September 18, Kathmandu: Nipah virus was first identified in 1999 after an outbreak among pig farmers in, Malaysia. Since then, there have been several outbreaks of the virus in countries like Bangladesh, India, the Philippines, Thailand among others. The latest outbreak has been in neighbouring India with more than a dozen deaths recorded in just the past few weeks. The Ministry of Health and Population of Nepal has issued an alert considering the outbreak of the Nipah virus in neighbouring Indian states of Sikkim and Bihar. Kaushal Ghimire talked with public health expert and research scientist Sameer Mani Dixit about the Nipah virus and its threat to Nepal’s public health.
In short, what is the Nipah virus and how big a threat is it to the public health of Nepal?
The virus is from a family of viruses that are zoonotic, what that means is it starts from an animal host and proceeds to infect humans, similar to Covid-19 except it is from a different family of viruses altogether. What is also similar to the coronavirus is that it infects our respiratory system, and it is capable of causing serious damage to the respiratory system. Unlike the coronavirus, it is highly severe and its fatality rate is very high, that is anything from 50 to 70%, depending on which researcher you believe is right. The bottom line is that it causes severe infection and high fatality.
What different Can we do this time so that we do not have to repeat the same fate that we faced during the covid 19 infection?
The first thing right now is let’s not panic. Although the Nipah virus causes severe infection, its ability to transmit between humans is still considered very low. It can be transmitted from animals to humans, which has been shown and proven over and over again. And yes, it can also be transmitted from human to human, but unlike the coronavirus, its ability to transfer from a human to a human is low. So basically, for now, it is mainly transmitted from bats and humans or from pigs to humans, those have been been the majority of most of the cases. And in most cases, the fatality or the infection has been linked to an animal host and not to another fellow human host.
Coming back to your question, the same thing applies to Nipah that applies to the coronavirus because it’s a respiratory virus and it can transmit by aerosol. The main thing is to have a mask on, have your hands washed time and again, and not have direct contact with an infected person. These are the standard precautions that we advise for the coronavirus pandemic, which will be the same for Nipah.
Nipah has already been seen in some of the Indian states and the worrying thing is that it has been confirmed in states like Sikkim and Bihar which share a porous border with Nepal. How much are we at risk, especially in the bordering areas, of the infection crossing over from Sikkim and Bihar to over Nepal?
The risk is always high with the open border and the way the virus spreads, I mean, the capacity for the virus to spread might be lower than corona, but the potential is still there. In such cases, it is advisable to take maximum precaution and look for symptoms. The problem right now is it very easy to get confused because, on one hand, we have corona, the second is influenza which is the regular seasonal flu, and now we have this new Nipah outbreak being recorded in few states in India in low numbers, but the symptoms are very similar for all of them. So it is advisable to make sure that everyone continues to wear a mask. Especially in the border area, it must be made compulsory to wear masks, as there is no vaccine or medication for Nipah at the moment.
As a public health expert, what advice would you like to give to the general public about the Nipah virus?
Again, there is no need to panicking because we are already in the middle of the coronavirus pandemic and we have health protocols in place. And also the fact that this virus is not going to be similarly contagious as the corona has been. Wear a mask and try to maintain the same kind of precaution as maintained for the coronavirus, I think that should hold for now because again like the coronavirus, the Nipah has between 7 to 15 days incubation time, and it will die out in the humans if it is not allowed to transmit.