Abstract
Nipah virus (NiV) has been transmitted from patient to caregivers in Bangladesh presumably through oral secretions. We aimed to detect whether NiV-infected patients contaminate hospital surfaces with the virus. During December 2013–April 2014, we collected 1 swab sample from 5 surfaces near NiV-infected patients and tested surface and oral swab samples by real-time reverse transcription PCR for NiV RNA. We identified 16 Nipah patients; 12 cases were laboratory-confirmed and 4 probable. Of the 12 laboratory-confirmed cases, 10 showed NiV RNA in oral swab specimens. We obtained surface swab samples for 6 Nipah patients; 5 had evidence of NiV RNA on >1 surface: 4 patients contaminated towels, 3 bed sheets, and 1 the bed rail. Patients with NiV RNA in oral swab samples were significantly more likely than other Nipah patients to die. To reduce the risk for fomite transmission of NiV, infection control should target hospital surfaces.
Highlights
Our objective was to identify whether Nipah patients contaminate nearby hospital surfaces with Nipah virus (NiV) RNA and, if so, which hospital surfaces are most commonly contaminated and which patients are most likely to contaminate their environment
One encephalitis case was reported from a nearby hospital, and we identified an additional 2 encephalitis cases from the community investigations
Of the 332 encephalitis cases identified in surveillance hospitals, we tested blood samples and oral swab samples from 312 (94%) case-patients and collected hospital surface swab samples from 49 case-patients who had a history of consuming raw date palm sap or contact with other encephalitis patients as reported by their caregiver on admission at the hospital
Summary
Nipah virus (NiV) has been transmitted from patient to caregivers in Bangladesh presumably through oral secretions. One third of identified Nipah patients in Bangladesh were infected through person-to-person transmission [8]; most of these were family caregivers who provided hands-on care to Nipah patients at home and in hospital [3,6,9,10]. NiV RNA has repeatedly been identified in infected patients’ oral secretions [14,15], and epidemiologic evidence suggests that exposure to respiratory secretions is a likely route of NiV transmission from patient to caregiver [6]. In 2004, during an NiV outbreak with person-to-person transmission in Bangladesh, NiV RNA was found on a hospital wall near where an NiV patient received care [6]
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