How serious is Nipah
The Nipah virus is a zoonotic, bat-borne illness that has a high fatality rate when it infects people and other animals. In Southeast Asia and North East Africa, the Nipah virus has been responsible for several epidemic outbreaks. The Nipah virus and the Hendra virus, both of which have contributed to illness outbreaks, are members of the genus Henipavirus.
Nipah History
When an outbreak of neurological and respiratory illness on pig farms in peninsular Malaysia resulted in 265 human cases, including 108 fatalities, the first instances of Nipah virus infection were discovered in 1998. The next year, 1999, saw the isolation of the virus. One million pigs were killed as a result of this pandemic. Abattoir employees in Singapore had 11 instances, including one fatality, after being exposed to pigs imported from troubled Malaysian farms.
The Centers for Disease Control and Prevention have designated the Nipah virus as a Category C agent. The location Sungai Nipah near Port Dickson, Negeri Sembilan, which translates to "nipah river," is where the human case from which the Nipah virus was initially identified originated.
In a new strategy created during the Ebola outbreak for rapid research and development before and during an epidemic toward new diagnostic tests, vaccines, and medications, the Nipah virus is one of many viruses recognized by WHO as a possible source of a future epidemic.
The outbreak was initially misdiagnosed as Japanese encephalitis, but local doctors noticed that adult cases were unusually high and that those who had received the Japanese encephalitis vaccine were not immune to the pandemic. The Ministry of Health began a national campaign to inform people about the hazards of Japanese encephalitis and its vector, Culex mosquitoes, despite the fact that these findings were made during the first month of the outbreak.
The majority of the human and pig respiratory and encephalitic signs of infection from the Malaysian epidemic. Later outbreaks have resulted in respiratory sickness in people, raising the possibility of transmission from person to person and proving the existence of more deadly virus strains.
According to seroprevalence statistics and viral isolations, Pteropid fruit bats, such as Pteropus vampyrus (a large flying fox) and Pteropus hypomelanus (a little flying fox), both of which are present in Malaysia, are the main reservoir for the Nipah virus.
The Nipah virus is suspected to be spread from flying foxes to pigs in peninsular Malaysia as a result of an expanding overlap between bat habitats and pig farms. At the index farm, the pigs were exposed to urine, dung, and half-consumed fruit due to the closeness of the orchards to the pig pen. Retrospective investigations show that viral spillover into pigs may have been happening in Malaysia since 1996 without being noticed. The movement of sick pigs to neighboring farms during 1998 helped the virus spread, and further outbreaks resulted.
Nipah Transmission
The majority of human infections during the first known epidemic in Malaysia, which also impacted Singapore, happened as a direct result of coming into touch with ill pigs or their infected tissues. Unprotected contact with the tissue of a sick animal or unprotected exposure to the pigs' fluids are the two most likely routes of transmission.
Consumption of fruits or fruit products (such as raw date palm juice) contaminated with urine or saliva from infected fruit bats was the most likely cause of infection in the following outbreaks in Bangladesh and India.
Studies on viral persistence in human fluids or the environment, including fruits, are not yet available.
Families and caregivers of infected patients have also been observed to contract the Nipah virus from one another.
The Nipah virus spread subsequently in Bangladesh and India through intimate contact with bodily fluids and excretions of infected individuals. In Siliguri, India in 2001, transmission of the virus within a medical environment was also observed; 75% of cases involved hospital workers or guests. About half of the cases that were recorded in Bangladesh between 2001 and 2008 were caused by human-to-human transmission while treating patients who were afflicted.
Nipah Symptoms and signs
Acute respiratory infections in humans can range in severity from asymptomatic to lethal, including encephalitis.
People who are infected at first have symptoms including fever, headaches, myalgia (muscle pain), vomiting, and sore throat. Dizziness, sleepiness, altered awareness, and neurological symptoms indicative of acute encephalitis may ensue. Atypical pneumonia and serious respiratory issues, such as acute respiratory distress, can also occur in some patients. Severe instances include encephalitis and convulsions, which progress to coma within 24 to 48 hours.
It is thought that the incubation period (the time from infection to the start of symptoms) lasts between 4 and 14 days. However, it has been shown that incubation can last up to 45 days.
The majority of persons who survive acute encephalitis fully recover, however, some survivors have been noted to have long-term neurologic disorders. A lingering neurological effect, such as a seizure problem or personality alterations, is present in 20% of individuals. Those who eventually recover relapse or get delayed onset encephalitis in a tiny percentage of cases.
Estimates for the case fatality rate range from 40% to 75%. Depending on local resources for clinical care and epidemiological surveillance, this rate may vary from epidemic to outbreak.
Nipah Treatment
Though WHO has designated Nipah as a priority illness for the WHO Research and Development Blueprint, there are presently no medications or vaccines that are specifically designed to treat Nipah virus infection. For the treatment of severe respiratory and neurologic problems, intensive supportive care is advised.
Nipah Prevention
preventing the Nipah virus in pigs
There are currently no vaccinations available to protect against the Nipah virus. Based on the knowledge gathered from the 1999 Nipah outbreak that affected pig farms, routine, thorough washing and disinfection of pig farms using suitable detergents may be useful in avoiding infection.
The location where the animals are kept should be promptly isolated if an epidemic is detected. To lessen the danger of transmission to humans, diseased animals may need to be killed, with the carcasses carefully buried or burned. The illness can be stopped from spreading by limiting or outlawing the transport of animals from contaminated farms to other locations.
Establishing an animal health/wildlife monitoring system, utilizing a One Health approach, to detect Nipah cases is crucial in order to provide early warning for veterinary and human public health authorities since Nipah virus epidemics have implicated pigs and/or fruit bats.
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