In India, the Nipah virus resurfaces and kills two people in Kerala

2023-09-19 12:45:17

Transmitted by bats, often fatal, this virus causes fever, vomiting and serious respiratory and neurological infections.

Indian authorities launched a virological testing campaign on Thursday September 14 to stop the spread of the Nipah virus, a deadly disease already causing two deaths in the state of Kerala, in southern India. At least four people were hospitalized, including the child of one of the victims. More than 700 people, including 153 medical sector employees, are under observation after being in contact with infected people, health authorities said.

«We are working to quickly trace the contacts of infected people and isolate anyone with symptomssaid Veena George, the state’s health minister, who also indicated that the strain of the virus was being examined, according to Reuters. Since 2018, this is the fourth time that an epidemic of the Nipah virus has appeared in the country.

A virus transmitted by bats

Rare, certainly, but deadly, this virus can cause fever, vomiting and severe respiratory and neurological complications: serious cases can lead to epileptic seizures and encephalitis, which can go so far as to cause a coma. The mortality rate from the virus is between 40 and 75%, according to the World Health Organization (WHO). Faced with this new epidemic, the authorities announced the supervision of public gatherings and the closure of certain schools.

Nipah is a type of Henipavirus, related to the Hendra virus, first discovered in Australia when it caused the deaths of humans and horses. The Nipah virus can infect humans directly through contact with the bodily fluids of bats, specifically their saliva and urine. Some cases of transmission between humans have also been recorded, or through contaminated pigs.

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«It is carried by fruit bats which settle at the tops of trees“, Joanne Macdonald, associate professor of molecular engineering at the University of the Sunshine Coast, told the British newspaper The Guardian. «Bats contaminate fruits through their urine: when people eat these fruits, they catch the virus and get sick».

Epidemics are rare, but Nipah has been listed by the WHO as a priority disease for research due to its global epidemic potential, placing it in the same category as Ebola, Zika and Covid-19. In addition to its epidemic potential, Nipah is considered a high-risk disease by the WHO due to the lack of vaccine or treatment.

Since 1998, epidemics mainly in Bangladesh and India

The first outbreak of Nipah was detected in 1998. Starting from the village of Nipah, which later gave its name to the disease, the virus then spread among pig farmers in Malaysia and Singapore. This first epidemic infected nearly 300 people in Malaysia, and caused the death of around a hundred others. In order to contain the epidemic, a million pigs were slaughtered. The virus had also spread to Singapore, where 11 cases and one death were then recorded: these were slaughterhouse employees who had been in contact with pigs imported from Malaysia.

Since then, the disease has been mainly recorded in Bangladesh and India, with both countries reporting their first outbreaks in 2001. In India, the first two outbreaks caused the deaths of 50 people, while Bangladesh suffered more from the virus in recent years, with more than 100 people dying since 2001. According to the WHO, 600 cases were recorded between 1998 and 2015.

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In the last five years, India has faced four epidemics of the virus: in 2018, in 2019, in 2021, and a new one since last month in the state of Kerala, which has already caused two deaths. In 2018, at least 17 people died after being infected with the virus, also in the state of Kerala.

No vaccine or treatment

There is no known vaccine or treatment for this virus, which explains the fear it generates despite its relatively rare occurrences. “Once contracted, the only treatments are rest, hydration and treatment of symptoms», underlines Joanne Macdonald.

While the incubation period generally varies between about four and 14 days, it can be up to 45 days. In 2019, a study by the Institut Pasteur, the CNRS and the John Hopkins Bloomberg School of Public Health carried out on more than 2,000 cases of the Nipah virus in Bangladesh demonstrated that adult cases presenting respiratory symptoms infected more individuals than others.

During previous epidemics, the Indian authorities managed to stop contamination in a few weeks, by setting up widespread testing campaigns and strictly isolating contact cases.

Zoonoses, increasingly common

Zoonoses, diseases transmissible from animals to humans, have increased in recent decades. For many scientists, this is explained by industrial agriculture and deforestation, in particular because these phenomena cause more contact between wild animals, domestic animals and humans. Global warming is also responsible for changes in the ecosystem of certain species. Finally, the increase in travel around the world has also enabled this rapid evolution of zoonoses.

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Scientists have warned that the climate crisis is increasing the risk of “zoonotic spillovers“. They predict that 15,000 cases of the virus will be transmitted between species over the next 50 years, according to The Guardian.

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