PE, Bellini WJ, Ksiazek TG, Mishra A |title = Nipah virus-associated encephalitis outbreak, Siliguri, India |journal = Emerging Infectious Diseases |volume = 12 |issue = 2 |pages = 235–40 |date = February 2006 |pmid = 16494748 |url = https://www.cdc.gov/ncidod/eid/vol12no02/05-1247.htm#1 |doi = 10.3201/eid1202.051247 |pmc = 3373078 |last2 = Comer |last3 = Lowe |last4 = Rota |last5 = Rollin |last6 = Bellini |last7 = Ksiazek |last8 = Mishra }}</ref> Nipah virus first appeared in Malaysia in 1998 in peninsular Malaysia in pigs and pig farmers. By mid-1999, more than 265 human cases of encephalitis, including 105 deaths, had been reported in Malaysia, and 11 cases of either encephalitis or respiratory illness with one fatality were reported in Singapore.<ref>{{cite journal |last1 = Eaton |first1 = BT |last2 = Broder |first2 = CC |last3 = Middleton |first3 = D |last4 = Wang |first4 = LF |title = Hendra and Nipah viruses: different and dangerous. |journal = Nature reviews. Microbiology |date = January 2006 |volume = 4 |issue = 1 |pages = 23–35 |doi = 10.1038/nrmicro1323 |pmid = 16357858 |accessdate = }}</ref> In 2001, Nipah virus was reported from [[Meherpur District]], Bangladesh <ref name=chadha>{{cite journal |vauthors = Chadha MS, Comer JA, Lowe L |title = Nipah virus-associated encephalitis outbreak, Siliguri, India |journal = Emerging Infectious Diseases |volume = 12 |issue = 2 |pages = 235–40 |year = 2006 |pmid = 16494748 |url = https://www.cdc.gov/ncidod/EID/vol12no02/05-1247.htm |doi = 10.3201/eid1202.051247 |pmc = 3373078 |deadurl = no |archiveurl = https://web.archive.org/web/20110629142002/http://www.cdc.gov/ncidod/eid/vol12no02/05-1247.htm |archivedate = 29 June 2011 |df = dmy-all }}</ref><ref name=hsu>{{cite journal |vauthors = Hsu VP, Hossain MJ, Parashar UD |title = Nipah virus encephalitis reemergence, Bangladesh |journal = Emerging Infectious Diseases |volume = 10 |issue = 12 |pages = 2082–7 |year = 2004 |pmid = 15663842 |url = https://www.cdc.gov/ncidod/EID/vol10no12/04-0701.htm |doi = 10.3201/eid1012.040701 |pmc = 3323384 |deadurl = no |archiveurl = https://web.archive.org/web/20110411233331/http://www.cdc.gov/ncidod/EID/vol10no12/04-0701.htm |archivedate = 11 April 2011 |df = dmy-all }}</ref> and [[Siliguri]], India.<ref name=chadha /> The outbreak again appeared in 2003, 2004 and 2005 in [[Naogaon District]], [[Manikganj District]], [[Rajbari District]], [[Faridpur District]] and [[Tangail District]].<ref name=hsu /> In Bangladesh, there were outbreaks in subsequent years as well.<ref>{{cite news |date = 18 March 2008 |newspaper = The Daily Star |title = Arguments in Bahodderhat murder case begin |url = http://www.thedailystar.net/newDesign/latest_news.php?nid=28294 |accessdate = 21 May 2014 |deadurl = no |archiveurl = https://web.archive.org/web/20121024191333/http://www.thedailystar.net/newDesign/latest_news.php?nid=28294 |archivedate = 24 October 2012 |df = dmy-all }}</ref> For the first time in India, an outbreak has been reported in the Kozhikode district of Kerala. Ten deaths have been recorded, including one healthcare worker.<ref>{{cite web| url=http://www.bbc.com/news/world-asia-india-44207740 | title=Lini Puthussery: India's 'hero' nurse who died battling Nipah virus | publisher=BBC News | access-date=22 May 2018}}</ref> Those who have died are mainly from the districts of Kozhikode and Malappuram, including a 31-year-old nurse, who was treating patients infected with the virus.


== References ==
== References ==

Revision as of 07:38, 23 May 2018

Nipah Virus Infection
Structure of a henipavirus
SpecialtyInfectious diseases Edit this on Wikidata

Nipah Virus Infection (NiV) is a viral zoonosis caused by Nipah virus of the genus Henipavirus in both animals and humans.[1] It was first identified in fruit bats of the Pteropodidae family, which are also the natural hosts of the virus.[2] Out of an estimated 582 human cases of Nipah virus, 54 percent were fatal.[3]

Signs and symptoms

The symptoms start to appear within 3–14 days after exposure. Initial symptoms are fever, headache, drowsiness followed by disorientation and mental confusion. These symptoms can progress into coma as fast as in 24–48 hours. Encephalitis is the dreaded complication of nipah virus infection. Respiratory illness can also be present during the early part of the illness.[2] Nipah-case patients who had breathing difficulty are more likely than those without respiratory illness to transmit the virus.[4] The disease is suspected in symptomatic individuals in the context of an epidemic outbreak.

Diagnosis

Laboratory diagnosis of Nipah virus infection is made using real time polymerase chain reaction (RT-PCR) from throat swabs, cerebrospinal fluid, urine and blood analysis during acute and convalescent stages of the disease. IgG and IgM antibody detection can be done after recovery to confirm Nipah virus infection. Immunohistochemistry on tissues collected during autopsy also confirms the disease.[2] Viral RNA can be isolated from the saliva of infected persons.

Treatment

Currently there is no effective treatment for Nipah virus infection. The treatment is limited to supportive care. It is important to practice standard infection control practices and proper barrier nursing techniques to avoid the transmission of the infection from person to person. All suspected cases of Nipah virus infection should be isolated and given intensive supportive care. Ribavirin has been shown effective in in vitro tests, but has not yet been proven effective in humans. Passive immunization using a human monoclonal antibody that targets the Nipah G glycoprotein has been evaluated in the ferret model as post-exposure prophylaxis.[3][2] The anti-malarial drug chloroquine was shown to block the critical functions needed for maturation of Nipah virus, although no clinical benefit has yet been observed.[5] m102.4, a human monoclonal antibody, has been used in people on a compassionate use basis in Australia and is presently in pre-clinical development.[3]

Prevention

Prevention of Nipah virus infection is important since there is no effective treatment for the disease. The infection can be prevented by avoiding exposure to bats in endemic areas and sick pigs. Drinking of raw palm sap (palm toddy) contaminated by bat excrete,[6] eating of fruits partially consumed by bats and using water from wells infested by bats [7] should be avoided. Bats are known to drink toddy that is collected in open containers, and occasionally urinate in it, which makes it contaminated with the virus.[6] Surveillance and awareness are important for preventing future outbreaks. The association of this disease within reproductive cycle of bats is not well studied. Standard infection control practices should be enforced to prevent nosocomial infections. A subunit vaccine using the Hendra G protein was found to produce cross-protective antibodies against henipavirus and nipavirus has been used in monkeys to protect against Hendra virus, although its potential for use in humans has not been studied.[8]

Risk of exposure

Fruit bats are the natural reservoirs of Nipah virus

The risk of exposure is high for hospital workers and caretakers of those infected with the virus. In Malaysia and Singapore, Nipah virus infection occurred in those with close contact to infected pigs. In Bangladesh and India, the disease has been linked to consumption of raw date palm sap (toddy) and contact with bats.[9]

Outbreaks

Nipah virus outbreaks have been reported in Malaysia, Singapore, Bangladesh and India. The highest mortality due to Nipah virus infection has occurred in Bangladesh. In Bangladesh, the outbreaks are typically seen in winter season.[10] Nipah virus first appeared in Malaysia in 1998 in peninsular Malaysia in pigs and pig farmers. By mid-1999, more than 265 human cases of encephalitis, including 105 deaths, had been reported in Malaysia, and 11 cases of either encephalitis or respiratory illness with one fatality were reported in Singapore.[11] In 2001, Nipah virus was reported from Meherpur District, Bangladesh [12][13] and Siliguri, India.[12] The outbreak again appeared in 2003, 2004 and 2005 in Naogaon District, Manikganj District, Rajbari District, Faridpur District and Tangail District.[13] In Bangladesh, there were outbreaks in subsequent years as well.[14] For the first time in India, an outbreak has been reported in the Kozhikode district of Kerala. Ten deaths have been recorded, including one healthcare worker.[15] Those who have died are mainly from the districts of Kozhikode and Malappuram, including a 31-year-old nurse, who was treating patients infected with the virus.

References

  1. ^ "WHO Nipah Virus (NiV) Infection". www.who.int. Archived from the original on 18 April 2018. Retrieved 21 May 2018. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
  2. ^ a b c d "Nipah Virus (NiV) CDC". www.cdc.gov. CDC. Archived from the original on 16 December 2017. Retrieved 21 May 2018. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
  3. ^ a b c Broder, Christopher C.; Xu, Kai; Nikolov, Dimitar B.; Zhu, Zhongyu; Dimitrov, Dimiter S.; Middleton, Deborah; Pallister, Jackie; Geisbert, Thomas W.; Bossart, Katharine N.; Wang, Lin-Fa (October 2013). "A treatment for and vaccine against the deadly Hendra and Nipah viruses". Antiviral Research. 100 (1): 8–13. doi:10.1016/j.antiviral.2013.06.012. ISSN 0166-3542. Retrieved 21 May 2018.
  4. ^ Luby, Stephen P.; Hossain, M. Jahangir; Gurley, Emily S.; Ahmed, Be-Nazir; Banu, Shakila; Khan, Salah Uddin; Homaira, Nusrat; Rota, Paul A.; Rollin, Pierre E.; Comer, James A.; Kenah, Eben; Ksiazek, Thomas G.; Rahman, Mahmudur (2009). "Recurrent Zoonotic Transmission of Nipah Virus into Humans, Bangladesh, 2001–2007". Emerging Infectious Diseases. 15 (8): 1229–1235. doi:10.3201/eid1508.081237. ISSN 1080-6040. PMC 2815955. {{cite journal}}: |archive-date= requires |archive-url= (help); |archive-url= requires |url= (help); Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
  5. ^ Broder, Christopher C.; Xu, Kai; Nikolov, Dimitar B.; Zhu, Zhongyu; Dimitrov, Dimiter S.; Middleton, Deborah; Pallister, Jackie; Geisbert, Thomas W.; Bossart, Katharine N.; Wang, Lin-Fa (October 2013). "A treatment for and vaccine against the deadly Hendra and Nipah viruses". Antiviral Research. 100 (1): 8–13. doi:10.1016/j.antiviral.2013.06.012. ISSN 0166-3542. Retrieved 21 May 2018.
  6. ^ a b Islam, M. Saiful; Sazzad, Hossain M.S.; Satter, Syed Moinuddin; Sultana, Sharmin; Hossain, M. Jahangir; Hasan, Murshid; Rahman, Mahmudur; Campbell, Shelley; Cannon, Deborah L.; Ströher, Ute; Daszak, Peter; Luby, Stephen P.; Gurley, Emily S. (April 2016). "Nipah Virus Transmission from Bats to Humans Associated with Drinking Traditional Liquor Made from Date Palm Sap, Bangladesh, 2011–2014". Emerging Infectious Diseases. 22 (4): 664–670. doi:10.3201/eid2204.151747. ISSN 1080-6040. Archived from the original on 11 December 2017. {{cite journal}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
  7. ^ Balan, Sarita (21 May 2018). "6 Nipah virus deaths in Kerala: Bat-infested house well of first victims sealed". The News Minute. Archived from the original on 22 May 2018. Retrieved 21 May 2018. {{cite news}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
  8. ^ Bossart, Katharine N.; Rockx, Barry; Feldmann, Friederike; Brining, Doug; Scott, Dana; LaCasse, Rachel; Geisbert, Joan B.; Feng, Yan-Ru; Chan, Yee-Peng; Hickey, Andrew C.; Broder, Christopher C.; Feldmann, Heinz; Geisbert, Thomas W. (8 August 2012). "A Hendra Virus G Glycoprotein Subunit Vaccine Protects African Green Monkeys from Nipah Virus Challenge". Science translational medicine. 4 (146): 146ra107. doi:10.1126/scitranslmed.3004241. ISSN 1946-6234. PMC 3516289. {{cite journal}}: |archive-date= requires |archive-url= (help); |archive-url= requires |url= (help); Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
  9. ^ Luby, Stephen P.; Gurley, Emily S.; Hossain, M. Jahangir (2012). TRANSMISSION OF HUMAN INFECTION WITH NIPAH VIRUS. National Academies Press (US). Archived from the original on 22 May 2018. Retrieved 21 May 2018. {{cite book}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
  10. ^ Chadha MS, Comer JA, Lowe L, Rota PA, Rollin PE, Bellini WJ, Ksiazek TG, Mishra A; Comer; Lowe; Rota; Rollin; Bellini; Ksiazek; Mishra (February 2006). "Nipah virus-associated encephalitis outbreak, Siliguri, India". Emerging Infectious Diseases. 12 (2): 235–40. doi:10.3201/eid1202.051247. PMC 3373078. PMID 16494748.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  11. ^ Eaton, BT; Broder, CC; Middleton, D; Wang, LF (January 2006). "Hendra and Nipah viruses: different and dangerous". Nature reviews. Microbiology. 4 (1): 23–35. doi:10.1038/nrmicro1323. PMID 16357858.
  12. ^ a b Chadha MS, Comer JA, Lowe L (2006). "Nipah virus-associated encephalitis outbreak, Siliguri, India". Emerging Infectious Diseases. 12 (2): 235–40. doi:10.3201/eid1202.051247. PMC 3373078. PMID 16494748. Archived from the original on 29 June 2011. {{cite journal}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
  13. ^ a b Hsu VP, Hossain MJ, Parashar UD (2004). "Nipah virus encephalitis reemergence, Bangladesh". Emerging Infectious Diseases. 10 (12): 2082–7. doi:10.3201/eid1012.040701. PMC 3323384. PMID 15663842. Archived from the original on 11 April 2011. {{cite journal}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
  14. ^ "Arguments in Bahodderhat murder case begin". The Daily Star. 18 March 2008. Archived from the original on 24 October 2012. Retrieved 21 May 2014. {{cite news}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
  15. ^ "Lini Puthussery: India's 'hero' nurse who died battling Nipah virus". BBC News. Retrieved 22 May 2018.
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