Nipah Virus Disease: Stay Alert Despite the Distance

     Recently, many of you may have heard news about the outbreak of "Nipah Virus" in certain areas of India, such as Barasat city, which has caused considerable concern. The doctor wants everyone to understand with mindfulness that while this disease may seem frightening due to its high fatality rate of 40-75% and the current lack of vaccines or specific treatments, "being informed" is your best defense.

Why should we be alert right now?

     Nipah virus isn't exactly new, but it is a zoonotic disease (transmitted from animals to humans) that requires close monitoring. Symptoms can be severe, even leading to encephalitis (brain inflammation). Since there is no certain standard treatment yet, prevention and early detection are absolutely crucial.

Locations of Nipah and Hendra virus outbreaks and fruit bat habitats.

(Image referenced for informational purposes from www.cdc.gov/vhf/nipah/outbreaks/distribution-map.html)

Nipah Virus

     Nipah Virus is an RNA virus that causes encephalitis and respiratory illness. The disease can be transmitted through contact with animal waste and secretions from carrier animals. The Department of Disease Control, Ministry of Public Health, has classified it as a highly dangerous infectious disease, on par with Ebola, Smallpox, Lassa Fever, Hendra, and Marburg viruses. Therefore, physicians must test patients in specialized laboratories.

Transmission Routes

From the wild to humans, we find that "Fruit Bats" are the natural reservoir for this virus. Transmission to humans usually occurs through:

• Direct Contact: Contact with secretions, whether it be saliva, urine, or droppings of bats or infected animals.
• Consumption: Eating fruits with bite marks or those contaminated with bat secretions, such as unheated fresh date palm sap.
• Intermediate Hosts: Animals like pigs, goats, or sheep that become infected by eating contaminated fruit and then spread the virus to close contacts.
• Human-to-Human Transmission: While less common than COVID-19, it can spread through close contact with the secretions of an infected person during the contagious stage.

Warning Signs: When should you see a doctor?

Symptoms of Nipah virus often start like a common flu, causing many people to be complacent.

• Early Stage: High fever, headache, sore throat, and muscle pain.
• Critical Stage: If the infection reaches the respiratory system, symptoms like coughing and difficulty breathing occur. Most dangerously, "Encephalitis" can develop, causing confusion, disorientation, drowsiness, seizures, or loss of consciousness within a short period.

Diagnosis via Disease Investigation

Diagnosing Nipah virus requires clinical history and laboratory testing. A Patient Under Investigation (PUI) is someone with respiratory symptoms or encephalitis and a risk history, such as contact with secretions from fruit bats, pigs, or other patients.

• Physicians will consider using PCR to detect the virus or genetic material from secretions during the early stage, or ELISA to detect antibodies (IgM/IgG) in the later stage.
• If a suspicious case is found, the disease investigation team must take proactive action within 12 hours to identify epidemiological links and immediately control the risk area.

Preventive Measures

Build a shield for yourself and your family by focusing on these simple self-care tips:

• Avoid entering areas with dense bat populations, such as caves or fruit orchards where bats congregate.
• Refrain from eating fruits that have fallen to the ground or show bite marks. Always wash thoroughly and peel fruit before eating.
• Regularly wash your hands with soap or alcohol gel as a basic measure to reduce risk.
• For those who have recently returned from high-risk areas like India, the doctor recommends closely monitoring your symptoms for 3 weeks. If any abnormalities occur, see a doctor immediately and provide your travel history.

The fear of disease decreases when we are knowledgeable and cautious. Ramkhamhaeng Hospital would like to encourage everyone to always maintain good health, as our best wish is to see everyone healthy every day.