Topline
Health officials in India are racing to contain an outbreak of Nipah virus after a teenage boy died from an infection over the weekend, the latest in a series of outbreaks in the region of the incurable virus that kills as many as three in four people it infects and has been flagged as having the potential to seed a new pandemic.
Key Facts
Nipah is a rare and potentially deadly virus that was first discovered in 1999 after an outbreak among pigs and pig farmers in Malaysia and Singapore.
Nipah is a zoonotic virus—meaning it can spread from animals to humans—and can infect humans through direct contact with infected animals or their bodily fluids or after eating contaminated food such as fruit products contaminated with urine or saliva from infected bats.
Cases of human-to-human transmission of Nipah have also been reported during past outbreaks, particularly among the families and caregivers of infected people.
In humans, symptoms typically arise between a few days and two weeks after infection, according to the World Health Organization, though periods as long as 45 days have been reported and it’s possible people may be infectious during this time (the WHO says pigs are “highly contagious” during this incubation period).
Nipah symptoms typically start with fever, headache and signs of respiratory illness like coughing that can rapidly worsen to brain swelling (encephalitis) and seizures that lead to a coma within a day or two.
Between 40% to 75% of people infected with Nipah will die from the virus, health agencies estimate, with the specific rate depending on the outbreak and strength of local medical systems managing the disease (long term neurological conditions like seizures and personality changes have been reported among those who recover from encephalitis).
News Peg
Health officials in India’s southern state of Kerala are rushing to track and identify the contacts of a 14-year-old boy who died of Nipah on Sunday. State officials say they are tracking more than 350 people who may be at risk of infection, 101 of whom are considered “high-risk” contacts and six of whom are displaying Nipah symptoms. A significant portion of these contacts—around 70 people—are healthcare workers who interacted with the teenager. Kerala is considered to be one of the most at-risk areas from Nipah in the world and this outbreak is the state’s fifth since 2018. Experts warn the area might be at particular risk from virus spillovers given the destruction of natural bat habitats by humans in the region.
Surprising Fact
Nipah virus partly inspired Steven Soderbergh’s Hollywood film “Contagion.” The 2011 film, which had a star-studded cast including Matt Damon, Laurence Fishburne, Jude Law, Gwyneth Paltrow and Kate Winslet, was largely praised for its portrayal of science and the process of infectious disease management in light of a fictional and highly lethal viral pandemic.
Key Background
Fruit bats, also known as flying foxes, are the natural hosts for Nipah. Nipah is in the same group of viruses as a number of pathogens known to cause disease in humans, including measles and mumps. Infection does not appear to cause noticeable disease in the fruit bats but the virus is known to infect a wide range of hosts—including humans, pigs, sheep, goats, horses, cats and dogs—and has been documented to cause severe disease in at least humans and pigs in past outbreaks. Its ability to infect a wide variety of hosts can make it harder for public health experts to track and to contain its spread. Nipah outbreaks have previously been reported in Bangladesh and India—the main places where the disease has been recorded since 2001—as well as Malaysia, the Philippines and Singapore. Between 1998 and 2015, there were some 600 cases of Nipah reported, according to the WHO.
How Can We Prevent And Treat Nipah Virus Infections?
There are no drugs or vaccines authorized for use against Nipah virus in either humans or animals. Treatment for those infected is limited to supportive care and targeting specific symptoms as and when they arise. Some immunological therapies made of monoclonal antibodies are in the early stages of clinical trials, according to the Centers for Disease Control and Prevention. Antiviral treatment remdesivir, already used in humans for other diseases, was also effective when given after exposure to the virus in animal studies, the CDC said. A vaccine for Hendra virus, a close relative of Nipah, is available for horses in Australia and appears to offer a degree of protection against Nipah infection.
What To Watch For
Researchers are actively working on treatments and vaccines for Nipah. Earlier this month, the Coalition for Epidemic Preparedness Innovations announced plans to begin human trials of a monoclonal antibody to prevent Nipah infection early next year. The antibody works by binding to the virus in a manner that hopefully blocks it from infecting cells. In January, researchers launched human trials for what could become the first Nipah vaccine. The experimental shot is being developed by Oxford University’s Pandemic Sciences Institute. It uses the same viral vector technology as the COVID-19 vaccine the group developed and developed with pharma giant AstraZeneca.
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Further Reading
Disease X: The 100 Days Mission to End Pandemics (Book by Kate Kelland)
