The newest virus outbreak struck the tropical coast of Kerala, India this May. Since then, the Nipah virus has infected about 19 people, 17 of whom died(1). The virus, named after a village in Malaysia, Sungai Nipah, is the site of the first known outbreak in 1998-99. During that outbreak, over 200 people became ill, and since then additional outbreaks have been reported in Bangladesh and India. Originally attributed to contact with sick pigs, the latest outbreak of the virus is being attributed to the transmittance from bats. Person-to-person spread has also occurred through direct, unprotected contact with infected body fluids. Besides outbreaks in Malaysia, Singapore, Bangladesh and India, the Nipah virus has been found affecting bats in countries like, Cambodia, Indonesia, Madagascar, Thailand and Timor-Leste(2)(3).
Be Aware of 'Fake News'
In the case of a new medical outbreak, like the Nipah virus, it is particularly critical to understand when to act and how to react to risks to ensure business continuity. In the light of “fake” or misleading headlines, it is more important than ever to be critical in evaluating the recommendations on managing the virus and verifying it comes from a valid source. For example, various media outlets stated that the virus is spread by fruit which ultimately led to a massive shut down of fruit shops locally and fruit bans in surrounding countries like the UAE(4).
The Nipah Virus Impact
Symptoms range from a mild respiratory illness with sore throat, fever and headaches, through to a severe pattern – with inflammation of the brain which can cause permanent disability, or be fatal. The fatality rate ranges between 40% and 85% but greatly depends on the local capabilities and clinical infrastructure of the affected area.
There is currently no treatment or preventative vaccine to treat the virus but the World Health Organization has listed Nipah as a 'Blueprint priority disease' for urgent research in February, due to its “potential to cause a public health emergency and the absence of efficacious drugs and/or vaccines”(5).
Due to the impact of the virus so far, combined with the lack of treatment, there is an apparent risk that further outbreaks will occur in humans, and that new locations may be affected. As this is a relatively new disease, the time for diagnosis is significant. This highlights the immediate need for infection control plans to be implemented.
For travellers, it is imperative to use the basic precautions against infections at all times. This includes paying attention to hygiene, washing hands often, avoiding contact with people who are sick, avoiding contact with bats and other animals, and selecting safe food and beverages. Hospitals and other healthcare facilities can be the site of outbreaks, and should only be visited if medical attention is required.
Organisations need to be prepared to respond to an increasing number of outbreaks – many will already have plans for pandemic flu, which can be adapted to new diseases such as Nipah.
Indian Ministry of Health and Family Welfare press release 2 June 2018, http://www.searo.who.int/india/topics/emergencies/ministry-of-health-and-family-welfare-press-release-2june2018.pdf
World Organisation for Animal Health, Nipah Virus, http://www.oie.int/en/animal-health-in-the-world/animal-diseases/Nipah-Virus/
World Health Organizaiton, South –East Asia, Nipah virus outbreak in the WHO South-East Asia Region, http://www.searo.who.int/entity/emerging_diseases/links/nipah_virus_outbreaks_sear/en/
Reuters, UAE bans fruits from Indian state after Nipah virus outbreak, https://www.reuters.com/article/us-india-emirates-south-africa/uae-bans-fruits-from-indian-state-after-nipah-virus-outbreak-idUSKCN1IU1I35 World Health Organization, List of Blueprint priority diseases, http://www.who.int/blueprint/priority-diseases/en/
Authored by: Irene Lai MD - Medical Director, Medical information and Analysis at International SOS