What is the Nipah virus? What to know as India tackles fresh outbreak

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A 12-year-old boy died of the Nipah virus in the Indian state of Kerala on Sunday, Sept. 5, 2021, sparking fears of a fresh health crisis in a country that has already lost more than 441,000 lives to the coronavirus pandemic.

At least two health workers have since tested positive for the infection, and authorities are working to trace the boy’s contacts, in a bid to prevent the spread of a disease that is deadlier than covid-19.

Nipah disease – which the World Health Organization has listed as a priority disease given its epidemic potential – is garnering interest in a country that has long grappled with the coronavirus pandemic. After the United States, India has the second-highest death toll in the world and has seen its health care system crumble amid severe outbreaks of new variants.

“As of now, there is no need to panic, but we need to exercise caution,” Veena George, the health minister of Kerala, said according to local media, while Minister of Health Mansukh Mandaviya said a team from the National Centre for Disease Control had been deployed to the area to offer assistance.

– When was Nipah virus discovered and how does it spread?

Nipah virus (NiV) was first discovered during an outbreak among pig farmers in Malaysia in 1999. The workers are thought to have contracted the virus through infected livestock and their secretions.

Fruit bats, which are also known as “flying foxes,” are the natural host of the Nipah virus, according to the World Health Organization. The virus can be transmitted from animals to humans – primarily from bats or pigs – or through human to human contact.

The fruit bats, from the Pteropodidae family, often live in date trees near markets, and the virus has spread from bats to humans through food items – such as fruit and raw date palm juice – that were contaminated by infected bats.

A range of domestic animals from horses to cats and dogs are also able to catch and spread the infection but the virus is considered highly contagious among pigs, who can pass the virus on to humans who come into contact with their bodily fluids or tissue.

The deadly infection can also be transmitted through close human to human contact – the virus can spread from those infected, to their family or carers, through the person’s bodily fluids.

In 2018, India grappled with an outbreak that killed 17 of the 19 people diagnosed with the virus. In 2019, a new case was recorded in the country, but swift action and widespread contact tracing prevented further spread.

– What are the symptoms?

Symptoms of the disease are wide-ranging. Milder symptoms include fever and headaches, vomiting, sore throat and muscle aches.

In severe cases, patients can experience acute infections such as encephalitis (inflammation of the brain) and respiratory issues. Other reported side effects include seizures which may lead to a coma and personality changes.

As with covid-19, some who contract the virus remain asymptomatic.

– How widespread is Nipah virus?

In the decades since it was first detected, outbreaks have also been recorded in many Southeast Asian countries such as Singapore, Bangladesh and India.

In some parts of Asia new cases of the Nipah virus have been recorded “almost annually,” according to the Centers for Disease Control and Prevention.

– Is the Nipah virus more deadly than the coronavirus?

The WHO estimates that the Nipah virus fatality rate is high – between 40 and 75 percent – which makes it far deadlier than covid-19, which has a mortality rate of between 0.1 percent and 19 percent, depending on the country.

However, while the chances of dying from Nipah virus once being diagnosed are high, the infection is far less transmissible than covid-19.

– How is it diagnosed, and is there a cure or vaccine?

Health experts worry that unlike the coronavirus, awareness of the Nipah virus remains extremely low, making it harder to prevent, treat and diagnose. Due to a lack of knowledge, the virus is not always suspected in patients displaying symptoms.

PCR tests using samples of bodily fluids are mainly used to diagnose the virus, along with antibody detection methods.

There is no certain cure for the Nipah virus and there is not currently a vaccine that can help to prevent infection.

According to the WHO and CDC, the main treatment available is supportive care – that is, managing the symptoms, and ensuring those infected have as much rest, and hydration, as possible.

Close unprotected physical contact with Nipah virus-infected people should be avoided. Regular hand washing should be carried out after caring for or visiting sick people.

Ways to prevent animal to human infections include avoiding foods contaminated by fruit bats – or washing and peeling fruits that could be affected – and avoiding unprotected contact with infected bats or pigs.

The CDC recommends people living in areas where outbreaks have occurred to regularly wash their hands with soap and water, and avoid contacting the bodily fluids or blood of those infected.