Abstract
15 patients after the middle of 2018, during the initial onset of the epidemic of identified Nipah viral infection (fruits borne virus) in adjacent state, presented with fever, acute coma, delirium, movement disorders, required referral to district headquarters hospital, for virology confirmation, and management. 135 mostly afebrile patients, who refused referral to government hospital, for virology confirmation, presented with symptoms of mainly subacute pan encephalitis, over the past 14 months; 90% presented with conglomeration of vertigo, staring, personality changes, imbalance in gait, difficulty to walk, bilateral drooling of saliva, tremors, confusion, altered sensorium, nausea, vomiting; 83% presented with dysarthria, 28% presented with symptoms of raised intracranial pressure-mimicking accelerated, malignant hypertensive emergencies, bradycardia, vomiting; decreased vision in 4.6%, myoclonic jerks in 58%, choreoathetosis in 8%. All of them could not afford INR 10000 for virology confirmation. Fruits borne viral subacute pan encephalitis, can present as subacute neurovascular syndrome, simulating ischemic stroke, mediated by Hapten triggered autoimmune angiopathy (blood borne) with resultant bilateral, asymmetrical multifocal, infarcts, cerebritis with consequent edema, requiring recognition, successful treatment with acyclovir, antiedema, antiepileptic measures and not antiplatelets, since the etiology is inflammatory and not degenerative. Promoting awareness to steam cook, pressure cook, cook with coconut oil (pie) fruits, steaming fresh fruit juices, before consumption will prevent incidence of fruits borne, tobacco leaves borne, and endemic viral infection. Economical screening card tests for Nipah fruits borne virus, will enable early detection, authenticate notification, early recognition treatment of subacute pan encephalitis presenting as neurovascular syndrome, mimicking ischemic stroke Global aborted blood pollution, contraceptive menstrual blood pollution, documented by rising environmental estrogen, beta human chorionic gonadotropins, alpha fetoprotein, favours emergence, virulence, drug resistance of microbes, including the recent fruits borne virus; global eradication of contraception, abortion (—non-evidence-based medical practice, without therapeutic indication, therapeutic protocols, therapeutic policies), to be replaced by global baby boom (promoting childbirth >10 - 20 children per family) will prevent further emergence, virulence of microbial infections, including Nipah, oncoming Ebola corona. Over the past 5 years, consumption of water living without scales, gills, fins,-toxin containing mammals, presented as cortical venous, sigmoid sinus thrombosis, in 3.5%, choreoathetosis in 12.5%, unresponsive but restless in 12.5%, quadriparesis, hemiparesis in 37.5% mimicking neurovascular syndrome, ischemic stroke; treatment with methylprednisolone, immunoglobulin reverted.
Highlights
15 patients after the middle of 2018, during the initial onset of the epidemic of identified Nipah viral infection in adjacent state, presented with fever, acute coma, delirium, movement disorders, required referral to district headquarters hospital, for virology confirmation, and management. 135 mostly afebrile patients, who refused referral to government hospital, for virology confirmation, presented with symptoms of mainly subacute pan encephalitis, over the past 14 months; 90% presented with conglomeration of vertigo, staring, personality changes, imbalance in gait, difficulty to walk, bilateral drooling of saliva, tremors, confusion, altered sensorium, nausea, vomiting; 83% presented with dysarthria, 28% presented with symptoms of raised intracranial pressure-mimicking accelerated, malignant hypertensive emergencies, bradycardia, vomiting; decreased vision in 4.6%, myoclonic jerks in 58%, choreoathetosis in 8%
For the past 14 months, after fruits borne virus has emerged, become endemic, secondary to aborted blood pollution, contraceptive menstrual blood pollution, evidenced by rising environmental estrogen, alpha feto protein, beta human chorionic gonadotropin, representing maternal blood, fetal blood, placental blood, and not industrial emissions, or industrial waste, 135 patients, presented with symptoms of subacute encephalitis, simulating suspicious ischemic stroke; of them 90% presented with conglomeration of vertigo, staring, difficulty to walk, personality changes, imbalance in gait, drooling of saliva, tremors, confusion, altered sensorium, vomiting; 83% presented with dysarthria, 28% presented with, symptoms of raised intracranial pressure-mimicking accelerated (Figure 1), malignant hypertensive emergencies, bradycardia, vomiting; decreased vision in 4.6%, myoclonic jerks in 58%. choreoathetosis in 8%
135 mostly afebrile patients, who refused referral to district Government head quarters hospital, with associated history of consumption of fresh fruits, fresh fruit juices, presented with subacute encephalitis manifestations of few days to few weeks duration; of them 90% presented with conglomeration of vertigo, staring, personality changes, imbalance in gait, difficulty to walk, drooling of saliva, tremors, confusion, altered sensorium, nausea, vomiting; 83% presented with dysarthria; 28% presented with symptoms of raised intracranial pressure-mimicking accelerated, malignant hypertensive emergencies, bradycardia, vomiting; decreased vision in 4.6%, myoclonic jerks in 58%, choreoathetosis in 8%
Summary
By fruits borne viral infection—Nipah, was identified, notified, in middle of 2018, in the neighbouring state, around 15 patients over a span of 2 - 3 months, had come with manifestations of fever, coma, choreoathetosis, myoclonic jerks, epilepsia partialis continua, evidenced by cerebral imaging with multifocal, bilateral, asymmetrical infarcts, extensive cerebral edema, they were referred to district headquarters hospital for virology confirmation and management. 2 - 3 months after the onset of Nipah virus epidemic, many afebrile patients presented with dysarthria, staring, personality changes, less communicative, drooling of saliva, vertigo, giddiness, vomiting, altered sensorium, staggering gait, hemiparesis, monoparesis, of few days to few weeks duration, association with fresh fruits, fresh fruit juices consumption history, refused referral to district headquarters hospital, and did not have resources to get virology confirmation ~INR 10000; cerebral imaging evidenced subacute bilateral, asymmetrical infarcts, bilateral, extensive cerebral edema; on treatment with antiviral, coupled with antiedema, antiepileptics, remarkable, gratifying cure for the endemic fruits borne viral infection was achieved
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
