Nipah Virus Infection

Abstract

Nipah virus, a paramyxovirus related to Hendra virus, first emerged in Malaysia in 1998. Clinical presentation ranges from asymptomatic infection to fatal encephalitis. Malaysia has had no more cases since 1999, but outbreaks continue to occur in Bangladesh and India. In the Malaysia-Singapore outbreak, transmission occurred primarily through contact with pigs, whereas in Bangladesh and India, it is associated with ingestion of contaminated date palm sap and human-to-human transmission. Bats are the main reservoir for this virus, which can cause disease in humans and animals. There are currently no effective therapeutics, and supportive care and prevention are the mainstays of management.

Antivirals in medical biodefense

“…Hendra (HeV) and Nipah (NiV) viruses, in the genus Henipavirus, are considered zoonotic agents in Australia (horses) and South-East Asia (pigs), respectively. Both viruses may be able to infect other domesticated mammals, and there is a real concern in the veterinary and biodefense communities about spill-over infections and the high fatality rate in humans (632 human NiVcases: 59% case fatality [7,131]. Henipaviruses have so far not caused global epidemics, but due to a high percentage of severe outcomes, as well as lack of vaccines or treatments, HeV and NiV are designated biosafety level (BSL-4) agents [106].…”

“…Broad-spectrum antivirals on the other hand show significant activity against several members of the same or distinct virus families, allowing the empirical treatment of severe viral infections prior to positive diagnosis of the viral agent. Leading examples are at his point the pyrazinecarboxamide compounds T-705 (favipiravir; [2,7,48]), T-1105 and T-1106, which are broad-spectrum viral RNA polymerase inhibitors, initially developed for the treatment of influenza virus, and found effective against bunyaviruses [21,54,59], alphaviruses [1], filoviruses [13] arenaviruses [125], paramyxoviruses [29], and flaviviruses [128]. A favipiravir resistance mechanism in influenza virus has been described [52].…”

Nipah Virus: A Hidden and Continuous Threat to Humankind

“…Similar vasculitis lesions were also seen in other organs like respiratory tract, heart and kidneys. Vasculitis in Nipah virus infection commonly involved small and medium sized vessels resulting into endothelial multinucleated syncytia formation and fibrinoid necrosis (30) . Diagnosis Nipah virus is highly pathogenic and thus for isolation and propagation, Biosafety Level-4 containment is needed (10) .…”

“…WHO has declared Nipah virus to be a priority pathogen, and pharmaceutical companies may be funded to carry out trials in underdeveloped countries where affording medication and vaccination is a troublesome task. Coalition for Epidemic Preparedness Innovations (CEPI) an International coalition of governments and pharmaceutical companies was formed in January 2017 to develop safe, effective and affordable vaccines for diseases with pandemic potential including Nipah virus (30) .…”

A Pictogram of Nipah Virus Infection and Treatment

“…1 Nipah virus is naturally harboured in fruit eating pteropid bats and is reported to cause neurological and respiratory disease in pigs, horses and humans. NIV infection is prevalent in the south Asian region.…”