Nipah virus kills one teenager as health experts race to track 350 others
Indian health officials are anxiously awaiting the test results of six people displaying Nipah virus symptoms, after a teenage boy died on Sunday.
Authorities in the southern state of Kerala are tracking around 350 people who came into contact with the 14-year-old Nipah victim, including 101 “high risk” contacts and six who are displaying some symptoms, according to an update on Monday.
The highly fatal disease – which inspired the Hollywood film Contagion – is classified as a priority pathogen by the World Health Organization: it has “serious potential” to drive mass outbreaks: it has a mortality rate as high as 75 per cent, but there are no rapid tests, vaccines or specific treatments to fight it.
The latest outbreak – Kerala’s fifth since 2018 – was detected on Saturday, when the teenage boy tested positive. Only a day later he died after suffering from a cardiac arrest, according to the state’s health minister Veena George.
“There was a hope of coming back to life,” she wrote on Facebook on Sunday. “But the saddest parting happened at 11.30am this morning… expressing sorrow and pain to the family on the demise of that beloved son.”
In an update on Monday Ms George warned that six others have exhibited symptoms and are awaiting test results, which could arrive as early as Monday evening.
Symptoms of the respiratory disease vary – it often starts with a fever, headache or myalgia before developing into dizziness or confusion, which signals brain inflammation. In severe cases, people become comatose within 24 hours.
Of those who survive, roughly 20 per cent are left with long-term neurological conditions, including personality changes or seizure disorders.
“Out of the samples sent for testing, six of the persons have symptoms,” Ms George said on Monday, according to Indian outlet the Economic Times. “Three of them are on the secondary contact list. Even though the parents of the deceased boy do not have symptoms, we have sent their samples also for testing to rule out all possibilities.”
In all, 350 people have been traced and monitored, including 101 who are “considered high risk”. Around 68 people are healthcare workers who interacted with the teenager, others include those who travelled on a private bus he used after falling ill.
Nipah virus spreads through contact with the bodily fluids of infected animals or people, though it is nowhere near as contagious as pathogens like Covid-19 and flu.
During the first known epidemic in Malaysia and Singapore in 1999, the virus jumped from pigs to farmers and killed 105 people, but more recently in Bangladesh and India it has been traced to bats in sporadic, smaller outbreaks.
In many cases, the victims had consumed the juice of raw dates, a popular food for bats, but this time officials are investigating whether the boy could have contracted the virus after eating hog plum fruit from a field near his home.
In Kerala, the pathogen was first identified in 2018, in an outbreak which claimed the lives of 17 people. The virus has sporadically reared its head in the region in the years since, with the most recent outbreak last September killing two and infecting four others. Then, schools and offices were shut and at least 800 people tracked down as the state raced to contain the spread.
There is little else that can be done. Despite a “priority pathogen” for the WHO, there are still no vaccines or drugs to specifically target the virus.
Several shots are in development, including candidates at the companies Auro Vaccines and Public Health Vaccines, as well as at the universities of Oxford and Tokyo. And earlier this month, the Coalition for Epidemic Preparedness Innovations (Cepi) announced that a new monoclonal antibody treatment will progress to human trials in India and Bangladesh next year.
But Prof Linfa Wang, an emerging infectious disease specialist at Duke-NUS Medical School in Singapore, told the Telegraph that there is also an urgent need for rapid diagnostics, to reduce reliance on laboratory tests in an outbreak setting.
“We need a rapid test like the one we used for Covid. There is effort in doing just that, including our team here in Singapore. But the irony is that we need more cases to validate the test,” he said.
He added that the latest outbreak is a reminder of the threat, but not yet cause for global alarm.
“It’s complicated: on one hand, we should be worried about non-stop spill over on a yearly basis; but on the other hand, it ironically means the virus is not very transmissible despite the “frequent” jumping of species,” Prof Wang said. “Overall, I don’t think we need to be too worried at this stage.”
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