Nipah: Viruses with up to 75% mortality reappear in Asia and authorities go on alert

The coronavirus has had heavy consequences for the entire world. One of the lessons that the pandemic provoked, however, was the need to prepare for future occasions. In this sense, the recurrence of a virus in Asia with a mortality rate of up to 75% has attracted international media attention.

A 12-year-old boy died last week in a hospital in the city of Calicut, on the west coast of India. According to Kerala state health authorities, the child died from an infection caused by the Nipah virus (NiP), which is much more deadly than Covid-19, although less transmissible.

It is estimated that the boy had contact with 188 people before he died. All are undergoing quarantine or are hospitalized in an attempt to contain the spread of the virus. Nipah is transmitted from animals to humans, through contaminated food or directly between people.

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Hospitalized for a week, the boy developed a very high fever and the condition worsened with signs of encephalitis—inflammation and swelling in the brain—until he died.

Fruit bats of the Pteropodidae family are the main vectors for Nipah, although the pathogen has, in its first outbreak in Malaysia in 1999, infected pigs, horses, goats, sheep, cats and dogs. According to the WHO, most of these first infections occurred after unprotected human contact with contaminated secretions or tissues from sick pigs.

Infected humans can present from asymptomatic infection to respiratory infection (mild or severe) and fatal encephalitis. The main symptoms initially reported are: fever, headache, myalgia (muscle pain), vomiting and sore throat. Dizziness, drowsiness, altered consciousness and neurological signs may also occur, which may be indicative of acute encephalitis.

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The incubation period for the virus, which occurs between infection and the onset of symptoms, ranges from 4 to 14 days. In severe cases, encephalitis and seizures progress to coma within 24 to 48 hours.

Some of these people even manage to survive and fully recover, but about 20% of patients are left with neurological sequelae, such as seizure disorders and personality changes, and may even present relapses.

The Nipah outbreaks never reached a pandemic level, but health officials say the virus could give rise to a pandemic. At the moment there is no vaccine or any type of treatment for the Nipah virus, that is, methods have not yet been created to prevent contamination or medications to improve the condition.

As a result, WHO has already included Nipah in its list of prioritized diseases and pathogens for research and development in emergency contexts.