Update On Nipah Virus

With the Nipah Virus (NiV) scare giving jitters to people in Kerala, the district administration here has advised people not to panic.

There were no fruit bats in the city, through which the virus transmits into humans, officials said, adding that another primary source of transmitting the virus were pigs, which were also in less numbers in the city.However, District Medical and Health Officer K Padmaja has cautioned people from eating fruits having bite marks. The virus transmits into humans if anyone eats a fruit bitten by a bat.“If anyone intends to buy fruits, then make sure that fruits do not have bite marks,” she said, adding that people should also stay away from places where pigs roam around.

Padmaja suggested that people should maintain hygiene and that there was no need to be worried about the virus. The Health Department officials were also taking the assistance of the National Institute of Virology, Pune to gather more information about the virus and the steps to be taken to contain it from spreading.Senior Regional Director (Regional Office for Health and Family Welfare) and Airport Health Organisation Chief Medoju Anuradha said no alert was sounded at the Rajiv Gandhi International Airport (RGIA) in Shamshabad so far as the problem was confined to Kerala.An international warning too was not given after the reporting of the virus. “There is no need to panic and the Centre is taking necessary precautionary measures to tackle the situation,” she added.

All about the infectionAll about the infection

• NiV is an emerging infectious disease of public health importance in South East Asia region

• NiV has infected 477 people and killed 252 since 1998

• Outbreak of Nipah in South Asia has a strong seasonal pattern and limited geographical range

• Case fatality rate of NiV ranges from 40 to 70 per cent although it has been as high as 100 per cent in some outbreaks

• The virus is named after a Malaysian village where it was first discovered

The first outbreak of NiV in Siliguri, eastern India in the year 2001, had triggered a scare among the public because of the clustering of deaths in space and time.Cases and deaths among doctors and healthcare providers, and rumours of it being a pneumonic plague or some unknown disease with no clue to diagnosis and treatment resulted in a panic situation with scores of people leaving the town.According to a practice handbook on NiV, ‘Surveillance, Prevention and Control of Nipah Virus Infection’, person-to-person transmission, which was not reported in earlier NiV outbreaks in Malaysia and Singapore, was apparent in the Siliguri outbreak. For this reason, NiV was not considered in the differential diagnosis.The lesson is that in an outbreak of unknown aetiology, care has to be taken before excluding newer pathogens as possible aetiological agents. Also, laboratory confirmation may not be forthcoming early in such outbreaks.

There is an urgent need to strengthen epidemiological investigation capabilities so that possible modes of transmission and the reservoir of infection can be identified and appropriate control measures instituted in a timely manner. The Siliguri outbreak highlighted the importance and urgency of establishing a strong surveillance system supported by a network of state-of-the-art laboratories.

Health Minister C Laxma Reddy on Tuesday said that the Health Department was in touch with the National Centre for Disease Control (NCDC) in New Delhi and Manipal Centre for Virology and Research (MCVR) as the State does not have kits and trained staff for conducting medical tests for Nipah, if needed.Arrangements have been made to set up separate isolation wards with over eight beds at Osmania General Hospital and Gandhi Hospital in the city and Mahatma Gandhi Memorial hospital in Warangal. The department is also making efforts to collect samples related to blood, urine and cerebrospinal fluid as a precautionary measure to prevent the virus.The Minister said instructions have been issued to officials to be on alert in the wake the outbreak of the virus in Kerala.