Experts Say Nipah Virus Has Potential To Be Another Pandemic — With A Higher Death Toll

Earlier this month, a 12-year-old boy in the Kozhikode district of Kerala, India, died of Nipah virus, a virus most people have probably never heard of. A virus that experts say has the potential to become another global pandemic, with a significantly higher death toll.
About 70 percent of people infected with the Nipah virus die, says Dr. Stephen Luby, Professor of Infectious Diseases at Stanford University. When the virus first appeared in Malaysia in 1999, it killed more than 100 of the 300 or so infected. When it surfaced in Kerala in 2018, only two of the nineteen people who contracted Nipah survived.
Often even survivors are left to suffer. Many have long-term consequences, including "persistent convulsions and personality changes," according to the CDC.
For these and other reasons, the World Health Organization has declared Nipah a "virus of concern" and experts are calling for more research and attention.
The Nipah virus is a zoonotic virus
Similar to the coronavirus, Nipah is a zoonotic virus, which means it can spread between animals and humans. Generally, transmission occurs when a person eats contaminated food or comes into direct contact with an infected animal. Flying foxes "are the natural carriers of nipah". Once nipah spreads from an animal to a person, that person can infect other people.
Although it is still uncertain, experts believe contaminated food caused this current outbreak.
"One plausible theory is that those infected [in Kerala] ate food or fruit contaminated with bat saliva or excrement," said Dr. Thekkumkara Surendran Anish, associate professor of community medicine at Government Medical College, Thiruvananthapuram, told NPR.
Nipah is not easily transferable ... yet
BSIP / UIG / Getty
The good news - if there can ever be good news in discussing a deadly virus - is that Nipah virus is not very transmissible.
"There are the occasional Nipah super-spreaders that infect a lot of people," says Luby. "But the average transmission rate is less than one person per infection."
When you consider that we are currently battling a highly contagious respiratory virus with a highly infectious variant, this is news we want.
However, this good news can (possibly only) be temporary. Luby states, “[Every time a person becomes infected, the virus is in an environment that selects for human adaptation and transferability. The risk is that a new strain, transmitted more efficiently from person to person, could cause a devastating outbreak. "
As we have learned too well - viruses mutate. And if they mutate, they could mean even more trouble.
Availability of vaccines or treatments
Unfortunately, we don't have a cure or vaccine for the Nipah virus yet, although there is hope on the horizon. (Again, let's take a moment to thank scientists and doctors who work tirelessly to protect us from current and potential pandemics!)
In addition to a potential vaccine candidate, the researchers are looking for a drug called M 102.4. One study found the drug was able to neutralize Nipah in Phase I clinical trials.
It is important to neutralize the virus before it can do any harm, considering how worrying symptoms of the Nipah virus can get. The first symptoms include a fever and headache, which can last for three days or up to two weeks. After that, an infected person can expect a sore throat, cough, and difficulty breathing. Soon afterwards (too soon) the symptoms become severe. Nipah can cause brain cells to swell, causing drowsiness, confusion, and possible coma and death.
The CDC notes that remdesivir (also used against COVID-19) has shown some effectiveness in non-human primates when given prophylactically after exposure.
When Nipah goes global ...
C.K Thanseer / DeFodi Pictures / Getty
The Nipah virus appears to be under control in Kerala right now, but experts warn that we must not let our vigilance down. "[A] As long as we don't know a lot, the possibility of an epidemic cannot be ruled out," says Anish.
Prevention is the key. Along with "Standard Infection Control Measures", the CDC encourages anyone living in an area where nipah outbreaks have occurred to practice good hand hygiene, avoid sick bats, and avoid raw date palm syrup wherever bats sleep, Avoid potentially fruit contaminated by bats, and avoid contact with blood or fluids from people who are infected with nipah.
Likewise, WHO urges anyone who consumes fruit or fruit products (such as raw date palm juice) to wash and peel the fruit thoroughly before consumption to reduce the risk of international transmission. Also, discard any fruit that shows signs of bat bites.
Currently, Nipah has been identified in Malaysia (during the 1999 outbreak) as well as in Bangladesh and India. As our world is shrinking due to international travel and trade and climate change is forcing bats into new habitats, that could change.
"We see [fruit bats] here [in Cambodia] and in Thailand, in markets, in prayer areas, schools and tourist places like Angkor Wat - there is a large bat roost there", Veasna Duong, head of virology at the Pasteur research laboratory in Phnom Penh , Cambodia, said the BBC's future program. “In a normal year, Angkor Wat hosts 2.6 million visitors. That's 2.6 million ways for the Nipah virus to jump from bats to humans in just one place every year. "
From there, it's not hard to imagine that one of those 2.6 million opportunities could jump on an international flight and lead to yet another global pandemic. One that is far more deadly and far more difficult to deal with.
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