Nipah virus in Kerala: Symptoms and prevention tips you need to be aware of

Nipah virus has been found in the Kozhikode district of Kerala again. This is the third time the virus has been spotted in the district since 2018. 4 cases of the contagious viral infection has been confirmed in the state. Two deaths, which were said to be unnatural, have been due to Nipah virus. Among the infected ones are a nine year old kid, and a 25 year old male. 49 year old Kallat Mohammedali is said to be the index case of the outbreak, reports have said.

The World Health Organisation (WHO) defines nipah infection as a zoonotic illness that is transmitted to people from animals, and can also be transmitted through contaminated food or directly from person-to-person. The first recognised outbreak of Nipah was in Malaysia in which human infections resulted from direct contact with sick pigs or their contaminated tissues. "In subsequent outbreaks in Bangladesh and India, consumption of fruits or fruit products (such as raw date palm juice) contaminated with urine or saliva from infected fruit bats was the most likely source of infection," the WHO says.

Infected people have fever, headaches, myalgia, vomiting and sore throat. People also complain of dizziness, drowsiness, altered consciousness, and neurological signs that indicate acute encephalitis. The incubation period is 4 to 14 days, mostly.

"Most people make a full recovery, although some are left with residual neurological conditions after acute encephalitis. Some cases of relapse have been reported," the WHO says. The fatality rate is 40-75%. In severe cases, people also experience pneumonia and severe respiratory problems. "Encephalitis and seizures occur in severe cases, progressing to coma within 24 to 48 hours," the WHO warns.

Fruit bats are the hosts of the virus which is highly contagious in nature. The virus spreads to humans from bats and pigs mostly, through contaminated food. It can also spread from human to human directly. In earlier outbreaks in India, the virus had spread through the contaminated urine and saliva of bats. Human to human transmission of the virus mostly occurs between family members and caregivers.

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So far, no drugs are available against Nipah virus. To prevent it one should follow safety measures. "If an outbreak is suspected, the animal premises should be quarantined immediately. Culling of infected animals – with close supervision of burial or incineration of carcasses – may be necessary to reduce the risk of transmission to people. Restricting or banning the movement of animals from infected farms to other areas can reduce the spread of the disease," the WHO suggests.

"Nipah virus infection can lead to a range of symptoms, which can vary in severity. The typical symptoms associated with the Nipah virus include fever, headache, acute respiratory infection, pain in the muscles, and vomiting. The severity of the symptoms varies from patient to patient," says Dr. Manoj Sharma, Senior Consultant, Internal Medicine at Fortis Hospital, Vasant Kunj.

"To prevent this virus transmission, it's very important that we avoid contact with infected humans. Wash fruits and vegetables thoroughly. Avoiding contact with animals and not visiting places where the outbreak has already taken place," Dr. Sharma warns.

As per Dr. Tushar Tayal, Consultant, Internal Medicine, CK Birla Hospital, Gurugram, initial symptoms of NIPAH are nonspecific such as fever, headache, dizziness, myalgia, vomiting, and loose stools. This may progress to brain involvement in the form of seizures and encephalitis. There may also be respiratory involvement causing respiratory failure. Nipah infection has very high morbidity in the form of psychiatric and neurological complications (depression, personality changes, deficits in attention, verbal, and/ or visual memory) after recovery. The mortality rate of Nipah is also very high as it is majorly untraceable, and has a fatality rate of 40 to 75 percent, according to the World Health Organisation (WHO).

The chain of transmission of the virus can be cut down by reducing bat to human transmission by consuming clean fruits and discarding fruits with sign of bat bites. One should wear gloves while handling animals. Close physical contact with those who are already infected should be avoided. Wash your hands regularly if there is an outbreak in your area.

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