(Age-old practices of infection control are crucial to limit the deadly outbreak)
Context:- Nipah virus (NiV) infection is a newly emerging zoonosis that causes severe disease in both animals and humans. The natural host of the virus are fruit bats of the Pteropodidae Family, Pteropus genus.
NiV was first identified during an outbreak of disease that took place in Kampung Sungai Nipah, Malaysia in 1998. On this occasion, pigs were the intermediate hosts.
However, in subsequent NiV outbreaks, there were no intermediate hosts. In Bangladesh in 2004, humans became infected with NiV as a result of consuming date palm sap(ताड) that had been contaminated by infected fruit bats.
Human-to-human transmission has also been documented, including in a hospital setting in India.
NiV is also capable of causing disease in pigs and other domestic animals.
There is no vaccine for either humans or animals. The primary treatment for human cases is intensive supportive care.
The outbreak of the deadly Nipah virus around Kozhikode, Kerala, is a test of India’s capacity to respond to public health emergencies. In 2018, the World Health Organisation listed Nipah as one of the 10 priority pathogens needing urgent research, given its ability to trigger lethal outbreaks and the lack of drugs available against it.
As an RNA (Ribo Nucleic Acid) virus, Nipah has an exceptional rate of mutation(परिवर्तन) — that is, it can easily adapt to spread more efficiently among humans than it does now. Such an adaptation would result in a truly dangerous microbe.
Nipah already kills up to 70% of those it infects, through a mix of symptoms that include encephalitis, a brain inflammation marked by a coma state, disorientation, and long-lasting after-effects, such as convulsions(brain disorder), in those who survive.
Thankfully, in most outbreaks in South Asia so far the virus has displayed a “stuttering chain of transmission”. This means that once the virus spreads from fruit bats, its natural reservoir, to humans, it moves mainly to people in close contact with patients, such as hospital staff and family caregivers.
But these caregivers are at high risk, because the sicker the patients become, the more virus they secrete.
Preliminary reports suggest that the Kozhikode outbreak is also displaying a stuttering chain of transmission. Of the 11 confirmed Nipah fatalities, three were from the same family. While researchers are still investigating how they were exposed, a bat colony living in a well in the family’s yard is a strong suspect.
This fits in with how outbreaks have historically begun in the subcontinent. In a 2007 outbreak in Nadia, West Bengal, for example, patient zero is believed to have acquired the virus from palm liquor contaminated by bat droppings.
But these are preliminary reports, and new information may change what we know about the present virus. Several patients with symptoms of infection are under observation.
Only when clinical investigations are complete can it be determined how contagious(संक्रामक) the virus really is.
If it is found travelling over long distances, the authorities will have to be ready with strategies to combat its spread.
Good News
Kerala’s public health systems have acted with extraordinary efficiency so far. Doctors identified the virus in the very second patient, a diagnostic speed unrivalled(बेमिसाल) in developing countries. This must be commended(प्रशस्त).
Big Challenges
But big challenges remain. The death of a nurse shows that health-care workers may not be taking adequate precautions when dealing with patients, by using masks and following a strict hand-wash regimen(परहेज).
Final Words
The virus has no specific treatment. The best defences against it are the age-old principles of infection control, which Indian hospitals have not mastered as yet.
Kerala’s health authorities must ensure these principles are widely adopted, and no preventable transmission takes place.
Vocabulary words:
Disorientation (noun) = The condition of having lost one's sense of direction (स्थितिभ्रान्ति)
Convulsion (noun) = A sudden, violent, irregular movement of the body
Stutter (verb) = Stammer (हकलाना)
Contagious (adj) = Infectious (संक्रामक)
Unrivalled (adj) = Better than everyone or everything of the same type (बेमिसाल)
Regimen (noun) = A prescribed course of medical treatment, diet or exercise (परहेज)
Testimony (noun) = Evidence, proof of something (साक्ष्य)
Fractious (adj) = Difficult to control, unruly (अनियंत्रित)
Recede (verb) = Gradually diminish, retreat (पीछे हटना)
Sluggish (adj) = Inactive (निष्क्रिय)
Erstwhile (adj) = Former (भूतपूर्व)
Expatriate (adj) = Non-native, emigrant (प्रवासी)
Appease (verb) = Assuage or satisfy (खुश)
Restive (adj) = Unable to remain still (अशांत)
Curtail (verb) = Reduce in extent (घटाना)
Prominent (adj) = Important, famous (प्रसिद्ध)
Definition:
Patient zero (noun) = Used to refer to the person identified as the first carrier of a communicable disease in an outbreak of related cases
