Nipah viral infection

Nipah virus

• Nipah is a zoonotic virus that has emerged in the Asia-

Pacific region.
• It is a RNA virus belonging to the Paramyxoviridae family
and under the genus Henipavirus,
Outbreaks

• Nipah virus was first discovered when it caused a viral

encephalitis outbreak among pig farmers in Malaysia.
• The virus was named after a village in Malaysia, where
the infected patient lived.
• Since then, there have been multiple outbreaks of acute
Nipah encephalitis in various districts in Bangladesh, in
the neighboring district of Siliguri in India, and in the
Southern Philippines.
• In May 2018, an outbreak was reported in Kerala state.
Animal reservoirs

• Animal reservoirs — The primary animal reservoirs of

henipaviruses are bats of the genus Pteropus
• Fruit bats of the Pteropodidae family are the natural host
of Nipah virus.
• Outbreaks of the Nipah virus in pigs and other domestic
animals such as horses, goats, sheep, cats and dogs
were first reported during the initial Malaysian outbreak in
1999.
• The virus is highly contagious in pigs.
Human infections

• Human infection results from two mechanisms; either

through direct bat-to-human transmission or through
indirect transmission from bats through an intermediate
animal host(pigs). Human-to-human transmission can
also occur.
• The incubation period ranges from 7 to 40 days.
Clinical features
• Nipah virus causes primarily an encephalitic syndrome
with a high mortality rate of approximately 30-
70%. Respiratory symptoms and abnormal chest
radiographs have also been seen in some patients.
• Infected people initially develop symptoms including fever,
headaches, myalgia, vomiting and sore throat. This can
be followed by dizziness, drowsiness, altered
consciousness, and neurological signs that indicate acute
encephalitis. Some people can also experience atypical
pneumonia and severe respiratory problems, including
acute respiratory distress.
Diagnosis

• Diagnosis: IgM ELISA and an indirect IgG ELISA or PCR

Treatment

• Treatment is limited to supportive care. Because Nipah

virus encephalitis can be transmitted person-to-person,
standard infection control practices and proper barrier
nursing techniques are important in preventing hospital-
acquired infections
Ribavirin

• The drug Ribavirin (1,000 mg daily in 2 divided doses)

has been shown to be effective against the viruses in vitro,
but human investigations to date have been inconclusive
and the clinical usefulness of ribavirin remains uncertain.
Any Immunisation????

• Passive immunization using a human monoclonal

antibody targeting the Nipah G glycoprotein has been
evaluated in the post-exposure therapy in the ferret model
and found to be of benefit.