Following the death of two people from the uncommon and deadly brain-damaging viral disease Nipah, India's southern Kerala state has closed schools and offices and designated containment zones in sections of the state, raising the possibility of an epidemic of the virus.
In the aftermath of the virus's fourth outbreak since 2018, more than 130 people have been tested for it. During the 2018 outbreak, at least 21 people perished.
The state's health ministry set severe isolation measures on Wednesday.
What exactly is the Nipah virus?
According to the Centers for Disease Control and Prevention (CDC), the Nipah virus (NiV) was discovered in 1999 during an outbreak of the disease in pigs and humans in Malaysia and Singapore, which resulted in almost 300 human cases and over 100 deaths.
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| Staff members install a sign reading 'Nipah isolation ward, entry strictly prohibited' at a hospital where a ward is being prepared for suspected Nipah virus patients in Kozhikode district on September 12, 2023. [Stringer/Reuters] |
The epidemic had a significant economic impact because more than one million pigs were culled to help control the disease's spread.
Although there have been no further known outbreaks of NiV in Malaysia or Singapore since 1999, cases have been recorded virtually regularly in various parts of Asia since then, primarily in Bangladesh and India.
NiV is a zoonotic virus, which means it first transmits between animals and humans, according to a 2020 CDC statement. The fruit bat (genus Pteropus), often known as the flying fox, is an animal host reservoir for NiV.
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| A field lab assistant holds up a bat after catching it in a net to collect specimens for Nipah virus research in the Shuvarampur area of Faridpur, Bangladesh [File: Mohammad Ponir Hossain/Reuters] |
Fruit bats, pigs, and human-to-human contact (through saliva or urine) can all spread the virus. A spillover incident occurs when an animal infects a person, and once a person is infected, NiV can spread from person to person.
Human infections range from asymptomatic to acute respiratory infections (moderate to severe) and encephalitis (brain swelling), which can cause coma in as little as 24 hours. According to World Health Organization (WHO) data, encephalitis has a death rate of 40-75 percent.
Those who survive acute encephalitis can make a full recovery, although long-term neurologic problems such as seizure disorder and personality alterations have been observed in survivors. According to the WHO, a tiny minority of survivors "relapse or develop delayed onset encephalitis."
How may the Nipah virus be avoided?
There are currently no vaccinations available against the Nipah virus. Based on prior epidemic experience and information, systematic and thorough cleaning and disinfection of pig farms using proper detergents may be useful in preventing infection.
If an epidemic of animals is feared, the facilities should be quarantined promptly. According to the WHO, "culling of infected animals - with close supervision of burial or incineration of carcasses - may be necessary to reduce the risk of transmission to people."
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| Residents fix a sign reading ‘Nipah containment zone’ on a barricade to prevent the spread of Nipah virus in Ayanchery village in Kozhikode district, Kerala [Stringer/Reuters] |
In the absence of NiV-specific vaccines, raising knowledge about risk factors and educating about correct precautions, in addition to regular disease safety measures, is the only option to decrease or prevent infections between people.
The risk of international transmission through fruits or fruit products contaminated with fluids from diseased fruit bats can be reduced by carefully washing and peeling the food before eating. Fruit that has been bitten by a bat should be discarded.
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