Napah

  

Nipah Virus

What is Nipah Virus?

Nipah Virus (NiV) is an emerging infectious disease which first appeared in domestic pigs in Malaysia and Singapore in 1998 and 1999.

There is evidence of Nipah infection among several species of domestic animals including dogs, cats, goats, and horses. Sheep may also be affected. However, since the initial outbreak it has primarily affected humans in different parts of the world.

The disease causes respiratory and occasionally nervous signs in pigs. It has devastating zoonotic potential.

The organism which causes Nipah Virus encephalitis is an RNA virus of the family Paramyxoviridae, genus Henipavirus, and is closely related to Hendra virus. Hendra virus, formerly known as equine morbillivirus pneumonia or acute equine respiratory syndrome, is an acute, viral respiratory infection of horses and humans that has been reported in Australia.

Nipah Virus infection, also known as Nipah Virus encephalitis, was first isolated and described in 1999. The name, Nipah, is derived from the village in Malaysia where the person from whom the virus was first isolated succumbed to the disease.

Nipah Virus is a disease listed in the World Organisation for Animal Health (OIE) Terrestrial Animal Health Code and must be reported to the OIE (OIE Terrestrial Animal Health Code). Hendra virus is not yet an OIE listed reportable disease.

   

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General Disease Information Sheets

    

Where is the disease found?

There have been Nipah Virus infection outbreaks in pigs Malaysia and Singapore, and human disease in Malaysia, Singapore, India, and Bangladesh. Evidence of the virus without clinical disease has also been found in fruit bats in Cambodia, Thailand and Madagascar.

How is Nipah transmitted and spread?

Fruit bats, also known as‘flying foxes,’ of the genus Pteropus are natural reservoir hosts of the Nipah and Hendra viruses. The virus is present in bat urine and potentially, bat feces, saliva, and birthing fluids. Perhaps as a result of deforestation programmes, the Malaysian pig farms where the disease first originated had fruit trees which attracted the bats from the tropical forest, thus exposing domestic pigs to bat urine and feces. It is thought that these excretions and secretions initiated the infection in pigs which was then followed by a rapid spread through intensively reared pigs. Furthermore, transmission between farms may be due to fomites – or carrying the virus on clothing, equipment, boots, vehicles, etc.

What is the public health risk

associated with this disease?

Nipah Virus is a zoonotic disease. Transmission to humans in Malaysia and Singapore has almost always been from direct, contact with the excretions or secretions of infected pigs. Reports from outbreaks in Bangladesh suggest transmission from bats without an intermediate host by drinking raw palm sap contaminated with bat excrement, or climbing trees coated in bat excrement.

In Bangladesh and India, there have been reports of possible human-to-human transmission of the disease so precautions are necessary for hospital workers caring for infected patients. Precautions should also be taken when submitting and handling laboratory samples, as well as in slaughterhouses.

Typically the human infection presents as an encephalitic syndrome marked by fever, headache, drowsiness, disorientation, mental confusion, coma, and potentially death. During the outbreak in Malaysia, up to 50% of clinically apparent human cases died. There is no specific treatment for Nipah Virus. Supportive care is the general treatment for this disease.

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General Disease Information Sheets

 

What are the clinical

signs of Nipah Virus?

Nipah Virus in pigs affects the respiratory and nervous systems. It is known as porcine respiratory and neurologic syndrome, porcine respiratory and encephalitic syndrome (PRES), and barking pig syndrome (BPS). It is a highly contagious disease in pigs; however the clinical signs vary depending on the age and the individual animal’s response to the virus. In general, mortality (death due to the disease) is low except in piglets. However, morbidity (illness from the disease) is high in all age groups.

Most pigs develop a febrile respiratory disease with a severe cough and difficulty breathing. While the respiratory signs predominate, encephalitis has been described, particularly in sows and boars, with nervous signs including twitching, trembling, muscle fasciculation, spasms, muscle weakness, convulsions, and death. Some animals, however, remain asymptomatic.

Natural infection of dogs with NiV causes a distemper- like syndrome with a high mortality (death) rate.

How is the disease diagnosed?

The disease is difficult to diagnose based on clinical signs alone, however confirmation can be made through prescribed laboratory tests (OIE Manual of Diagnostic Tests and Vaccines for Terrestrial Animals).

     

Nipah Virus

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Nipah Virus

    

What is being done to prevent

or control this disease?

Prevention and control measures focus on immediate eradication by mass culling of infected and in-contact pigs and on antibody surveillance of high risk farms to prevent future outbreaks.

After culling, the burial sites are disinfected with chlorinated lime. It is also recommended to use sodium hypochlorite (bleach) to disinfect the contaminated areas and equipment. Other important control measures have been a ban on transporting pigs within the countries affected, a temporary ban on pig production in the regions affected, as well as improvement of biosecurity practices. Education and use of personal protective equipment (PPE) by persons exposed to potentially infected pigs is highly recommended. Also, improved hygiene at pig operations is suggested.

One of the most important biosecurity measures for affected areas is to decrease the likelihood of the bat reservoir coming into contact with pig productionfacilities.

Research into development of vaccines has been ongoing in Australia and France.

       Kozhikode/Thiruvananthapuram: With several deaths caused by the outbreak of  Nipah virus (NiV) in Kozhikode in Kerala, a statewide alert has been given to remain vigilant. Kozhikode district collector told news agency ANI on Monday that the death toll due to the Nipah virus outbreak has reached six. On Sunday (May 20, 2018), the National Institute of Virology, Pune, confirmed the presence of Nipah virus in three samples that were already sent to the institute. Meanwhile, Kerala Health Secretary Rajiv Sadanandan asked people not to panic and said that it can be managed, adding the government has already started their work towards fever deaths. He added there was a similar issue in Bangladesh and it has been managed well.

  

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According to the World Health Organisation (WHO), Nipah virus (NiV) is a newly emerging zoonosis that causes severe disease in both animals and humans. The Nipah virus, also known as Nipah Virus encephalitis, was first identified in Malaysia and Singapore in 1998-1999, when it caused disease in pigs and humans. During the 1998-99 outbreak, the virus affected 265 people and about 40 percent of those patients who were hospitalized with the severe nervous disease died from the infection.

What causes Nipah virus? How does it spread?

The organism which causes Nipah Virus encephalitis is an RNA virus of the family

Paramyxoviridae, genus Henipavirus. NiV is closely related to Hendra virus, which is an acute, viral respiratory infection of horses and humans that have been reported in Australia.

The disease spreads through fruit bats, also known as‘fl ying foxes,’ of the genus Pteropus – natural reservoir hosts of the Nipah and Hendra viruses. Transmission of the virus to humans takes place via direct contact with infected bats, infected pigs, or from other NiV infected people.

Humans were apparently infected with Nipah virus only through close contact with infected pigs during the 1998-99 outbreak in Malaysia and Singapore. However, in 2004, humans became infected with NiV after consuming date palm sap that had been contaminated by infected fruit bats. Human-to-human transmission of NiV has been reported in Bangladesh and India.

What are the signs and symptoms of Nipah virus?

Basically, NiV infection in humans is linked to encephalitis – inflammation of the brain- characterized by fever, headache, drowsiness, disorientation, mental confusion, coma, and potentially death. According to the CDC, symptoms can progress to coma within 24-48 hours. In some cases, patients may develop a respiratory illness during the early part of their infections.

How is Nipah virus treated? Is there a cure for NiV?

In humans, the primary treatment for Nipah virus is intensive supportive care. The drug ribavirin has been shown to be effective against the viruses in vitro. However, the clinical efficacy of ribavirin remains inconclusive to date in human trials.

Unfortunately, there is no specific NiV treatment or a vaccine for either humans or animals.

How can you prevent getting Nipah virus infection?

Since human-to-human transmission of Nipah virus has been documented, standard infection control practices are important in preventing the spread of the disease. Health workers should take proper precautionary measures when caring for infected patients or handling and submitting laboratory samples to avoid hospital-acquired infections.

Avoiding exposure to sick pigs and bats in endemic areas, not drinking raw date palm sap, and not consume fruits that have fallen on to the ground can help prevent Nipah virus infection.

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More Information?

References:

1. OIE Terrestrial Animal Health Code:
http://www.oie.int/en/international- standard-setting/terrestrial-code/ access-online/

2. OIE Manual of Diagnostic Tests and Vaccines for Terrestrial Animal: http://www.oie.int/en/international- standard-setting/ terrestrial-manual/access-online/

3. OIE Technical Disease Card:
http://www.oie.int/en/animal- health-in-the-world/ technical-disease-cards/

4. The Center for Food Security and Public Health, Iowa State University http://www.cfsph.iastate.edu/

5. Merck Veterinary Manual:
http://www.merckvetmanual.com/ mvm/index.jsp?cfile=htm/bc/ toc_50000.htm

6. Atlas of Transboundary Animal Diseases Animales Transfronterizas
P. Fernandez, W. White; Ed.: 2011

Ask our experts:

List of Reference Laboratories:

http://www.oie.int/en/our-scientific- expertise/reference-laboratories/ list-of-laboratories/

List of Collaborating Centres:

http://www.oie.int/en/our-scientific- expertise/collaborating-centres/ list-of-centres/

       

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General Disease Information Sheets

 

Key Facts

• Many of the original human cases of the Nipah Virus disease were provisionally diagnosed as Japanese encephalitis (JE) before the isolation and identification of the newly discovered Nipah Virus.

• Perhaps as a result of deforestation programmes, many of the Malaysian farms first affected had fruit trees close to where the pigs were housed which attracted the bats and ultimately increased the exposure of the pigs to bat excretions containing the virus.

• In the 1998-1999 outbreaks of Malaysia and Singapore, over 1 million pigs were destroyed to control the disease, causing devastating economic and social consequences.

• Human cases occurred in Bangladesh and India in 2003, 2004, 2007, 2008 without apparent related domestic animal outbreaks.

• 12, rue de prony • 75017 paris france
• tel. 33 (0)1 44 15 18 88 – fax 33 (0)1 42 67 09 87 • http://www.oie.intoie@oie.int

Cover photo: © G.Cattiau INRA. Inside photos: © N.Denormandie OIE,

© F.Carreras INRA, © M.meuret INRA.

       

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