Nipah virus disease: A rare and intractable disease

Abstract

Nipah virus, an enveloped ribonucleic acid virus, has been a major cause of encephalitis outbreaks with high mortality, primarily in the Indo-Bangladesh regions. Except for the first outbreak in Malaysia-Singapore, which was related to contact with pigs and the outbreak in Philippines associated with horse slaughter, most other outbreaks have affected the Indo-Bangladesh regions. The Indo-Bangladesh outbreaks were associated with consumption of raw date palm sap contaminated by fruit bats and had a very high secondary attack rate. The patient usually presents with fever, encephalitis and/or respiratory involvement with or without thrombocytopenia, leukopenia and transaminitis. Diagnosis can be confirmed by isolation and nucleic acid amplification in the acute phase or antibody detection during the convalescent phase. Treatment is mostly limited to supportive care and syndromic management of acute encephalitis syndrome. Ribavirin, m102.4 monoclonal antibody and favipiravir are the only anti-virals with some activity against Nipah virus. Standard precautions, hand hygiene and personal protective equipments are the cornerstone of comprehensive infection prevention and control strategy. With the recent outbreaks affecting newer geographical areas, there is a need for physicians to be aware of this disease and keep abreast of its current detection and management strategies.

Nipah Virus: Past Outbreaks and Future Containment

“…Pteropus fruit bats are considered the natural reservoirs of the virus [5,6]. NiV was discovered in 1998 during the first reported outbreak in the Sungai Nipah, a village in Malaysia, where humans contracted NiV from pigs, the intermediate hosts of the virus [7,8]. Recurring NiV outbreaks have been reported annually in different parts of Bangladesh from 2001, where the infection occurred due to the consumption of raw date palm sap contaminated with saliva and excreta of the bats.…”

“…Recurring NiV outbreaks have been reported annually in different parts of Bangladesh from 2001, where the infection occurred due to the consumption of raw date palm sap contaminated with saliva and excreta of the bats. In India, the first outbreak occurred in Siliguri, West Bengal in 2001 with mostly nosocomial or person-to-person close contact, and in 2007, a repeated outbreak was reported in Nadia in West Bengal [7,9]. Recently, in 2018, a NiV outbreak was recorded in the Kozhikode district of Kerala, a South Indian state where the index patient was reported to have contracted NiV from fruit-eating bats.…”

Structure-Based Design of Nipah Virus Vaccines: A Generalizable Approach to Paramyxovirus Immunogen Development

“…The Malaysian strain of NiV is primarily encephalitic with no documented cases of human-to-human transmission (10). Since its emergence, NiV has reappeared almost annually in outbreaks in Bangladesh and India often associated with a high mortality rate (60-70%) (11)(12)(13)(14)(15)(16)(17). While most cases have zoonotic exposures, the Bangladesh strain of NiV can also spread human-to-human by the respiratory route (12,(18)(19)(20)(21)(22), infection can be neurotropic, and patients often develop encephalitis (8,15,(23)(24)(25)(26).…”

Interactions of the Nipah Virus P, V, and W Proteins across the STAT Family of Transcription Factors

“…Nipah virus (NiV) is a member of the Henipavirus genus in the Paramyxoviridae family. A zoonotic pathogen, NiV has been responsible for one major outbreak and a series of smaller outbreaks over the last 20 years ( 1 – 3 ). NiV infection presents with respiratory and neurological symptoms, in which encephalic symptoms can persist long term after initial infection clears ( 4 ).…”