Pestilence: What To Know About The Deadly Nipah Virus As India Races To Contain Another Outbreak

What To Know About The Deadly Nipah Virus As India Races To Contain Another Outbreak

Robert Hart

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).

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.

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.

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.

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