Nipah Outbreak News in Bangladesh and elsewhere since 4 Aug till 14 Oct 2021

A researcher at Oxford warns of a virus that threatens a new pandemic [Mediarun Search, 14 Oct 2021]

By Camelia Kirk

Nipah virus is one of the next pandemic threats, warns an Oxford scientist who developed a vaccine for AstraZeneca Against COVID-19, Sarah Gilbert.
According to her, there is still no vaccine for this virus, and studies that were underway had to be interrupted due to the Covid-19 pandemic.

“If we had a delta type of Nipah virus, we would suddenly have a highly transmissible virus with a 50 per cent mortality rate,” Sarah Gilbert said during an event at the Cheltenham Festival of Literature in the UK.

Credit: Dr_Microbe/istockResearchers fear that the Nipah virus may lead to a new pandemic
Nipah tops the list of ten priority diseases identified by the World Health Organization (WHO).Who is the) have been identified as potential sources of future epidemics.

virus made a A recent victim in India Hundreds of nearby contacts were forced into isolation to contain a potential outbreak.

What is the Nipah virus?
It is a zoonotic disease, i.e. transmitted from animal to human. It is usually transmitted by eating fruit contaminated with saliva or urine from infected bats, which are the natural reservoir for this virus.

Transmission can also occur directly from person to person or from contact with infected pigs.

Since its discovery in Malaysia among pig farmers, the virus has caused some outbreaks in Asia among humans. In addition to India and Malaysia, cases have also been recorded in Indonesia. In Brazil, there is no record yet.

Signs and symptoms
The incubation period (ranging from infection to onset of symptoms) is believed to be 4 to 14 days.

Nipah virus causes flu-like symptoms such as fever, cough, sore throat, body aches, fatigue and difficulty breathing.

Also, in more severe cases, it can cause the brain to swell and the condition to progress into a coma.

The mortality rate is estimated to be around 40% to 75%. There is no specific treatment, only supportive treatment to relieve symptoms.

How the Nipah virus jumped from humans to animals has shaped the search for covid's origins [The Washington Post, 14 Oct 2021]

By Karin Brulliard and Ben Guarino

The virus had lurked for years, lacking only one thing it needed to inflict widespread human death: a perfect opportunity.

U.S. coronavirus cases tracker and map

In late 1998, it got it. The virus arrived in central Malaysia by air, inside furry bats that alighted on the boughs of fruit trees swaying over pig farms. The bats, messy eaters, dropped their half-consumed meals. The swine, undiscerning eaters, gobbled up the leftovers. The virus, ready to move, hopped into the pigs and passed through their coughs to the humans who worked with them.

Why the world should be worried about India’s Nipah virus outbreak [OPB News, 13 Oct 2021]

By Kamala Thiagarajan

In 2018, we reported how the South Indian state of Kerala beat back the deadly Nipah virus.
Local filmmakers and musicians even made a celebratory music video about it. Three years later, the state is faced with yet a new case of Nipah — its third outbreak since 2018 — and it couldn’t have come at a worse time. Kerala, known for its palm-lined beaches on the Arabian Sea, is still reeling after a caseload of 4 million COVID infections since the pandemic began.

The Nipah virus is making news again after tragic reports that a 12-year-old boy died of the disease on Sept. 5, in Kerala's Kozhikode district. He had been admitted to a private hospital after running a high fever and showing symptoms of encephalitis — swelling of the brain.

While figuring out how to prevent and treat the Nipah virus is very much a work in progress, there have been advances.

Nonetheless, Nipah remains a concern, not just in India but for the entire planet. The World Health Organization classifies it as a "virus of concern" for future epidemics because "each year it spills over from its animal reservoir into humans," says Dr. Stephen Luby, professor of infectious disease at Stanford University. And when humans are infected it can be transmitted from person-to-person.

But the virus is not as transmissible as some other viruses. "There are occasional Nipah superspreaders who infect a lot of people," says Luby. "But the average transmission rate is less than one person per infection.

"However, each time a person is infected, the virus is in an environment that selects for human adaptation and transmissibility. The risk is that a new strain that is more efficiently transmitted person-to-person could generate a devastating outbreak. Indeed, since 70% of people who are infected with Nipah virus die, such a strain could represent the worst pandemic humanity has ever faced."

That's why, he says, it's important to "continue to invest in strategies to reduce the risk of spillover and to develop countermeasures across a range of high-risk pathogens."

Still a mysterious virus
Following the boy's death, public health authorities swung into action, contact tracing friends, family and health workers. They identified and isolated 251 people, including 30 close family members. Eleven samples from those in close contact with the boy were sent for testing, and on Aug. 8; they were negative. But how this child contracted Nipah is still unclear.

"It's really difficult to establish the cause of the boy's illness," says Dr. Thekkumkara Surendran Anish, associate professor of community medicine at the Government Medical College in Thiruvananthapuram. "The infected patient was just too sick to tell us anything about what he ate or did. That's why it's all speculation."

In the two strains of Nipah encountered so far — originating in Malaysia in 1999 and later in Bangladesh — pigs and fruit bats are believed to be the intermediary hosts. "One plausible theory is that those who've been infected [in Kerala] ate food or fruit contaminated with bat saliva or excreta," says Anish.

When reports emerged that the boy could have possibly contracted Nipah from eating the rambutan — a tropical fruit with thick red spines resembling lychee that grew around his home — sales of the fruit plunged in Kerala. But the fear that the fruit is the cause of the disease is pure speculation and without evidence, experts say.

By contrast, information about the route of virus' spread has been established in prior outbreaks. In strains of Nipah originating in Malaysia in 1999 and later in Bangladesh, pigs and fruit bats are believed to be the intermediary hosts, says Anish.

"We have a very clear understanding of how Nipah virus moves from fruit bats into people," says Luby. "Bats are attracted to raw date palm sap that is harvested during the wintertime.
When people drink raw date palm sap that has been contaminated by bats, they are at risk of contracting Nipah." The World Health Organization calls the drink a "likely source" of outbreaks in humans in India and Bangladesh.

Survival rates are low
While it is possible to recover, the virus has a high fatality rate.

In 2018, when Nipah emerged for the first time in Kerala, only two of the 19 infected people survived. When it was detected again in 2019, a 23-year-old man was infected, but swift isolation ensured the virus did not spread to others in his community. The patient survived.

"[With] COVID, you are most infectious before the symptoms set in," says Anish. "Once they do, your ability to infect other people wanes. But that's not the case with Nipah. When the symptoms set in, you start spreading the virus." In areas more prone to Nipah infections (Bangladesh, Malaysia, India, and Singapore) being aware of this can help, he says.

After the current case was identified, COVID precautions have helped control the spread of Nipah in Kerala, says Dr. K Puthiyaveettil Aravindan, a former professor of pathology at the Government Kozhikode Medical College. "Hospital workers were already kitted out in full protective equipment. People were masked." Since the virus is spread from human-to-human through bodily fluids, physical distancing and masking helped.

The virus is not, however, as transmissible as some other viruses. "There are occasional Nipah superspreaders who infect a lot of people," says Luby. "But the average transmission rate is less than one person per infection."

Hopes for treatment and a vaccine
With all the concerns about Nipah, efforts to develop a vaccine are ongoing. "There are several promising Nipah virus [vaccine] candidates that have demonstrated high efficacy in animals," says Luby. In addition, CEPI, the Coalition for Epidemic Preparedness Innovations, is supporting human trials of multiple vaccine candidates.

One study on vaccines, a pre-print, focused on the effectiveness of ChAdOx1 — a multipurpose vaccine vector which can be customized to carry DNA from a wide variety of pathogens. In a trial on African green monkeys, it proved effective when tailored against the Nipah virus.

While the vaccine is still in clinical trials, there's also a non-patented drug called M 102.4 developed by Christopher C. Broder, a professor of immunology and microbiology at Uniformed Services University of the Health Sciences. It's a monoclonal antibody that can attach to proteins in a virus and render it ineffective.

"Suppose you get a massive dose of a virus in your body. It's a matter of time before the pathological process begins and it damages your cells," says Anish. "You don't have time to depend on the immune reaction generated by a vaccine at that point. In this narrow window [before you develop symptoms], you can use an agent that can neutralize the virus."

During Kerala's 2018 outbreak, M 102.4 was flown in from Queensland, Australia for use on an emergency basis. At the time, it had not been tested on humans. Since then, initial tests in humans have been successful. In a study published by The Lancet, Phase I clinical trials in humans have shown the drug can neutralize Nipah.

In case of any major outbreak, health authorities in Kerala and elsewhere now can use the antibody to get it under control, says Aravindan.

A virus on the move
It's likely that other Indian states may be affected, too. "Kerala can't be the only hot spot" says Aravindan. "It's possible that the health system in other states may not be catching these infections at all."

He also has concerns about future spread. Genetic changes in the virus are likely, making hosts out of new species of bats and making the virus more transmissible among humans, he says. He adds that Nipah could emerge as a global problem similar to COVID due to international trade, global travel and climate change that causes bats to seek new habitats.

For those reasons, he says, it's imperative "to analyze which species [of bats] could be infected, the places they're located" and whether there might be additional intermediary host animals.

For now, the Nipah virus scare in Kerala seems to be under control. But "as long as there's a lot we don't know, the possibility of an epidemic can't be ruled out," Anish says.

Hendra virus: New type uncovered in flying foxes - Outbreak News Today [Outbreak News Today, 13 Oct 2021]

A paper detailing the findings has been published just days after the new genetic type (HeV-g2) was detected in a horse near Newcastle in New South Wales, the most southern case of Hendra yet recorded.

Hendra virus can be transmitted from flying foxes to horses, and from horses to people.
Previous studies had found the virus in flying foxes in Queensland and parts of New South Wales. After monitoring flying fox samples from 2013-2021, researchers at CSIRO’s Australian Centre for Disease Preparedness (ACDP) found the new genetic type in flying foxes in Victoria, South Australia, and Western Australia.

ACDP is a World Organisation for Animal Health (OIE) reference laboratory for Hendra and Nipah virus diseases. Reference expert and CSIRO scientist Dr Kim Halpin said spillover of the disease from flying foxes to horses has still only been reported in Queensland and New South Wales.

“However, because Hendra Virus Genotype 2 is so genetically similar to the original Hendra virus, there is a potential risk to horses wherever flying foxes are found in Australia,” Dr Halpin said.

“It’s important to note that Hendra has never been reported to spread directly from flying foxes to humans – it’s always been transmitted from infected horses to humans. We expect this new genetic type would behave the same way.

“And given the similarities, while more research is needed, we expect the existing Hendra virus vaccine for horses should work against this new type too.

“This finding really underscores the importance of research into flying foxes – it’s crucial to helping us understand and protect Australians against the viruses they can carry.”

Another project, called “Horses as Sentinels”, led by the University of Sydney and CSIRO and funded by a Biosecurity Innovation Program grant from the Department of Agriculture, Water and the Environment, detected the same genetic type earlier this year in samples collected from a horse from Queensland in 2015. Results of this research are available in preprint.

Dr Steve Dennis, President of Equine Veterinarians Australia, said the findings are a reminder there’s a risk of Hendra virus wherever there are flying foxes and horses.

Oxford jab creator says vaccine development has gone ‘backwards’ [Evening Standard, 12 Oct 2021]

By
Rod Minchin

Professor Dame Sarah Gilbert says her team is struggling to raise money to develop vaccines against already known diseases.

Lessons have not been learnt from the coronavirus pandemic in the need to properly fund the development of vaccines into other infectious diseases, one of the creators of the Oxford AstraZeneca jab has said.

Professor Dame Sarah Gilbert said her team was struggling to raise the money needed to develop vaccines against diseases already known about, yet alone those yet to emerge.

She said the Covid-19 pandemic should have taught us that vaccines must be stockpiled in case diseases mutated and became highly infectious.

We learned in the pandemic that we could do things faster, we could do things better, we want to be applying those lessons, but we still need to get the funding in place to do that
Before starting work on the Oxford-AstraZeneca vaccine in January last year, Dame Sarah said she had been working on vaccines for the Nipah virus, Lassa fever and Mers.

During an event at the Cheltenham Literature Festival with Oxford colleague Dr Catherine Green, Dame Sarah said her work had gone “backwards” since the pandemic.

“We’ve actually gone backwards in terms of the work we’re doing on development of vaccines for the outbreak pathogens before the pandemic,” she said.

“It’s just really slowed right down, trying to get that moving again is really difficult and the funding still isn’t there to move that on.

“We learned in the pandemic that we could do things faster, we could do things better, we want to be applying those lessons, but we still need to get the funding in place to do that.

“We need stockpiles of vaccines against these pathogens we already know about because how’s it going to look if suddenly there’s a big Nipah outbreak that starts to spread around the world?

“We’ve known about that for years and we started making a vaccine five years ago, but we haven’t done it yet, it’s not finished.”

Scientists believe Nipah virus has the potential to cause a pandemic and recently a 12-year-old boy died in India having become infected.

“Something everybody is very much aware of now, is how as SARS-CoV-2 has spread through the world,” Dame Sarah said.

“It’s mutated, it’s evolved and what we’ve ended up with is the Delta variant which is very highly transmissible.

“If we get a Delta variant of Nipah virus then suddenly we’ve got a highly transmissible virus with a 50% fatality rate.”

Dame Sarah said vaccines of known diseases needed to be stockpiled and health workers in areas where there are outbreaks needed to be vaccinated quickly.

“We can make vaccines, we can have stockpiles, we can immunise the health care workers in the regions where the outbreaks are most likely to happen,” she told the festival.

“To protect the healthcare workers themselves and that’s really important because we want them to be able to go and do their job and respond to the start of a new outbreak.

“But if we don’t protect them, they get infected and then it’s often healthcare workers inadvertently spread the outbreak because they go back to their communities or their homes and then they’re infected and they spread it.

“We have to make sure they’re fully protected, and you can do that with really good personal protective equipment, but you do much better if you have a vaccine.”

Nipah virus that kills HALF its victims is ‘next pandemic threat’, warns Covid jab scientist [The Sun, 12 Oct 2021]

By Vanessa Chalmers

THE Nipah virus, which kills at least half of victims, is one of the world’s next pandemic threats, an expert has warned.

Oxford vaccine creator Professor Dame Sarah Gilbert said there is no vaccine against the virus which causes brain swelling.

But should it evolve to spread at a faster rate, as Covid has learned to do, it could be disastrous.

Dame Sarah said: “Something everybody is very much aware of now, is how as SARS-CoV-2 has spread through the world.

“It’s mutated, it’s evolved and what we’ve ended up with is the Delta variant which is very highly transmissible.

“If we get a Delta variant [evolved to be more transmissible] of Nipah virus then suddenly we’ve got a highly transmissible virus with a 50 per cent fatality rate.”

During an event at the Cheltenham Literature Festival, Dame Sarah said her team was struggling to raise the money needed to develop vaccines against diseases already known about, yet alone those yet to emerge.

Before starting work on the Oxford-AstraZeneca vaccine in January last year, Dame Sarah said she had been working on vaccines for the Nipah virus, Lassa fever and Mers.

But her work has gone “backwards” since the pandemic.

Dame Sarah said: “We learned in the pandemic that we could do things faster, we could do things better, we want to be applying those lessons, but we still need to get the funding in place to do that.

“We need stockpiles of vaccines against these pathogens we already know about because how’s it going to look if suddenly there’s a big Nipah outbreak that starts to spread around the world?

“We’ve known about that for years and we started making a vaccine five years ago, but we haven’t done it yet, it’s not finished.”

Nipah is "top of the list" of ten priority diseases that the World Health Organisation (WHO) has identified as potential sources of future epidemics

The health agency said in 2018 “there is an urgent need for accelerated research and development for the Nipah virus”.

Scientists have previously told The Sun Nipah could “absolutely be the cause of a new pandemic”.

The southern Indian state of Kerala had to stop a potential outbreak of the virus in September.

It came after a 12-year-old boy died of the disease, prompting isolation of hundreds of close contacts.

Two healthcare workers who nursed the boy were admitted to hospital.

Initially the virus may cause a fever, headache, and respiratory symptoms, before escalating to brain swelling and a coma.

The outbreak was the fifth in India since 2001, according to the WHO, with others centered in South East Asia.

Outbreaks tend to occur when humans catch Zipah from an animal, making it what's called a zoonotic disease.

Cases have been blamed on contact with sick pigs or by eating fruit that is contaminated with saliva or urine from infected bats.

There is potential that places like Cambodia, Indonesia, Madagascar, the Philippines and Thailand are at risk because there are known areas where bats live.

Bangladesh adds additional Nipah virus case/death to 2020 tally - Outbreak News Today [Outbreak News Today, 9 Oct 2021]

No country has reported more human Nipah virus cases in the past two decades than Bangladesh, which the Institute of Epidemiology, Disease Control and Research (IEDCR) has reported more than 300 since 2001.

During the past month, the IEDCR added another case/death on the 2020 tally, bringing the total cases to seven and deaths to five.

There was no explanation or additional details where this case came from or the circumstances involved.

This website reported 6 cases/4 deaths on January 30, 2020. When we reported the totals to date in 2021 on September 10, (2 cases/0 deaths), the 2020 totals were the same.

Nipah infection: no official word on proposed bat surveillance in Kerala [The Hindu, 5 Oct 2021]

Animal Husbandry Department yet to get any official directive
The Animal Husbandry Department is yet to get any official directive on the proposed surveillance of bats on river banks from Kasaragod to Ernakulam against the backdrop of recurring cases of Nipah infection in the state.

The infection was reported in Kerala thrice in two years since 2018. Kozhikode reported the first outbreak and a single case and a death occurred here in September this year too. Some of the victims in 2018 were from Malappuram district. In 2019, another single case was reported in Ernakulam district. Incidentally, it has been a month since Mohammed Hashim, the 12-year-old native of Pazhoor near Chathamangalam in the district, succumbed to the infection.

K.K. Baby, District Coordinator, Animal Disease Control Project Office, Kozhikode, said here on Tuesday that the periodic surveillance was supposed to be a joint exercise by the Veterinary, Forest, and Health departments. It was to determine the presence of the Nipah virus. The State Institute of Animal Diseases too was planned to be roped in. The proposal was moved by Health Minister Veena George. “There is no official word on the bat surveillance,” he added. The Health Department too does not seem to have any idea about it.

Nipah virus antibodies (IgG antibodies) were detected in bat samples collected by the National Institute of Virology, Pune, from Kodiyathoor and Thamarassery recently. A sample belonging to the Pteropus species, collected from Thamarassery, was found to have the antibodies, while similar ones were detected in another sample from the Rousettus species collected from Kodiyathoor. The results of over 50 bat samples collected as part of the outbreak investigation are still awaited. There is lack of clarity on further epidemiological studies. Also, how the virus got transmitted to humans is yet to be conclusively proven. Public health experts have been demanding a permanent surveillance system to detect similar zoonotic infections.

Nipah outbreak in the neighbourhood: Activate alert mode in Nepal [The Himalayan Times, 4 Oct 2021]

By DR PUSHPA R JOSHI

An analysis of the recently experienced pandemics and endemics shows that the evolution of human civilisation and thereby encroachment of the wild habitats by humans for settlements and agricultural practices, climate change and excessive deforestation have resulted in the spilling over of the new viruses from wild animals to domestic animals and humans
Nepal has not yet completely resuscitated from the ongoing COV- ID-19 pandemonium, and the menace of another potential endemic is hovering over the country. Recently, an outbreak of Nipah virus (NiV) infection was reported in neighbouring India, 23 years after the first ever cases of it were identified on pig farms in Malaysia in 1998. The first casualty of the recent outbreak was a 12-year-old boy from Kozhikode district in Kerala on September 5. Since then, NiV infection has claimed at least 20 lives and is rapidly spreading in the southern state of India.

Taking a leaf out of the recent experiences with COVID-19, the Ministry of Health and Population (MoHP) has issued a press statement stating that the risk of the virus's propagation in Nepal through the open borders could not be ruled out. Therefore, the concerned authority needs to remain on high alert to cope with the unprecedented adversity of NiV.

NiV infection is a zoonotic illness that is transmitted to humans from animals as well as through contaminated food or directly from person-to-person. The natural reservoir of the virus is the fruit bat. The World Health Organisation (WHO) has classified NiV as a virus of concern for future epidemics as the virus seems to be frequently spilling over from its animal reservoir into humans.

NiV infection presents itself with non-specific symptoms ranging from mild to severe course of illness. The common symptoms are fever and headache along with signs of respiratory illness – cough, sneezing, sore throat, breathlessness and a tight chest. The symptoms typically appear in 4-14 days after exposure to the virus.

In severe cases, a stage of brain encephalitis may follow; the symptoms include drowsiness, disorientation and mental confusion. This severe condition can rapidly progress to a coma within 24-48 hours. A convenient way of diagnosis of the disease is not available; the confirmatory diagnosis relies entirely on sophisticated molecular techniques.

Prophylaxis through drugs or vaccines against the virus has not been approved so far. Therefore, appropriate precautions are the only currently available prevention options.

In light of reoccurrence of NiV infection, amidst the ongoing COVID-19 mayhem, it has raised disquiet of scientists. In fact, over the last century, researchers have been subtly acknowledging the increasing outbreaks of infectious diseases at regular intervals.

Ebola, H1N1-influenza (swine flu), severe acute respiratory syndrome (SARS), Middle East Respiratory Syndrome (MERS), avian influenza and COVID-19 are the recent infectious diseases that our generation has already experienced, either as endemic or as a pandemic, in the first quarter of the 21st century.

A study on global trends in emerging infectious diseases published in Nature in 2008 reveals that almost two-thirds of all infectious diseases are zoonotic in nature, and more than 70 per cent of known infectious diseases have originated in wildlife.

There is an understanding that the reconnaissance of increasing frequency of these outbreaks in recent times is due to advancement in scientific approaches as well as improved surveillance and technological prowess in identifying new viruses.

However, a careful analysis of the recently experienced pandemics and endemics shows that the evolution of human civilisation and thereby encroachment of the wild habitats by humans for settlements and agricultural practices, climate change and excessive deforestation have resulted in the spilling over of the new viruses from wild animals to domestic animals and humans.

In addition, intensive animal husbandry in the form of poultry, pig farming and cattle rearing has severely increased this risk. The so-called wet markets where animals are slaughtered in unhygienic conditions are also breeding beds for transmission of zoonotic diseases.

Another factor that has contributed in the rapid transmission of infectious diseases is the ruthless increase of the human population over the years. The dense clustering of humans, especially in urban areas, is encouraging the outbreaks to spread like a wildfire. Large scale people's movement and increased frequency of livestock and goods transport in modern times have also contributed in the rapid transmission of contagious viruses across continents.

Coming back to NiV infection, the disease is said to have been transmitted to humans from bats that are omnipresent in all continents.

However, bats typically prefer warmer temperatures, and hence, countries like Nepal and other south Asian countries are territorial habitats of bats. Although NiV infection is not yet reported in Nepal, the risk of a possible outbreak anytime soon cannot be ruled out. Therefore, ecologists, scientists, health care professionals and sociologists should be well prepared to tackle the possible adversities of NiV infection.

It is high time an alert mode was activated immediately in Nepal.

The recent experiences in COVID management should be taken as a launching pad for the productive management of a possible NiV outbreak and unprecedented outbreaks of other infectious diseases in the future.

The first and the foremost requirement is a wellequipped centralised diagnostic facility for novel bacterial and viral infection within the country. In addition, the government should be prepared to clog the porous borders as soon as the threat of the spread of the infectious diseases prevails in the neighbourhood.

Simultaneously, a long-term rapid action task force comprising public health experts should be constituted, and the concerned authorities should act according to their suggestions.

This is not yet too late for Nepal; however, time is running out swiftly.

One month after losing only son to Nipah, Hashim's parents return home [Mathrubhumi English, 2 Oct 2021]

By Gopika Girish

On October 5, it turns one month since 12-year-old Hashim Mohammad succumbed to Nipah virus.

Pazhur: “We thought it was an ordinary fever and sore throat. Even the doctors assured the same. We believed he would come back home,” Aboobacker could not hold his tears. On October 5, it turns one month since 12-year-old Hashim Mohammad succumbed to Nipah virus. Two days back, Hashim’s parents Aboobacker and Vaheedha completed 21 days of quarantine and returned to their house in Pazhur, where their one and only child Hashim had lived. Now their house remains empty and silent without his noises or mischieves.

Vaheedha recollected that Hashim started showing symptoms of fever and sore throat on August 27. She gave him paracetamol and went to bed. His temperature kept rising. On 29th, she took him to a private clinic in Eranhimavu and gave him antibiotic medicines as suggested by doctors.

But along with rising temperature, he started vomiting badly by August 30. On 31st morning, they took the boy to EMS hospital and conducted an antigen test. The test showed negative results but they took him to Santhi hospital for RT-PCR test. However, the RT-PCR test result also was negative. But his oxygen level kept dipping and they shifted him to Kozhikode Medical college in an ambulance.

Vaheedha said he was conscious throughout the period even though his body was growing weaker every second. He was admitted to ward 30 on account of fever. Vaheedha’s heart still aches when she remembers the irresponsible attitude of the duty doctors in MCH.

“Hashim started showing signs of epilepsy. The house surgency doctors did not give enough care even after he started foaming at mouth. The next day, they only conducted CT scan and X-ray. But by then, his condition was deteriorating. His muscles became stiff, he started biting his tongue and clenching his teeth.

The doctors from MCH asked to shift him to a private hospital as there were not enough ventilators for children. On September 1, they shifted him to the ventilator of MIMS hospital. Before his case worsened, he requested me to return home. I took him to the urinal. But I could not feed him any food. I felt like holding him again but fate stopped me,” Vaheedha opened up.

Musthafa, Hashim’s uncle, said that the tests for Nipah were conducted 2-3 days after admitting him in the hospital. The doctors didn't even take a wild guess of Nipah virus infection.

All of his relatives unanimously agreed that they are clueless about how he was infected with the virus because Hashim was a very calm and quiet child. He never liked climbing a tree or eating anything found lying on the ground, they said.

The goat and the rambutan

The goat in his house showed some weird symptoms after skipping food and water for a few days. The samples of the goat were collected by the health experts, but there was nothing serious in the tests.

Also, he had eaten a rambutan brought from his relative’s house before he was affected with fever. But his mother said that the rambutan was eaten by everyone in their house and close relatives in the neighbourhood. But no one had any diseases or even a headache. The bats......

His father said that Hashim had helped him to collect betel nuts from their surroundings a few days back. There are many palm and guava trees where bats are usually found. The Kodiyathur panchayat, from where the antibodies of Nipah were found from 100 bats, is next to Pazhur panchayat.

The fear-stricken Pazhur

The locals said that after September 5, Pazhur panchayat was totally closed for weeks. The people were living in fear without moving out of their their house. There were 188 people in the contact list of Hashim and 20 in the close contacts list.

Since everyone tested negative, the panchayat gradually resumed to its normal state. To their bad, now the bats have been found with antibodies of Nipah. The people of Pazhur are undergoing a trauma currently. They request the government for clearing out the bats without harming any humans.

The financial help from government The Chief Minister has announced financial assistance to Hashim's family. The boy's father had applied for Rs 2,42, 603 as hospital expenses. His father, Aboobacker, is a manual labourer. Abdurahiman, a former ECG technician at Kozhikode Medical College, also demanded that the mother, who had studied up to class 10, be given a job to support her family, who were devastated by the death of their only son.

Antibodies against Nipah found in bat samples from north Kerala, says Veena George [Hindustan Times, 30 Sep 2021]

Results of samples collected from bats after the death of a 12-year-old boy in north Kerala on September 6 have confirmed the presence of antibodies against the Nipah virus, state health minister Veena George said in Thiruvananthapuram on Wednesday.

The minister said after the death of the boy a team from the National Institute of Virology (NIV) had taken samples of many species of bats from the area and the samples indicated the presence of antibodies against the virus in two varieties. She said the latest results have given credence to the theory that bats are the main carriers of the Nipah virus.

The health department was on high alert after the third outbreak of Nipah, the first being in 2018 in Kozhikode and the second in Ernakulam in 2019. It cordoned off the entire area and samples were collected from all houses. Around 800 samples were checked in two days and all turned positive. Like earlier outbreaks, it was localised and contained effectively.

“The NIV has conveyed to us about the presence of IgG antibody in some. We are expecting more results in the coming days,” the minister said. She said different studies conducted by NIV, the Indian Council of Medical Research and National Institute of High Security Animal Diseases will continue. She said though the 21-day incubation period was over the department will observe a double incubation period of 42 days to declare the area Nipah free.

After the death of the boy, his parents said he had eaten rambutan fruit before taking ill and authorities have asked people not to eat fruits picked from the ground. But samples of half-eaten fruits did not show any signs of contamination during initial tests. Later authorities warned people not to disturb bat habitat in panic.

Reeling under the high number of Covid-19 cases, the state contributed more than 60 per cent of the country’s total cases for about four months. Amid Covid-19, the Nipah outbreak had really jolted the state. Experts said the strict protocol in place due to Covid-19, like masking, physical distancing and no overcrowding, helped the state to blunt the impact of the zoonotic disease.

Kozhikode reported the Nipah infection for the second time in three years-- in 2018 it claimed 17 lives in the district. Two persons also survived the infection. And in 2019 a youth tested positive for the zoonotic disease in Ernakulam but he was also nursed back to life after long hospitalization.

After the first outbreak in 2018, many promises like setting up of a high-end animal testing lab, virology institute, a scientific study on bats (chiropterology) and a treatment protocol for separate zoonotic diseases were made. Experts say most of these remained only promises.
“Since zoonotic diseases recur frequently in the state it needed an integrated approach and team of experts from all fields to study it,” said Dr N M Arun, an internal medicine expert.

Experts like him want a proactive strategy to face the increasing threat of recurring zoonotic diseases and not wait for the outbreak to act. The state needs to strengthen its surveillance system backed by enough scientific studies, they say.

It is a fact that zoonotic diseases have recurred at regular intervals in the state in the last three years. Many cases of Kyasnur forest disease (monkey fever), avian influenza, swine flu and anthrax were reported. Thousands of ducks were culled in Alappuzha two years ago to check the spread of avian influenza.

“We need a permanent mechanism for early detection of such diseases and early warning to the people. More research is also needed in the area,” said Dr Prejit Nambiar, a teacher at the Kerala Veterinary and Animal Sciences University, who specialises in zoonosis and food safety.
He said a close interaction is necessary between medical experts, veterinary professionals, environmental scientists and wildlife professionals to tackle zoonotic diseases.

Nipah virus in Kerala, India: WHO details - Outbreak News Today [Outbreak News Today, 26 Sep 2021]

In a follow-up on the Nipah virus case and death in Kerala state, India earlier this month, the World Health Organization published a Disease Outbreak News Friday that provides some additional information:

On 4 September 2021, the Kerala State Health department reported an isolated case of Nipah virus disease in Kozhikode district, Kerala state, India. Nipah has a relatively high case fatality ratio, and is an emerging zoonotic disease of public health importance in the South East Asia and Western Pacific WHO Regions.

This is the fifth outbreak of the disease in India (Siliguri town in 2001, followed by a second outbreak in Nadia district in 2007, both in West Bengal state. In 2018, an outbreak was reported in Kozhikode district, and in 2019, another outbreak in Kochi district, both in Kerala state).

On 29 August, a 12 year-old boy developed low grade fever, and the family sought care at a local health care facility. On 31 August, he was transferred to several hospitals as his condition deteriorated. On 1 September, the patient’s condition continued to deteriorate, and the family requested his transfer to another hospital in Kozhikode.

Bangladesh reports two Nipah virus cases in 2021

On 3 September, plasma, serum and cerebrospinal fluid samples were sent to the National Institute of Virology in Pune, India. On 4 September, the presence of Nipah virus in the plasma, cerebrospinal fluid and serum samples was confirmed by real-time polymerase chain reaction (RT-PCR) and IgM antibodies was confirmed in the plasma sample by ELISA serology test. On 5 September, the patient died and a safe burial and cremation were performed the same day in Kozhikode.

As of 6 September, epidemiological investigations identified contacts, including health care workers and close family members, who were placed under quarantine.

The current isolated case was reported in a rural area in Kerala state where an outbreak was previously reported in 2018. India has experienced and contained Nipah virus disease outbreaks in the past and has demonstrated the capacity to carry out outbreak control activities, including case identification, laboratory testing, case management, contact tracing and risk communication. This event is an isolated case and the risk is low at national level and low at the regional level.

Inside Kerala’s Pazhur Village – Where Nipah Broke Out And Was Contained [Outlook India, 19 Sep 2021]

A discipline earned while tackling Covid-19 may have saved Kerala from a wide outbreak of Nipah. Despite thin resources, the state health machinery kicked in to put checks in place. The outbreak, most probably spiraled out of bat-bitten Rambutan fruits.

Little did Vichutti from Pazhur village of Kerala's Kozhikode district know that the rambutan fruits he picked from his tiny patch of land alongside the River Iruvazhinji would put the entire country in a panic mode.

A tree-climber by occupation, Vichutti, whose official name is Vayoli Abubakkar, was happy to see rambutan, which is otherwise a rare fruit in this area, giving yield for the first time on his tree this year. After that, he went to the riverside quite frequently, picked the fruits and gave them to his 12-year-old son Muhammad Hashim.

On the morning of Sunday, September 5, Vichutti’s village woke up to the news that Hashim died due to Nipah infection, the first such case in Kerala after the state reported and controlled the virus outbreak from the same district in May 2018 that had claimed 17 lives.

The village has now been put under a complete lockdown with police deployment on all entry points. The villagers and the health department suspect bat-bitten rambutan fruits as the primary source of the virus outbreak. Outlook visited the riverside the day Hashim died – a 20-minute walk from his residence.

A kaccha road alongside an areca nut field takes you to the riverside where the rambutan tree stands. By evening, the ground beneath the tree is strewn with bird-bitten fruits.

“You can find a lot of bats here,” said Amjad, a neighbour, adding, “I had seen the boy’s father coming here a couple of times recently.”

On September 14, the Kerala government eased restrictions in Pazhur’s neighbouring villages as no new cases were reported even after the incubation period of 14 days and the samples of the close contacts of the deceased child tested negative.

Restrictions in Pazhur, which is Ward-9 in Chathamangalam panchayat, however, still continues.

“Ward 9 in the Chathamangalam panchayat will continue to be a containment zone. The decision was taken as per the direction of the medical board and the expert committee," state health minister Veena George said in a release.

Pazhur has 625 families. The village also had 49 ‘guest workers’ (an official terminology to describe migrant workers) but all of them left for their native places since the Covid-19 outbreak, EP Valsala, the elected member representing Ward-9, told Outlook.

Did Covid-19 experience help tackle Nipah?
Valsala says things didn’t go out of control here while dealing with the Nipah outbreak thanks to people’s experience of Covid-19.

“People were already wearing masks and following other Covid-19 protocols, which might have helped prevent spread of Nipah as well,” she said.

A similar line was echoed by Chathamangalam panchayat president Olikkal Gafoor and Junior Health Inspector (JHI) Abdu Rasheed, whose jurisdiction covers Pazhur basic section area, which includes Ward-9 and four other neighboring wards.

Rasheed also recalled how the situation caused panic in the pre-Covid times back in 2018 when Nipah outbreak was reported in Perambra in the same district. The Kozhikode Medical College, which is always a busy place, had worn a deserted look. People, scared of infection, had avoided every public place. There was 19 confirmed infections and 17 deaths with a fatality rate of 89.4 per cent. Two earlier Nipah outbreaks were reported in India in 2007 and 2001-- both cases in West Bengal.

Speaking to Outlook, Health Minister of Kerala, Veena George acknowledged Covid-19 protocol as a factor that possibly helped in preventing spread of Nipah virus infection. However she also added that dealing with two consecutive pandemics at a time had already exhausted the health system of the state. Kerala was already reporting one of the highest spikes in Covid-19 cases in the country.

The minister said she received confirmation about the Nipah virus infection from the National Institute of Virology (NIV) in Pune, which had tested the boy’s sample, at around 10 pm on September 4. She immediately informed the matter to the Chief Minister, Pinarayi Vijayan.
Within half an hour, an online meet was conducted with the health secretary, Kozhikode district collector, district medical officer and all other key officials. Three cabinet ministers from Kozhikode district were also present.

“The boy’s condition was very critical at that time,” the minister said.

“Sixteen committees were formed in the meeting, an action plan was created that included contact tracing, field surveillance, psycho-social support and so on,” she said.

The minister left for Kozhikode from the state capital Thiruvananthapuram the same night at 12 am.

“We were cautious not to create panic among the people but at the same time we wanted to get done with the initial contact tracing by early morning the next day,” she said. The boy was taken to one private doctor’s clinic and four hospitals including the government medical college in Kozhikode before he finally succumbed to the virus.

“It would have been a painful exercise to bother the boy’s parents at their moment of grief to extract information about each and every contact person. Considering that, we issued an institutional route map and traced all persons including the health workers and the drivers who had come in contact with the boy,” the minister said, adding, “The night of September 4 was crucial. We took all important decisions on that night itself.”

On the morning of September 5, a control room was opened in Kozhikode. The government declared areas within 3 kms radius of the boy’s house as containment zone. Also, Covid-19 vaccination was suspended in the district for 48 hours. The health department converted the Covid-19 pay ward in the Kozhikode medical college to a Nipah ward and an ICU was also kept ready anticipating any more cases. Treatment facility and medicine availability were ensured. Additional staffs were deployed and the health department also gave special training to health workers from doctors – of both government and private sectors – to ASHA workers in the district.

“More importantly, a Nipah lab was set up in Kozhikode medical college by special teams from Pune and Alappuzha,” Veena George said.

“There would be more symptomatic people as Covid pandemic was also prevailing. Any delay in testing samples could have caused more stress. Immediately setting up a lab was very crucial, she said. Also, mobile labs were set up for Covid testing in Nipah containment zone which enabled swab collection at home. "

“We ensured that we were fully prepared and equipped to identify new cases, prevent any further spread and to deal with new patients if any,” the minister said.

“Along with contact tracing, it was equally important to identify the source of infection as well,” Veena Geroge said. "The health department conducted field surveillance and house-to-house survey in the affected area. We called panchayat presidents and all-party leaders and formed volunteer groups for the survey. It was primarily intended to find unreported fever, unusual deaths and animal diseases in the past one month," she said. A central team was called for bat surveillance. They identified bat habitat across the river in the neighbouring Kodiyathur panchayat.

“Bats spread more virus when they are stressed. Hence, it was important not to scare bats,” said Veena George.

Besides rambutan, areca nuts are also suspected to have caused infection. The area has a large number of areca nut trees. The boy’s father is a coconut collector and climbs the coconut trees.

There are high chances of the boy getting infected by bat-bitten areca nuts. A goat in the boy’s house was rumoured to have died. However, it was later found that the animal was alive but had fallen ill a month ago. This goat’s samples are also sent for testing. “We are expecting those test results soon,” Veena George said.

As the state’s health machinery started rolling out on the night of September 4 itself, it took no time to reach action on the ground zero.

JHI Rasheed said he located the boy’s house with the help of local RRT member Anees MK on the same night at around 10:30 immediately after he got an alert from his department. Panchayat President Gafoor said the police and health officials blocked the entry points to the village the same night itself.

A microphone announcement was arranged for people’s awareness the next morning. Notices were distributed at houses for precaution.

The survey was conducted in 12,500 houses in Chathamangalam panchayat alone. The panchayat president said free food kits were distributed in ward-9 for the families of daily wagers who were hit by the sudden lockdown. A 11-member RRT team was formed to distribute basic items to households so that families could stay indoors.

According to JHI Rasheed, the boy started suffering from fever and headache on the night of August 27. His parents gave him paracetamol tablets on 27th and 28th. On 29th morning, when he was not improving, the parents took him to a private doctor’s clinic in the neighboring area.

The doctor prescribed Azithromycin 250 mg for three days. However, he started developing throat pain, woke up at 2 am on 30th and vomited twice. The ASHA worker of the area contacted the parents and suggested to go for a Covid-19 test.

The parents observed the boy on 30th. On Tuesday, August 31, they took him by an auto rickshaw to the nearby EMS hospital in Mukkam and conducted antigen test. In the same auto, they took him to another private hospital in the neighbouring Omassery to conduct RTPCR test.

From there, the same day, he was taken to the government medical college in Kozhikode by an ambulance. By the time, he had developed high-grade fever and fits. The boy’s mother later told local media that the boy was moved to yet another private hospital after the medical college asked the family to shift him from there citing non-availability of ICU. Hashim’s mother was reportedly feverish on the day the boy died, which had sent alarm bells.

However, the next day she said she was alright.

Asked if Pazhur was a success story or would it be too early to say so, health minister Veena George said “Things are under control after the 21 days’ incubation period. However, we should wait for another 21 days to be sure.”

The minister said the state has to be fully prepared to control Nipah outbreak in future. A BSL Level 3 lab in Kozhikode medical college will be set up soon, she said.

Experts Say Nipah Virus Has Potential To Be Another Pandemic — With A Higher Death Toll [Scary Mommy, 15 Sep 2021]

Earlier this month, a twelve-year-old boy in Kerala’s Kozhikode district in India died from the Nipah virus, a virus that most people probably never heard of. A virus that, according to experts, has the potential to become another global pandemic with a significantly higher death toll.

Approximately 70 percent of people who are infected with the Nipah virus die, says Dr. Stephen Luby, a professor of infectious disease at Stanford University. When the virus first appeared in Malaysia in 1999, it killed more than 100 of the approximately 300 people that had been infected. When it emerged in Kerala in 2018, only two of the nineteen people who’d contracted Nipah survived.

Often even survivors are left to suffer. Many are left with long-term consequences, including “persistent convulsions and personality changes,” according to the CDC.

For those reasons and others, the World Health Organization declared Nipah a “virus of concern” and experts are urging more research and attention.

Nipah Virus Is A Zoonotic Virus
Similar to coronavirus, Nipah is a zoonotic virus, which means it can spread between animals and people. Generally, transmission happens when a person consumes contaminated food or comes into direct contact with an infected animal. Fruit bats “are the natural carriers of Nipah.” Once Nipah spreads from an animal to a person, that person can go on to infect other humans.

Though it’s still uncertain, experts believe contaminated food caused this current outbreak.
“One plausible theory is that those who’ve been infected [in Kerala] ate food or fruit contaminated with bat saliva or excreta,” Dr. Thekkumkara Surendran Anish, associate professor of community medicine at the Government Medical College in Thiruvananthapuram told NPR.

Nipah Is Not Easily Transmissible…Yet

The good news—if there can ever be good news when discussing a deadly virus—is that Nipah virus is not very transmissible.

“There are occasional Nipah superspreaders who infect a lot of people,” says Luby. “But the average transmission rate is less than one person per infection.”

Considering we’re currently fighting a highly contagious respiratory virus with a highly infection variant, that’s news we want.

However, that good news might (only might) be temporary. Luby notes that, “[E]ach time a person is infected, the virus is in an environment that selects for human adaptation and transmissibility. The risk is that a new strain that is more efficiently transmitted person to person could generate a devastating outbreak.”

As we’ve learned too well—viruses mutate. And when they mutate, they could spell even more trouble.

Availability Of Vaccines Or Treatments
Unfortunately, we don’t yet have a cure or vaccine for Nipah virus, though there is hope on the horizon. (Once again, let’s take a moment to thanks scientists and doctors who work tirelessly to protect us from current and potential pandemics!)

Alongside a potential vaccine candidate, researchers are looking to a drug called M 102.4. One study found that in Phase I clinical trials, the drug was able to neutralize Nipah.

Neutralizing the virus before it can cause damage is important, considering how troubling Nipah virus symptoms can become. Initial symptoms include fever and headache, which can last for three days or up to two weeks. After that, an infected person can expect sore throat, cough, and respiratory issues. Soon thereafter (too soon), the symptoms turn severe. Nipah can cause swelling in the brain cells, which leads to drowsiness, confusion, and potentially coma and death.

The CDC notes that remdesivir (also used against COVID-19) has shown some effectiveness in nonhuman primates when given prophylactically after exposure.
If Nipah Goes Global…

The Nipah virus is seemingly currently under control in Kerala, but experts warn we can’t let down our guard. “[A]s long as there’s a lot we don’t know, the possibility of an epidemic can’t be ruled out,” Anish says.

Prevention is key. Along with “standard infection control measures,” the CDC encourages anyone who lives in an area where Nipah outbreaks have occurred to practice good hand hygiene, avoid sick bats and avoid anywhere where bats roost, avoid consuming raw date palm syrup, avoid consuming fruits potentially contaminated by bats, and avoid contact with blood or fluids of any person infected with Nipah.

Likewise, the WHO urges anyone consuming fruit or fruit products (like raw date palm juice) to wash thoroughly and peel the fruit before consuming it in order to decrease the risk of international transmission. Also, discard any fruit with signs of bat bites.

Right now, Nipah has been identified in Malaysia (during the 1999 outbreak) and Bangladesh and India. As our world shrinks due to international travel and trade, and as climate change forces bats into new habitats, that could change.

“We observe [fruit bats] here [in Cambodia] and in Thailand, in markets, worship areas, schools and tourist locations like Angkor Wat – there’s a big roost of bats there,” Veasna Duong, head of virology at the Institut Pasteur research lab in Phnom Penh, Cambodia told the BBC’s Future program. “In a normal year, Angkor Wat hosts 2.6 million visitors. That’s 2.6 million opportunities for Nipah virus to jump from bats to humans annually in just one location.”

From there, it’s not hard to imagine one of those 2.6 million opportunities hopping on an international flight and leading to another global pandemic. One that’s a lot deadlier and a lot harder to treat.

Bangladesh reports two Nipah virus cases in 2021 [Outbreak News Today, 10 Sep 2021]

With all the news surrounding the death of a Kerala state, India child from Nipah virus earlier this week, the Bangladesh Institute of Epidemiology, Disease Control and Research (IEDCR) just updated their Nipah case count for 2021.

According to their data, two Nipah virus cases have been reported in Bangladesh this year, down from six in 2020.

No deaths were recorded and no details were released about the patients, the dates or their location.

This brings Bangladesh’s Nipah totals since 2001 to 321 cases and 225 deaths, accounting for a 70 percent fatality rate.

Nipah virus is one of the pathogens in the World Health Organization R&D Blueprint list of epidemic threats needing urgent R&D action. Nipah virus was first identified during an outbreak of disease that took place in Malaysia in 1998. Both animal-to-human and human-to-human transmission have been documented. Well more than 600 cases of Nipah virus human infections have been reported since the Malaysia outbreak. Subsequent outbreaks in India and Bangladesh have occurred with high case fatality.

Authorities race to contain deadly Nipah virus outbreak in India [CBS News, 7 Sep 2021]

BY ARSHAD R. ZARGAR

New Delhi — Authorities in India's southern Kerala state are racing to contain an outbreak of the Nipah virus. The virus, which is not related to the coronavirus behind the current global pandemic and is far more deadly, killed a 12-year-old boy in Kerala over the weekend, prompting stepped-up efforts to trace his contacts. New infections have been confirmed.

The boy was admitted to a hospital a week ago with high fever. As his condition worsened and doctors suspected inflammation of his brain (encephalitis), his blood samples were sent to the National Institute of Virology, where tests confirmed a Nipah infection. He died early on Sunday.

Government authorities have stepped up contact tracing efforts, identifying, quarantining and testing people who may have come into contact with the young victim. According to the state's health minister, Veena George, 188 people who came into contact with the boy had been identified by Monday. Of them, 20 were considered high-risk primary contacts — primarily his family members, all of whom were being held under strict quarantine or hospitalized.

Two healthcare workers who came into contact with the victim were already showing symptoms of Nipah infection by Monday. They were admitted to a hospital and their blood samples sent for testing.

Climate change's role in the COVID pandemic
Authorities sealed off the area within about a two-mile radius of the boy's home, and they were screening people for symptoms in all adjoining districts of Kerala state. The neighboring state of Tamil Nadu was also on high alert for any suspect cases of fever.

This is the second time in three years that a Nipah virus outbreak has been reported in Kerala, which is also reeling under a high rate of COVID-19 infections. The state reports about 68% of India's approximately 40,000 new cases every day.

What is Nipah virus?
Like the coronavirus, Nipah is a zoonotic virus, or one that is transmitted from animals to humans. Transmission generally occurs when humans either come into direct contact with the animals, or through consumption of contaminated food. But a high number of human-to-human transmission cases of Nipah have also been reported.

Fruit bats of the family Pteropodidae — commonly known as the "flying fox" — are the natural carriers of Nipah. They are known to transmit the virus to other animals including pigs, dogs, cats, goats, horses and sheep.

An infected human typically shows symptoms including fever and headache for anywhere between three days and two weeks, followed by a cough, sore throat and respiratory issues.

The condition later progresses swiftly to swelling in the brain cells, leading to drowsiness, confusion, and then possible coma and death.

There is no cure or vaccine for Nipah yet, and patients are only given supportive medical care.
According to the World Health Organization, up to 75% of Nipah infections prove fatal. The mortality rate for the coronavirus, by comparison, is believed to be about 2%. About 20% of survivors experience neurological symptoms that can persist, including seizures and personality changes.

A wider threat?
The Nipah virus was first discovered in Malaysia in 1999 during an outbreak among pig farmers. Since then, there have been multiple outbreaks — all of them in South and Southeast Asia. In all, it is known to have killed more than 260 people.

A 2004 Bangladesh outbreak was traced back to humans consuming date palm sap that had been contaminated by infected fruit bats. The last outbreak in India, which hit Kerala in 2018, killed 17 of the 18 people who caught it. Those infections were all traced back to fruit bats found dead in the water of a family's well.

Nipah is considered less contagious than the coronavirus, but its much higher mortality rate, a longer incubation period of up to 45 days, and its ability to infect a much wider variety of animals all make Nipah a cause of significant concern for epidemiologists trying to predict and prevent the next pandemic.

Veasna Duong, head of virology at the Institut Pasteur research lab in Phnom Penh, Cambodia, has studied human-bat interactions in the region, and he told the BBC earlier this year that the close proximity that people and bats find themselves in at markets and other crowded places across Asia poses a serious risk.

"This kind of exposure might allow the virus to mutate, which might cause a pandemic," Duong told the BBC's Future program, adding that in some circumstances, the virus could even find a host to carry it out of Asia.

"We observe [fruit bats] here and in Thailand, in markets, worship areas, schools and tourist locations like Angkor Wat – there's a big roost of bats there," he told the BBC's Future program. "In a normal year, Angkor Wat hosts 2.6 million visitors. That's 2.6 million opportunities for Nipah virus to jump from bats to humans annually in just one location."

Scientists warn that as the climate warms and humans destroy more natural habitat of species like the fruit bats in Asia, opportunities for new zoonotic variants to emerge increase.

The WHO says in its note on the Nipah virus that, "the risk of international transmission via fruits or fruit products (such as raw date palm juice) contaminated with urine or saliva from infected fruit bats can be prevented by washing them thoroughly and peeling them before consumption. Fruit with signs of bat bites should be discarded."

Norway and Malaysia team up to further research the Nipah virus [ScandAsia.com, 4 Aug 2021]

by Mette Larsen

Norway’s Coalition for Epidemic Preparedness Innovations (CEPI), has teamed up with Malaysia’s Universiti Malaya (UM), Malaysia, to further research and gain a wider scientific understanding of the Nipah virus, media Biospectrum Asia writes.

The Nipah virus (NiV) is zoonotic, meaning that it can spread between animals and people. Fruit bats also called flying foxes, are the animal reservoir for NiV in nature and Biospectrum Asia writes that the Nipah virus is one of the deadliest pathogens known to infect humans.

To explore the Nipah virus more and to characterize and better understand immune responses generated against the virus, UM will work to collect biological material from Nipah survivors. To carry out the research, UM will collaborate with physicians and healthcare workers who responded to the first-ever documented Nipah virus outbreak in Malaysia in 1998/1999.

Under the new partnership, CEPI will be providing funding of $188.000 towards UM’s work and because Nipah outbreaks often are sporadic with few survivors, the work is set to provide critical new information on Nipah immunology that has not previously been studied.