Consultant physician Dr. Vivek Baliga reviews Nipah Virus infections that are affecting people off the southern coast of India. Find out how it spread and how it can be prevented effectively.

1. Nipah Virus Infection - A Brief
Review
Dr Vivek Baliga B
Consultant Physician
Baliga Diagnostics

2. Introduction
● Nipah virus is currently making headlines
● Killed 10 people in state of Kerala, affecting many more
● Here we will look at
○ What it is
○ How it is spread
○ What are the symptoms?
○ How can it be treated?
○ Can it be prevented?

3. A Little History
● Not a new virus
● Class of paramyxovirus
● Natural Host - Fruit Bat
● Can infect - pigs and humans
● First outbreak - Malaysia and Singapore - 1999
○ Fruit bats would drop infected pieces of mango into pig pens
○ Pigs would consume these fruit pieces and develop serious chest infections
○ Humans would eat these pigs and get infected.

4. In India….
● Regular occurrence in Bangladesh
● Recent outbreak in Kerala
● Source - Date palm sap (uncooked)
● Bats infect date palm sap with urine,
saliva and feces (full of virus)
● Ingested by humans without cooking -
leads to infections.
● Spreads between humans through
close contact.

5. Symptoms
● 5 - 14 days to develop symptoms after virus enters
● Fever
● Headache
● Fatigue
● Progress to drowsiness and coma due to a brain inflammation called
encephalitis
● End stage - death
● In Malaysia, out of 300 affected, 100 died
● 10 people died in Kerala so far

6. Diagnosis
● Mostly through clinical presentation
● No specific tests
● RT-PCR test has been used on throat swabs, urine etc
● ELISA test to detect antibodies IgM could aid diagnosis
THERE IS NO BEST TEST AS SUCH.

7. Treatment
● Supportive only - treat fever, dehydration etc
● No specific antiviral treatments available
● Research molecule ribavirin - no human trials so far
● Best way is to prevent exposure to date palm sap and bats

8. Vaccine?
● Nothing effective yet
● Immunisation using monoclonal antibodies has been shown to work in
hamsters.

9. THANK YOU!
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