Friday, February 04, 2011

Bangladesh: Mystery Fever Identified As Nipah

 

 

Note:  I’ll be away from my desk for much of the next two days, although I’ll endeavor to check in when I can.

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# 5288

 

 

Over the past two days reports of a `mystery fever’ that has claimed as many as 19 lives in Bangladesh's Hatibandha sub-district of Lalmonirhat district have been coming across the news wires.


Initially, some type of encephalitis was suspected, but now authorities reportedly believe they’ve identified the Nipah virus as the culprit.

 


Nipah virus electron micrograph

Nipah virus electron micrograph  Image courtesy of C.S. Goldsmith and P.E. Rollin (CDC), and K.B. Chua (Malaysia). (From CDC  Nipah Fact Sheet).

 

You can follow the progression of this story on FluTrackers over the past couple of days in this thread.

 

This morning Shiloh has this report from bdnews24.com.

 

 

BREAKING NEWS


Killer virus identified as Nipah

Fri, Feb 4th, 2011 5:33 pm BdST

Dhaka, Feb 4 (bdnews24.com) — The virus that has taken 14 lives in Hatibandha of Lalmonirhaat has been identified as the Nipah virus.

 

Locals claim the death toll was 19.

 

Institute of Epidemiology Diseases Control and Research (IEDCR) director Mahmudur Rahman told reporters on Friday afternoon that tests had confirmed the virus was Nipah.

 

IEDCR advised against drinking raw date juice to avoid infection.

  

Unknown until 1998, Nipah appears to be carried by certain species of fruit bats that are distributed across portions of of Australia, Indonesia, Malaysia, and the Philippines islands.  While the bats are the natural host for this virus (along with another variant called the Hendra Virus), they are unaffected by it.

 

The bats are believed to transmit the virus, via their saliva or other fluids, to pigs (Nipah) or horses (Hendra).  From there, the virus has found its way into the human population.

 

The Nipah virus was first detected in Malaysia in 1998, where it infected 250 people and claimed 100 lives.   The most common vector appeared to be from pigs to humans.  Over 1 million pigs were culled in Malaysia to control that outbreak.

 

The World Health Organization has this to say about the human-to-human transmission of the Nipah Virus.

 

Transmission

During the initial outbreaks in Malaysia and Singapore, most human infections resulted from direct contact with sick pigs or their contaminated tissues. Transmission is thought to have occurred via respiratory droplets, contact with throat or nasal secretions from the pigs, or contact with the tissue of a sick animal.

 

In the Bangladesh and India outbreaks, consumption of fruits or fruit products (e.g. raw date palm juice) contaminated with urine or saliva from infected fruit bats was the most likely source of infection.

 

During the later outbreaks in Bangladesh and India, Nipah virus spread directly from human-to-human through close contact with people's secretions and excretions. In Siliguri, India, transmission of the virus was also reported within a health-care setting, where 75% of cases occurred among hospital staff or visitors. From 2001 to 2008, around half of reported cases in Bangladesh were due to human-to-human transmission.

 

Reducing the risk of infection in people

In the absence of a vaccine, the only way to reduce infection in people is by raising awareness of the risk factors and educating people about the measures they can take to reduce exposure to the virus.

 

Public health educational messages should focus on the following.

  • Reducing the risk of bat-to-human transmission. Efforts to prevent transmission should first focus on decreasing bat access to date palm sap. Freshly collected date palm juice should also be boiled and fruits should be thoroughly washed and peeled before consumption.
  • Reducing the risk of human-to-human transmission. Close physical contact with Nipah virus-infected people should be avoided. Gloves and protective equipment should be worn when taking care of ill people. Regular hand washing should be carried out after caring for or visiting sick people.
  • Reducing the risk of animal-to-human transmission. Gloves and other protective clothing should be worn while handling sick animals or their tissues, and during slaughtering and culling procedures.

 

 

While the Nipah Virus may not pose anywhere near as great of a threat to the world as a pandemic influenza, it does point out the need for increased surveillance and improved public health programs around the world.

 

We ignore these emerging diseases, at our peril.  For once they establish themselves, they can quickly spread out of control.

 

And the next zoonotic disease to emerge may be a lot harder to deal with than the Nipah virus.