Nipah virus outbreak: Top 10 symptoms of the deadly virus; prevention and treatment tips
While Nipah virus starts with mild symptoms like headache, muscle pain, fatigue, nausea, it may progress to deadly symptoms as the disease advances.
Amid the outbreak of Nipah virus in Kerala, the state has been taking all the precautionary measures to control the spread. So far, two people have died and at least five have been infected by the virus which has high mortality rate but is less infectious. (Also read: Nipah in Kerala: Containment zones created, ICMR delivers antibody | 10 points)
WHO says the Nipah virus’s fatality rate may be between 40- 75 percent. Nipah virus is a viral infection and the name 'Nipah' comes from a Malaysian village, where the first outbreak was reported in 1998-1999 and it has high mortality.
While Nipah virus starts with mild symptoms like headache, muscle pain, fatigue, nausea, it may progress to mental confusion, seizures and encephalitis when the virus starts affecting brain function.
What is Nipah virus?
"Nipah virus (NiV) is a zoonotic virus that can cause severe illness in humans. It is primarily transmitted from animals to humans and can also spread from human to human. The symptoms of Nipah virus infection can range from mild to severe," says Dr Ajay Aggarwal, Director - Internal Medicine, Fortis Hospital Noida.
"Nipah virus was first identified in 1998 during an outbreak in Malaysia. Nipah virus infection can lead to severe respiratory illness and encephalitis (inflammation of the brain)," says Dr G Sneha, Consultant - General Medicine, CARE Hospitals, Banjara Hills, Hyderabad. (Also read: Nipah virus outbreak in India: What do we know so far?)
"Nipah virus is primarily seen in Indo Bangladesh region. In Malaysia, the source of infection was nosocomial, the source being pigs and bats who had transmitted the virus to humans. Consecutively, human to human infection is the cause of spread of the infection through droplet infection. Recently, two unnatural deaths were reported in Kozhikode, Kerela suspected to be due to a new virus outbreak in the area. It is feared that the deaths might be caused due to the Nipah virus," says Dr Tushar Tayal, Consultant, Internal Medicine, CK Birla Hospital, Gurugram.
Symptoms of Nipah virus
Initial symptoms of Nipah virus are non-specific such as fever, headache, dizziness, myalgia, vomiting and loose stools. This may progress to brain involvement in the form of seizures and encephalitis. There may also be respiratory involvement causing respiratory failure.
"Nipah infection has very high morbidity in the form of psychiatric and neurological complications (depression, personality changes, deficits in attention, verbal, and/or visual memory) after recovery. Mortality rate of Nipah is also very high as it is majorly untraceable, and has a fatality rate of 40 to 75 percent, according to the World Health Organisation (WHO)," says Dr Tayal.
Dr Ajay Agarwal shares Nipah virus's symptoms in detail:
1. Fever: Nipah virus infection often starts with a high fever.
2. Headache: Headaches are a common early symptom.
3. Muscle pain: Muscle aches and pain may occur, similar to flu-like symptoms.
4. Fatigue: Profound weakness and fatigue can be present.
5. Nausea: Many individuals experience nausea, sometimes accompanied by vomiting.
6. Dizziness: Some people may feel dizzy or lightheaded.
7. Mental confusion: As the disease progresses, confusion and disorientation may develop.
8. Seizures: In severe cases, individuals may experience seizures due to neurological complications.
9. Respiratory symptoms: Respiratory distress, including difficulty breathing, can occur in severe cases.
10. Coma: In the most severe cases, individuals can slip into a coma.
Dr G Sneha shares the following symptoms for Nipah virus
Fever: Nipah virus infection often begins with a high fever, typically 3 to 14 days after exposure.
Headache: Severe headaches are common.
Dizziness: Patients may experience dizziness or disorientation.
Nausea and vomiting: Gastrointestinal symptoms like nausea and vomiting may occur.
Neck rigidity: Stiff neck and muscle pain can be early signs of the infection.
Mental confusion: As the disease progresses, patients may become disoriented and develop mental confusion.
Coma: In severe cases, Nipah virus infection can lead to a coma within 24-48 hours.
"Furthermore, it's crucial to take precautions to prevent Nipah virus transmission, as it can spread from person to person through close contact, respiratory droplets, or contact with contaminated objects or surfaces. Public health measures such as isolation, quarantine, and infection control practices are essential to prevent outbreaks of Nipah virus infection. If you suspect a Nipah virus outbreak in your area or have concerns about potential exposure, it's essential to contact local health authorities for guidance and follow recommended preventive measures," says Dr Agarwal.
Dr G Sneha says there is no specific antiviral treatment for Nipah virus infection and supportive care is the mainstay of treatment.
It may include:
1. Hospitalization: Infected individuals are usually hospitalized to receive appropriate medical care and to prevent the spread of the virus.
2. Supportive care: This includes intravenous fluids to maintain hydration, pain management, and mechanical ventilation in severe cases to assist with breathing.
3. Experimental treatments: In some cases, experimental antiviral drugs or therapies may be considered, but their effectiveness is not well established.
"Also, there are very few experimental medications such as Ribavirin and favipiravir which have shown some benefit, but the treatment remains primarily symptomatic," says Dr Tayal.
Dr G Sneha suggests Nipah virus patient should be isolated and quarantined. Here are points to remember:
1. Isolation and quarantine: Infected hould be isolated to prevent further transmission. Close contacts should be monitored and quarantined if necessary.
2. Infection control: Healthcare workers and caregivers should follow strict infection control measures to prevent the spread of the virus.
3. Preventive measures: In areas with known Nipah virus outbreaks, measures such as avoiding contact with sick animals, not consuming fruits contaminated by bat saliva or urine, and practicing good hygiene are important for prevention.
4. Vaccines: Research is ongoing, and vaccines are being developed, but as of my last update in September 2021, there was no licensed vaccine for Nipah virus.
"Hand hygiene and personal protective equipment (PPE) remain as pillars of comprehensive infection prevention. We have to remember our learning from Covid and use the same precautions that we have been following for the past few years that is hand hygiene, social distancing and usage of masks," says Dr Tayal.