Nipah Virus Outbreak Research Articles

Epidemiological insights into Nipah virus: A sir model perspective

The Nipah virus outbreak in Kerala, India, in 2024 presented significant public health challenges, necessitating an in-depth analysis of its transmission dynamics and the effectiveness of response measures. This study employs the SIR (Susceptible, Infected, Recovered) epidemiological model to simulate the outbreak, focusing on key parameters such as transmission and recovery rates. The model reveals that the outbreak peaked around Day 10, with a maximum of approximately 631 infected individuals, highlighting the rapid spread of the virus. However, timely public health interventions, including contact tracing, isolation, and community engagement, effectively curtailed transmission, resulting in a swift decline in infected cases and a significant recovery rate. By Day 100, nearly the entire population had either recovered or remained uninfected, underscoring the success of containment efforts. This study emphasizes the critical role of proactive health strategies in managing infectious diseases and provides valuable insights for future preparedness against zoonotic outbreaks. The findings highlight the necessity of continuous monitoring and community involvement in strengthening public health infrastructure to mitigate the impact of similar outbreaks in the future.

Nipah virus: epidemiology, pathogenesis, treatment, and prevention.

Nipah virus (NiV) is a zoonotic paramyxovirus that has recently emerged as a crucial public health issue. It can elicit severe encephalitis and respiratory diseases in animals and humans, leading to fatal outcomes, exhibiting a wide range of host species tropism, and directly transmitting from animals to humans or through an intermediate host. Human-to-human transmission associated with recurrent NiV outbreaks is a potential global health threat. Currently, the lack of effective therapeutics or licensed vaccines for NiV necessitates the primary utilization of supportive care. In this review, we summarize current knowledge of the various aspects of the NiV, including therapeutics, vaccines, and its biological characteristics, epidemiology, pathogenesis, and clinical features. The objective is to provide valuable information from scientific and clinical research and facilitate the formulation of strategies for preventing and controlling the NiV.

Understanding the dynamics of nipah virus (NiV) transmission and outbreaks in India from Kerala’s perspective

This comprehensive analysis delves into the series of Nipah virus (NiV) outbreaks across India, with a particular focus on occurrences in Kerala. NiV, which belongs to the Paromyxoviridae family and Henipavirus genus, originated in Malaysia in 1998 and has consistently posed significant global health threats. In India, NiV outbreaks have sporadically emerged since the initial case in West Bengal in 2001, often with alarming mortality rates. The 2018 resurgence in Kerala exhibited an astonishing case fatality rate of 89%, emphasizing the need for tailored diagnostic and management strategies due to substantial variability in the incubation period and clinical manifestations. Understanding the predominant person-to-person transmission underscores the importance of comprehending transmission dynamics. Early detection, facilitated by the Integrated Disease Surveillance Program (IDSP), remains vital, as treatment options are currently confined to supportive care, necessitating the exploration of more effective therapeutics. The sporadic nature of NiV outbreaks, exemplified by the recent Kerala episode, emphasizes the urgency for robust response mechanisms, while collaborative efforts and capacity-building initiatives are essential for effectively managing these occurrences. Continued focus on prompt detection, advanced laboratory testing, accessibility to cutting-edge facilities, and heightened infection control measures remains imperative to mitigate future incidents.

Knowledge and attitude among Bangladeshi healthcare workers regarding the management and infection prevention and control of Nipah virus

BackgroundThe Nipah virus (NiV) is a zoonotic pathogen that belongs to the Paramyxoviridae family. It can cause severe respiratory and neurological diseases in humans, with varying clinical symptoms. Recognized as a critical public health concern by the World Health Organization, it requires concerted efforts in research and development to prevent outbreaks. MethodologyAn analytical cross-sectional study was conducted on 455 healthcare workers across four major regions in Bangladesh from April 2022 to May 2023. Using multistage convenient sampling and face-to-face interviews with a semi-structured questionnaire, we have examined the level of knowledge, attitudes, and individual perceptions of the preparedness for NiV. Data analysis included univariate and bivariate analyses, followed by binary logistic regression to ascertain the association with demographic factors. ResultsThe study identified a gender disparity favoring female healthcare workers (HCWs). Approximately 46.15 % of participants demonstrated a good knowledge about NiV, with doctors showing significantly higher knowledge odds (OR = 5.197, p < 0.001). Interestingly, graduate and post-graduate education levels did not yield a statistically significant correlation with knowledge. Specific training received was positively associated with knowledge levels (OR = 1.832, p = 0.014), highlighting the gap in routine infection prevention education. Regional differences were notable, with participants from Chittagong having a lower level of knowledge compared to Dhaka (OR = 0.307, p = 0.004). Attitudes towards NiV were predominantly positive, although higher education inversely correlated with positive attitudes, suggesting a potential gap between theoretical knowledge and practical attitudes. ConclusionWhile the attitude towards NiV is generally positive among Bangladeshi HCWs, there is a need to enhance knowledge levels, especially in primary care settings and certain regions. To effectively prepare for NiV outbreaks, it is crucial to prioritize continuous education and practical training. The study underscores the importance of implementing uniform educational strategies to equip HCWs across all categories and regions with adequate NiV knowledge and preparedness.

Computational investigation of remdesivir, favipiravir, ribavirin, and their phosphate derivatives against Nipah virus RNA-dependent RNA polymerase

ABSTRACT Outbreaks of human Nipah virus (NiV) cases have recently been reported in several countries. With a mortality rate of around 80% and no known therapy, there is an urgent need to test existing antivirals repurposed for it. Due to its central role in virus replication, the RNA-dependent RNA polymerase (RdRp) of NiV-L protein is a potential target for such antiviral therapies. In this study, Favipiravir, Remdesivir, Ribavirin, and their metabolites, including monophosphate (MP), diphosphate (DP), and triphosphate (TP), were virtually screened against RdRp. Using molecular dynamics (MD) simulations, lead hits from the docking study were examined for conformational changes. Additional analyses, including MM-PBSA, residual decomposition energy, and principal component analysis, were performed on the MD trajectory. Remdesivir-TP, Favipiravir-TP, and Ribavirin-TP exhibited the lowest binding energies of –7.8, −7.4, and −6.9 kcal/mol, respectively, and displayed an affinity for pocket 1, forming interactions with active site residues Asp726 and Asn727. During the 100 ns MD simulation, Remdesivir-TP demonstrated a more stable binding mode compared to Favipiravir-TP and Ribavirin-TP. The relative binding energies were −94.709 kJ/mol, −68.882 kJ/mol, and −46.98 kJ/mol for Remdesivir-TP, Favipiravir-TP, and Ribavirin-TP, respectively. This research anticipates Remdesivir-TP to be a potential candidate for an antiviral drug against NiV infection.

A systematic review on Nipah virus: global molecular epidemiology and medical countermeasures development.

Nipah virus (NiV) is an emerging pathogen that causes encephalitis and a high mortality rate in infected subjects. This systematic review aimed to comprehensively analyze the global epidemiology and research advancements of NiV to identify the key knowledge gaps in the literature. Articles searched using literature databases, namely PubMed, Scopus, Web of Science, and Science Direct yielded 5,596 articles. After article screening, 97 articles were included in this systematic review, comprising 41 epidemiological studies and 56 research developments on NiV. The majority of the NiV epidemiological studies were conducted in Bangladesh, reflecting the country's significant burden of NiV outbreaks. The initial NiV outbreak was identified in Malaysia in 1998, with subsequent outbreaks reported in Bangladesh, India, and the Philippines. Transmission routes vary by country, primarily through pigs in Malaysia, consumption of date palm juice in Bangladesh, and human-to-human in India. However, the availability of NiV genome sequences remains limited, particularly from Malaysia and India. Mortality rates also vary according to the country, exceeding 70% in Bangladesh, India, and the Philippines, and less than 40% in Malaysia. Understanding these differences in mortality rate among countries is crucial for informing NiV epidemiology and enhancing outbreak prevention and management strategies. In terms of research developments, the majority of studies focused on vaccine development, followed by phylogenetic analysis and antiviral research. While many vaccines and antivirals have demonstrated complete protection in animal models, only two vaccines have progressed to clinical trials. Phylogenetic analyses have revealed distinct clades between NiV Malaysia, NiV Bangladesh, and NiV India, with proposals to classify NiV India as a separate strain from NiV Bangladesh. Taken together, comprehensive OneHealth approaches integrating disease surveillance and research are imperative for future NiV studies. Expanding the dataset of NiV genome sequences, particularly from Malaysia, Bangladesh, and India will be pivotal. These research efforts are essential for advancing our understanding of NiV pathogenicity and for developing robust diagnostic assays, vaccines and therapeutics necessary for effective preparedness and response to future NiV outbreaks.

Strategic vaccine stockpiles for regional epidemics of emerging viruses: A geospatial modeling framework

Multinational epidemics of emerging infectious diseases are increasingly common, due to anthropogenic pressure on ecosystems and the growing connectivity of human populations. Early and efficient vaccination can contain outbreaks and prevent mass mortality, but optimal vaccine stockpiling strategies are dependent on pathogen characteristics, reservoir ecology, and epidemic dynamics. Here, we model major regional outbreaks of Nipah virus and Middle East respiratory syndrome, and use these to develop a generalized framework for estimating vaccine stockpile needs based on spillover geography, spatially-heterogeneous healthcare capacity and spatially-distributed human mobility networks. Because outbreak sizes were highly skewed, we found that most outbreaks were readily contained (median stockpile estimate for MERS-CoV: 2,089 doses; Nipah: 1,882 doses), but the maximum estimated stockpile need in a highly unlikely large outbreak scenario was 2–3 orders of magnitude higher (MERS-CoV: ∼87,000 doses; Nipah ∼ 1.1 million doses). Sensitivity analysis revealed that stockpile needs were more dependent on basic epidemiological parameters (i.e., death and recovery rate) and healthcare availability than any uncertainty related to vaccine efficacy or deployment strategy. Our results highlight the value of descriptive epidemiology for real-world modeling applications, and suggest that stockpile allocation should consider ecological, epidemiological, and social dimensions of risk.

IJCM_307A: Perception and practice of Nipah among first year undergraduate medical students of knct medical college

Background: Nipah infection is a zoonotic disease caused by Nipah virus with a very high case fatality rate (40-75%). The current outbreak (12-15 September 2023) was the third Nipah virus outbreak in Kozhikode district of Kerala, and overall the fourth outbreak in Kerala state since 2018. The state government had declared containment zones in the district and there was restriction of movement, public gatherings; wearing of masks and social distancing was mandatory in public spaces. The educational institutions including professional colleges were closed as a precautionary measure and switched to online classes. In this context, this study was conducted among the first-year medical students of KMCT medical college Objective: To assess the Perception and Practice about Nipah among first year undergraduate medical students of KMCT medical college Methodology: A cross sectional study was done among 2023 batch students of KMCT medical college students from September 18th to October 28, 2023. All the 150 students were taken by universal sampling for the study, out of which 144 were present at the time of data collection. Data was collected by investigators using a semi-structured questionnaire consisting of knowledge, attitude and practice-based sections. Scoring was done. The data was analyzed and recorded as frequencies and percentage. Results: Majority of the students (69%) had poor knowledge on Nipah, 29% had satisfactory knowledge and 2% of the students had very good knowledge. Majority of the students (89%) had good attitude towards Nipah while 10% had poor attitude. 68% students were found to have followed excellent practices, 30% had followed satisfactory practices while 2% had not practiced any good etiquette needed during an outbreak. Conclusion: Though they were having poor knowledge about Nipah, they followed good practices that helped in preventing and controlling the disease.

BEYOND HEROES AND VILLAINS: PORTRAYAL OF HEALTHCARE WORKERS IN FILM “VIRUS”

The portrayal of healthcare workers in films significantly influences public perception. This study delves into the Malayalam film "Virus," a dramatization of the 2018 Nipah virus outbreak in Kerala, India. Using a semiotic approach, it investigates the representation of healthcare workers through visual elements, character traits, and interactions within the film. Rather than resorting to clichéd depictions of heroic saviors` or villainous doctors, "Virus" offers a nuanced and realistic portrayal. The analysis scrutinizes how healthcare workers are visually depicted through clothing, body language, and facial expressions, reflecting their dedication, expertise, and resilience. It delves into the film's portrayal of character traits, emphasizing their unwavering commitment despite facing significant personal risk and exposure to a deadly virus. Furthermore, it examines how their interactions with patients and authorities illustrate the challenges they confront during a public health crisis. By dissecting these signs and symbols, the research aims to unravel the underlying messages conveyed about the healthcare profession in "Virus." This analysis has the potential to foster a more balanced public perception of healthcare workers in India and globally. Additionally, it highlights how films like "Virus" can employ scientific accuracy to depict the complexities of managing real-world epidemics.

Nipah virus outbreak

Nipah virus outbreak

Nipah Virus Disease: An Updated Review

The Nipah virus (NiV) is a member of the Paramyxoviridae family of zoonotic viruses that is extremely contagious and potentially fatal. The Nipah virus was first discovered in 1999 during an outbreak in Malaysia. Since then, it has periodically caused outbreaks throughout South and Southeast Asia, especially in Bangladesh and India, and it continues to be a serious public health concern. The virus is primarily transmitted to humans through direct contact with infected fruit bats, which serve as natural reservoir hosts for the Nipah virus. Human-to-human transmission can also happen when infected people's body fluids come into close contact with one another. The Nipah virus has a high death rate that varies depending on the outbreak and can cause a variety of clinical presentations, including encephalitis, severe respiratory illnesses, and asymptomatic infections. Fever, headache, dizziness, drowsiness, and confusion are common signs of Nipah virus infections, which may lead to the rapid onset of coma in the patient. The Nipah virus does not presently have a specific antiviral treatment; instead, infection control methods and supportive care are the foundation of management to stop the virus from spreading. Nipah virus outbreaks must be stopped with an approach that includes community involvement, public health education, and surveillance of both human and animal populations. Additionally, efforts are directed toward developing vaccines as a more potent form of prevention. The Nipah virus is a clear reminder of the continuous threat that newly emerging infectious diseases pose, as well as the necessity of having strong surveillance systems and quick response times in place to lessen the effects that these outbreaks have on public health.

Clinico-epidemiological presentations and management of Nipah virus infection during the outbreak in Kozhikode district, Kerala state, India 2023.

India experienced its sixth Nipah virus (NiV) outbreak in September 2023 in the Kozhikode district of Kerala state. The NiV is primarily transmitted by spillover events from infected bats followed by human-to-human transmission. The clinical specimens were screened using real-time RT-PCR, and positive specimens were further characterized using next-generation sequencing. We describe here an in-depth clinical presentation and management of NiV-confirmed cases and outbreak containment activities. The current outbreak reported a total of six cases with two deaths, with a case fatality ratio of 33.33%. The cases had a mixed presentation of acute respiratory distress syndrome and encephalitis syndrome. Fever was a persistent presentation in all the cases. The Nipah viral RNA was detected in clinical specimens until the post-onset day of illness (POD) 14, with viral load in the range of 1.7-3.3 × 104 viral RNA copies/mL. The genomic analysis showed that the sequences from the current outbreak clustered into the Indian clade similar to the 2018 and 2019 outbreaks. This study highlights the vigilance of the health system to detect and effectively manage the clustering of cases with clinical presentations similar to NiV, which led to early detection and containment activities.

An impending public health threat: analysis of the recent Nipah virus outbreak and future recommendations – an editorial

An impending public health threat: analysis of the recent Nipah virus outbreak and future recommendations – an editorial

Novel methods for the rapid and sensitive detection of Nipah virus based on a CRISPR/Cas12a system.

Nipah virus (NiV), a bat-borne zoonotic viral pathogen with high infectivity and lethality to humans, has caused severe outbreaks in several countries of Asia during the past two decades. Because of the worldwide distribution of the NiV natural reservoir, fruit bats, and lack of effective treatments or vaccines for NiV, routine surveillance and early detection are the key measures for containing NiV outbreaks and reducing its influence. In this study, we developed two rapid, sensitive and easy-to-conduct methods, RAA-CRISPR/Cas12a-FQ and RAA-CRISPR/Cas12a-FB, for NiV detection based on a recombinase-aided amplification (RAA) assay and a CRISPR/Cas12a system by utilizing dual-labeled fluorophore-quencher or fluorophore-biotin ssDNA probes. These two methods can be completed in 45 min and 55 min and achieve a limit of detection of 10 copies per μL and 100 copies per μL of NiV N DNA, respectively. In addition, they do not cross-react with nontarget nucleic acids extracted from the pathogens causing similar symptoms to NiV, showing high specificity for NiV N DNA detection. Meanwhile, they show satisfactory performance in the detection of spiked samples from pigs and humans. Collectively, the RAA-CRISPR/Cas12a-FQ and RAA-CRISPR/Cas12a-FB methods developed by us would be promising candidates for the early detection and routine surveillance of NiV in resource-poor areas and outdoors.

The Nipah Virus Scare: Kerala's Swift Response and Lessons Learned

Kerala's first Nipah virus outbreak occurred in 2018. It being in the pre-covid era presented major challenges to the public health authorities highlighting the need for rapid response and improved preparedness. This article provides an in-depth analysis of the outbreak, its epidemiology, clinical presentation, public health response, challenges faced, and the crucial lessons learned. Being a third-year medical student in a Nipah-affected area was an unsettling experience. The fear was palpable as we grappled with the uncertainty of the virus's spread. The pay wards in our hospital were converted into Nipah isolation wards within a day. Hearing terms like "quarantine" and "isolation" became chilling reminders of the dire situation, emphasizing the importance of strict protocols and safety measures to protect patients and healthcare workers

A comprehensive review on Nipah virus infection control measures

Nipah virus (NiV) has emerged as a deadly zoonotic pathogen, causing sporadic outbreaks with high mortality rates. The patient typically exhibits thrombocytopenia, leukopenia, and transaminitis along with fever, encephalitis, and/or respiratory involvement. This comprehensive review delves into the multifaceted realm of Nipah virus infection control measures. We explore the latest research, strategies, and practices aimed at preventing, containing, and mitigating the impact of NiV outbreaks. From surveillance and diagnosis to treatment and public health interventions, this review offers a holistic perspective on the ongoing efforts to combat this deadly virus.

A detailed analysis of codon usages bias and influencing factors in the nucleocapsid gene of Nipah Virus

Several outbreaks of Nipah Virus (NiV) have recently been reported in various parts of the world including India. The 18.2-kb size single-stranded negative-sense RNA genome of NiV has six genes that encode nine proteins. Among nine, the nucleoprotein (N) protein is the most abundant viral protein. The relative availability of N protein is a determining factor for the activation of genome encapsidation, replicase activity, and regulating viral RNA synthesis. In this study, we have conducted a codon usage analysis of N protein-encoding gene (N gene) of NiV. The relative synonymous codon usage (RSCU) values, in combination with an ENC value of 51.048, represented low codon usage bias in the N gene. The effect of mutational pressure on codon usage bias was confirmed by significant correlations of GC3s, G3s, C3s, A3s, U3s, and ENC values with whole nucleotide contents (GC%, G%, C%, A%, and U%). Correlation study of GC3s, G3s, C3s, A3s, and U3s with axis values of correspondence analysis (CA) also supported the role of mutational pressure. The correlation study of Gravy values with GC3s, G3s, C3s, A3s, and U3s revealed the presence of natural selection in addition to mutational pressure on codon usage bias. Moreover, NiV codon adaptation index (CAI) value higher than their corresponding expected CAI (eCAI) values against human (CAI, 0.726; eCAI, 0.715), pig (CAI, 0.837; eCAI, 0.819), and bat (CAI, 0.762; eCAI, 0.750) also indicated natural selection play role on codon usage bias. Additionally, geographical distribution, and evolutionary processes also influenced the codon usage bias to some extent.

In silico prediction of interaction between Nipah virus attachment glycoprotein and host cell receptors Ephrin-B2 and Ephrin-B3 in domestic and peridomestic mammals

Nipah virus (NiV) is a lethal bat-borne zoonotic virus that causes mild to acute respiratory distress and neurological manifestations in humans with a high mortality rate. NiV transmission to humans occurs via consumption of bat-contaminated fruit and date palm sap (DPS), or through direct contact with infected individuals and livestock. Since NiV outbreaks were first reported in pigs from Malaysia and Singapore, non-neutralizing antibodies against NiV attachment Glycoprotein (G) have also been detected in a few domestic mammals. NiV infection is initiated after NiV G binds to the host cell receptors Ephrin-B2 and Ephrin-B3. In this study, we assessed the degree of NiV host tropism in domestic and peridomestic mammals commonly found in Bangladesh that may be crucial in the transmission of NiV by serving as intermediate hosts. We carried out a protein-protein docking analysis of NiV G complexes (n = 52) with Ephrin-B2 and B3 of 13 domestic and peridomestic species using bioinformatics tools. Protein models were generated by homology modelling and the structures were validated for model quality. The different protein-protein complexes in this study were stable, and their binding affinity (ΔG) scores ranged between −8.0 to −19.1 kcal/mol. NiV Bangladesh (NiV-B) strain displayed stronger binding to Ephrin receptors, especially with Ephrin-B3 than the NiV Malaysia (NiV-M) strain, correlating with the observed higher pathogenicity of NiV-B strains. From the docking result, we found that Ephrin receptors of domestic rat (R. norvegicus) had a higher binding affinity for NiV G, suggesting greater susceptibility to NiV infections compared to other study species. Investigations for NiV exposure to domestic/peridomestic animals will help us knowing more the possible role of rats and other animals as intermediate hosts of NiV and would improve future NiV outbreak control and prevention in humans and domestic animals.

The Era of Molecular Biology: Diagnostics for Nipah Virus

Abstract: Nipah virus (NiV) is an emerging pathogen that, unlike other priority pathogens identified by the WHO, is endemic to Southeast Asia. It is most commonly transmitted through exposure to saliva or excrement from the Pteropus fruit bat or direct contact with intermediate animal hosts, such as pigs. NiV infection causes severe febrile encephalitic disease and/or respiratory disease; treatment options are limited to supportive care. The serological and nucleic acid amplification techniques have been developed for NiV and are used in laboratory settings, including some early multiplex panels for differentiation of NiV infection. The rural and remote nature of NiV outbreak settings, there remains a need for rapid diagnostic tests that can be implemented at the point of care. Additionally, more reliable assays for surveillance of communities and livestock will be vital to achieving a better understanding of the fruit bat host and transmission risk to other intermediate hosts, enabling the implementation to outbreak prevention and the management of this NiV. An improved understanding of NiV viral diversity and infection kinetics or dynamics will be central to the development of new diagnostics to enable effective validation and external quality assessments

Cannabis sativa: 2023-Outbreak and Re-emergence of Nipah virus (NiV) in India: Role of Hemp oil

This review paper highlights and updates the outbreak of Nipah virus (NiV), an emerging zoonotic bat borne virus that can cause severe respiratory illness and deadly encephalitis in humans. Nipah virus (NiV) outbreak was first reported in 1998 from Malaysia and then recorded in Bangladesh, India, Philippines, Singapore and Thailand. A recent fifth outbreak of Nipah virus (NiV) during August-September 2023 in Kerala State, India brought this emerging-re-emerging virus into the spotlight again. Due to the lack of vaccines and drugs with proven effectiveness against Nipah virus (NiV), treatment of patients is limited to supportive and prophylactic. Fruit bats are the main reservoir for this virus, which can cause disease in humans and animals. Nipah virus (NiV) can be transmitted from bats or livestock to humans, typically via contaminated food (fruit or raw date palm sap), and person-to-person through respiratory secretions. Hemp seed oil has gained remarkable popularity due to its perceived therapeutic properties, particularly antiviral properties for potential health benefits. During the recent outbreak of Nipah virus (NiV), the local traditional healers in India used hemp oil as the mouth wash for controlling throat infections, head ache, vomiting and suggested for the consumption of hemp seeds and oil as the functional food. However, clinical trials and scientific data supporting antiviral activity of Cannabis oil (CBD oil) against Nipah virus (NiV) is lacking. Therefore, further research should focus on exploring the molecular mechanisms of hemp oil against Nipah virus (NiV) is warranted. Multicenter clinical trials should be performed to validate the efficacy of hemp oil alone or in the form of formulations for the treatment of viral infections.