Nipah Virus Outbreak: Five things you should do to keep yourself safe, uninfected

The  **first confirmed case**  in a suspected  Nipah virus outbreak in Kerala is a 23-year-old man in Ernakulam who tested positive, with a deadly fever. The Kerala Health Minister, K K Shailaja,  has said that all necessary precautions and remedial steps to curb the spread of the deadly disease are in place. The patient has been shifted to an isolation ward, and all the people he came in contact with have been called in for blood tests — all  86 of them, that is. The first known “outbreak” of a Nipah virus infection was in 1998 when over 100 people in Malaysia were found infected after contracting the virus from domesticated pigs. In India, the first outbreak was in the state of West Bengal in 2001, where fruit bats were the source. There are many things to be aware of and many things you can do to stay safe during a Nipah virus outbreak.

• AVOID: Touching animals you don’t know and love

For one, contact with infected pigs, other infected animals, bats, or through contaminated fruits — these could very well be half-eaten fruits left behind by a fruit bat without an appetite. Even direct contact with people positive for the Nipah Virus  has been reported as the cause of outbreaks. What if you absolutely need to touch a sick animal? Wear gloves and other protective clothing to handle the animals, their meat or body tissue, says the World Health Organisation (WHO).

• AVOID: Buying fruits that are wrinkled, bitted or damaged in any way

WHO also acknowledges that there is a risk of international transmission via fruits or fruit products (like raw date palm juice), contaminated with urine or saliva from infected fruit bats. That said, the risk can be eliminated by washing the fruit thoroughly and peeling them before consumption. Fruit with signs of bat bites should be discarded. Freshly collected date palm juice should be boiled. [caption id=“attachment_6754341” align=“alignnone” width=“1280”] Global distribution of Nipah and Hendra virus risk. Image: WHO[/caption]

• AVOID: Drinking anything fermented or stored in the open/under palm trees

In Bangladesh and India, where Nipah infections are more frequent than anywhere else, exposure is linked to consuming raw date palm sap and contact with bats. Stay well away from drinks (particularly toddy) that are brewed in the open under the shade of tall trees. If there’s one thing worse than bat faeces falling into your fresh toddy, it’s infected bat faeces in your fresh toddy. Many of us probably live far from the cooling comfort of coconut/palm trees or a Batcave. But bats are still out and about in cities, so are pigs.

• AVOID: Touching anybody infected with the virus or their things

Importantly, human-to-human transmission has been documented and exposure to other Nipah virus-infected individuals is also a risk factor. Clothes, utensils and items typically used in the toilet or bathroom, like buckets and mugs, should be cleaned separately and maintained hygienically. What if you need to attend to someone that you think is Nipah positive? Protect yourself from direct contact using gloves, a mask and protective clothing. Regular hand washes are a must after caring for or visiting a Nipah victim. While animal-to-human cases are more common, human-to-human transmission has also  been reported, particularly in healthcare settings where contact and airborne droplets are prevalent. In addition to standard precautions, these medical professionals need to be trained in precautions and suitable medical laboratories for tests.

Is there a Nipah vaccine?

At present, no. Tackling the Nipah virus is a particularly difficult public health problem because there’s no means of preventing an infection other than taking precautions. Most infectious diseases specialists, including Dr Benjamin A Satterfield from the Department of Microbiology and Immunology at the Mayo Clinic, suggest that tackling the risk factors are a better way of dealing with an outbreak than vaccines themselves. In Malaysia, measures are already in place to avoid further exposure or outbreak of Nipah virus. For instance, livestock like pigs and cattle, which can act as hosts, are kept isolated to prevent them from coming into contact with the virus. In humans, it is recommended that infected people and everyone they have come in contact with, or anyone showing symptoms of infection is quarantined, as the infection is highly contagious. Research is being done towards treatment, led by Pune-based National Institute of Virology. An antiviral known as Ribavirin has been shown as having a role in reduced mortality in patients with symptoms of Nipah virus infection. However, treatment consists of supportive measures given to the patient as and when needed.