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Now people are worried about Nipah Virus (NiV) that is killing people in Southern India. And they are asking several worried questions. So here we go again to educate people, even though not much information is available, and protect them...

Nipah Virus was first identified during an outbreak of disease that took place in Kampung Sungai Nipah, Malaysia in 1998. Then, pigs were the intermediate hosts. Later in subsequent NiV outbreaks, there were no intermediate hosts. In Bangladesh in 2004, humans became infected with NiV as a result of consuming date palm sap that had been contaminated by infected fruit bats. Human-to-human transmission has also been documented in India since then. 

 Nipah virus (NiV) infection is a zoonosis (a disease which can be transmitted to humans from animals)

that causes severe disease in both animals and humans and has a very high fatality rate. The natural host of the virus are fruit bats of the Pteropodidae Family, Pteropus genus. However, some biologists dispute this. As it is a newly emerging infection, confusion still persists about details and there are neither  vaccines, nor cure for this disease. 

Nipah Virus is an airborne transmission infection and can affect those who come in direct contact with contaminated patients and dead bodies.

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. Nipah-case patients who had breathing difficulty are more likely than those without respiratory illness to transmit the virus.

Nipah and its viral cousin Hendra latch onto a proteins called ephrin-B2 and ephrin-B3  on the surface of nerve cells and the endothelial cells lining blood and lymph vessels, researchers have found. Nipah can also invade lung and kidney cells.

Virologists who have studied Nipah’s behavior in animals think that in humans, it initially targets the respiratory system before spreading to the nervous system and brain. Most patients who die succumb to an inflammation of blood vessels and a swelling of the brain that occurs in the later stages of the disease. 

The two known Nipah strains currently circulating aren’t all that easy to transmit.

While the mortality rate for those infected can be high, infection is not all that common. Before this latest outbreak, about 300 deaths had been linked to Nipah, most of which occurred in Southeast Asia and Bangladesh. But the actual number could be higher with some cases going untested or unreported. Because the symptoms of Nipah infection are similar to those for other diseases, including encephalitis and the flu, cases may be misdiagnosed. India has only two main diagnostic laboratories, both in the central city of Pune, equipped to confirm Nipah infection. 

“In order for a disease to spread globally, each person has to infect at least more than one person,” according to experts. But a person with Nipah tends to infect either zero or one other person, according to a 2009 study published online by the U.S. Centers for Disease Control and Prevention. By comparison, a person with measles can infect on average 10 others who aren’t vaccinated. And people who caught Ebola during the 2014 outbreak in West Africa tended to pass it on to between one and three others, PLOS Current Outbreaks reported in 2014.

Prevention of Nipah virus infection is important since there is no effective treatment for the disease.

People should stop eating 'damaged or bird or bat-bitten fruits'. Stop drinking toddy sap. Stop visiting places where the disease is highly prevalent. 

The only way to treat this virus is through intensive supportive care. The infection can be prevented by avoiding exposure to bats in endemic areas and sick pigs. Drinking of raw palm toddy contaminated by bat excrete, eating of fruits partially consumed by bats and using water from wells infested by bats  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. If you suspect something dangerous, go for immediate testing. 

 Surveillance and awareness are important for preventing outbreaks. The association of this disease within reproductive cycle of bats is not well studied. Standard infection control practices should be enforced to prevent infections of the respiratory track. 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.

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 (1).

Citations:

1.  Luby, Stephen P.; Gurley, Emily S.; Hossain, M. Jahangir (2012). TRANSMISSION OF HUMAN INFECTION WITH NIPAH VIRUS. National Academies Press (US). Archivedfrom the original on 22 May 2018. Retrieved 21 May 2018.

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