Nipah Virus Bat with Seasonal Itch Dr Diva Singh DSM Centre Ba 2021 Thought for the Day The Single Biggest threat to mans continued dominance on the planet is the virus Josua ID: 917123
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Preventing Future Pandemics.Nipah Virus “Bat with Seasonal Itch”
Dr. Diva SinghDSM Centre Ba2021
Slide2Slide3Thought for the Day:
“The Single Biggest threat to man’s continued dominance on the planet is the virus” –Josua Lederberg
Slide4Emerging Infectious Diseases including zoonosesMajority Zoonoses are becoming human disease outbreaksOur Focus today will be on bats, particularly Fruit Bats.
Fun Facts:Bats are mammals that can flyHas no feathers but fur
Baby bats are born live (pups) and not hatched from eggs
Hence breastfed and not hunting for insects
A rare finding has also seen male Dayak Bats (fruit bats) lactating.
Slide5NiPAH Virus (NiV)
Barking Pig Syndrome Porcine Respiratory and Encephalitis SyndromePorcine Respiratory and Neurologic Syndrome
Slide6TABLE OF CONTENTS
Virus originationStructureTransmission
Incubation Period
Slide7OriginationNiV was first identified during an outbreak of disease that took place in Kampung Sungai Nipah, Malaysia in 1999 hence, the name originated from the village. On this occasion, pigs were the intermediate hosts. However, in subsequent NiV outbreaks, there were no intermediate hosts. In Bangladesh in 2004, humans became infected with NiV as a result of consuming date palm sap that had been contaminated by infected fruit bats. Human-to-human transmission has also been documented, including in a hospital setting in India.
Hence an outbreak in India in the past 2 months have caused deaths due to NiV.
Slide8Is the period between exposure to an infection and the appearance of the first symptoms.
Infection with
NIPAH virus
is associated with encephalitis (inflammation of the brain). After exposure and an incubation period of
4 to 18 days
, illness presents with fever and headache, followed by drowsiness, disorientation and mental confusion
Slide9Cycle of eventsFrom September 1998 to April 1999, human cases of febrile encephalitis with high mortality were reported by the Malaysian Ministry of Health. Initially Japanese encephalitis (JE) was suspected; however, serological tests and the disease epidemiology suggested a different disease. Tissue culture isolation from cases identified an unrecognized paramyxovirus closely related to Hendra virus. Nipah virus was named after the village (Sungai Nipah) where the first cases were reported
Slide10AgentGenus HenipavirusVirus discovered, 1999Related to Hendra virusSevere, rapidly progressive encephalitis in humans
High mortality rateClose contact with infected pigsSevere, respiratory disease in pigs
Slide11Hendra virus is a severe respiratory and encephalitic disease causing virus that affects humans and horses. In March 1999, a similar outbreak occurred in Singapore. The disease affected abattoir workers that had been exposed to pigs imported from Malaysia for slaughter. Since 2001, human outbreaks and clusters of cases have been reported periodically in Bangladesh and a neighboring region of northern India.
Slide12Flying foxes (fruit bats)Carry the virusAre not affected
Virus found inUrinePartially eaten fruit (saliva?)
No known secondary host
Slide13TRANSMISSION
Slide14Transmission of NiPAH virus to humans may occur after direct contact with infected bats, infected pigs, or from other NiV infected people.In Malaysia and Singapore, humans were apparently infected with NiPAH virus only through close contact with infected pigs. The NiPAH virus strain identified in this outbreak appeared to have been transmitted initially from bats to pigs, with subsequent spread within pig populations. Incidental human infections resulted after exposure to infected pigs.
Slide15Pigs in MalaysiaDirect contactContact with body fluidsAerosolization of respiratory or
urinary secretionsVertical transmission across the placenta?Semen
Slide16Person-to-personNot reported in MalaysiaLikely in Bangladesh and India
Nosocomial infectionsBat-to-person
Not reported in Malaysia
Common in Bangladesh and India
Contaminated fruit, unpasteurized date palm juice
Slide17No occurrence of person-to-person transmission was reported in this outbreak.Conversely, person-to-person transmission of Nipah virus in Bangladesh and India is regularly reported. This is most commonly seen in the family and caregivers of Nipah virus-infected patients. Transmission also occurs from direct exposure to infected bats. A common example is consumption of raw date palm sap contaminated with infectious bat excretions.
Slide18To determine the potential for person-to-person transmission in Malaysia, a survey of persons involved with case-patients was conducted. Family members, physicians, nurses, and pathologists who had direct contact with infected persons had no signs of illness or serological evidence of Nipah virus infection. Additionally, there was no serological evidence of human infection among bat handlers, although children who ate contaminated fruit did become sick in Bangladesh. Ingestion of virus in contaminated, unpasteurized date palm juice may have been the source of an outbreak in Bangladesh in 2005. Since 2001, human outbreaks and clusters of cases have been reported periodically in Bangladesh and a neighboring region of northern India. In some of these outbreaks, Nipah virus seems to have been transmitted directly from bats to humans, with person-to-person transmission the most significant means of spread. Humans can shed Nipah virus in upper respiratory secretions and urine. Nipah virus may be transmitted on fomites. Nipah virus survives in the environment for long periods in favorable conditions; it survives for days in fruit bat urine and contaminated fruit juice
Slide19Epidemiology1998-1999: Malaysia265 persons hospitalized; 105 deaths
Primarily adult males with swine contactDisease in swineSevere respiratory diseaseTransmitted by movement of infected pigs
1.1 million pigs selectively slaughtered
Great economic loss
Surveillance and testing
Center for Food Security and Public Health, Iowa State University, 2011
Slide20Epidemiology1999: Singapore22 seropositive persons (1.5%)
All were male abattoir workers12 symptomaticEncephalitis, pneumonia, or both10 asymptomatic
Center for Food Security and Public Health, Iowa State University, 2011
Slide21Epidemiology2001: Siliguri, IndiaNosocomial transmission
2004: Bangladesh34 cases; 26 deathsTransmission
Close contact
Exposure to common source
Slide22Slide23Human IllnessFever and headacheEncephalitisDizziness, drowsiness, vomiting SeizuresProgresses to coma in 24-48 hours
Respiratory difficultyRelapsing neurologic symptoms
Slide24Human IllnessComplications (Malaysian outbreak)Septicemia (24%)
GI bleeding (5%)Renal impairment (4%)AsymptomaticRelapse or late-onset encephalitis
Residual neurological deficits
Treatment: Supportive, ribavirin
Slide25Sampling
Before collecting or sending any samples, the proper authorities should be contacted
Samples should only be sent under secure conditions and to authorized laboratories to prevent the spread of the disease
Slide26Diagnosis
Differentials for swine
Classical swine fever, PRRS, pseudorabies, swine enzootic pneumonia, porcine pleuropneumonia
Diagnostic tests
ELISA
Immunohistochemistry
Virus isolation
Slide27Prevention and Control of Such PandemicsKeep fruit bats away from pigs or any domesticated animals.Do not drink unpasteurized fruit juicesWash, peel, and/or cook all fruit thoroughly before eatingWashing hands thoroughlyProper personal gears when visiting abattoirs
Center for Food Security and Public Health, Iowa State University, 2011
Slide28NiPAH as a
Biological WeaponCDC Category C Bioterrorism AgentEmerging pathogen
Potentially high morbidity
and mortality
Major health impact
Aerosolization potential
Economic impact
Social disruption (fear, panic)
Slide29In Conclusion
NiV was on its way into the history books as an emerging pandemic but it was identified and contained, however, its Covid and its various mutated forms that showed the world what its like living in a crisis created by human beings themselves. We need to work together as a team to identify the break of chain
before we as decedents of neanderthal take a bow in to historic oblivion.
Slide30Slide31ReferenceMorin, B., Rahmeh, A.A. & Whelan, S.P. Mechanism of RNA synthesis initiation by the vesicular stomatitis virus polymerase.
EMBO J. 31, 1320–1329 (2012).Communie
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et al.
Atomic resolution description of the interaction between the nucleoprotein and phosphoprotein of Hendra virus
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PLoS
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Mounts AW, Kaur H, Parashar UD, et al. A cohort study of health care workers to assess nosocomial transmissibility of Nipah virus, Malaysia, 1999.
Journal of Infectious Disease
2019.
Wong KT, Shieh WJ, Kumar S, et al. Nipah virus infection. Pathology and pathogenesis of an emerging paramyxoviral zoonosis.
American Journal of Pathology
2019.
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