Nepal activates early warning, reporting system after Nipah outbreak in India

Amid the risk of an outbreak of the deadly Nipah virus in Nepal, authorities have activated an early warning and reporting system to investigate the suspected cases and take measures to contain its spread.

The move by the Ministry of Health and Population comes following an outbreak of the deadly virus, which killed a 12-year old boy in the southern state of Kerala in India.

At least two health workers have also been infected in the state, according to local media reports.

“We have at least 118 sentinel sites throughout the country,” Dr. Krishna Prasad Paudel, spokesperson for the Health Ministry, told the Post. “We have asked them (health workers) to remain vigilant and send samples of the suspects to the National Public Health Laboratory.”

Doctors say just like the coronavirus, Nipah is a zoonotic virus, which is transmitted from animals and to humans. But Nipah is far more deadly than the coronavirus that has wreaked havoc throughout the globe. Transmission generally occurs when people come in direct contact with infected animals or through the consumption of the meat of infected animals.

But cases of human to human transmission of the virus have been also reported in many places including in India among the families and caregivers of the infected people.

Poudel said Nepal is at risk of an outbreak of the Nipah virus, as fruit bats, which are the primary hosts of the virus, might be present in Nepal also.

“As it is mainly a zoonotic disease, chances of getting infected from animals is high, especially for pig farmers,” said Paudel. “What is concerning is that most of the symptoms of the Nipah virus are similar to that of Covid-19, but in case of Nipah infection, the condition of the patients deteriorates quickly.”

The Epidemiology and Disease Control Division has directed health facilities to send swab samples of the people with Covid-like symptoms if their health conditions start deteriorating suddenly.

The Nipah virus was first detected in 1999 after farmers and others who came in close contact with infected pigs in Malaysia and Singapore developed severe respiratory problems and inflammation in the brain.

According to the US Centers for Disease Control and Prevention, nearly 300 people were diagnosed with the disease then, and more than 100 of them died.

Experts said that authorities should take the issue seriously as the virus is far deadlier than the coronavirus with up to 75 percent death rate in humans.

“The virus is much more deadly than the coronavirus,” Dr. Sher Bahadur Pun, chief of Clinical Research unit at the Sukraraj Tropical and Infectious Disease Hospital, told the Post. “Even if the primary hosts of the virus are fruit bats and pigs, this virus is transmitted from human to human through secretion and excretion.”

Doctors say that fruit bats from India, which carry the Nipah virus, can easily enter Nepal due to their proximity and similar environments. Moreover, there is always a high chance of any disease seen in India entering Nepal due to the free movement of the people between the two countries, doctors say.

The World Health Organisation said that although the virus has caused only a few known outbreaks in Asia, it infects a wide range of animals and causes severe disease and death in people, making it a public health concern.

“No outbreak of the Nipah virus has been recorded in Nepal to date, but we are at high risk,” Dr. Basudev Pandey, former director at the Epidemiology and Disease Control Division, told the Post.

“We talk a lot about preparations but do nothing. I fear we will not learn anything from mistakes and make preparations accordingly to deal with possible outbreaks.”

Doctors say most of the symptoms of the Nipah virus match those of the coronavirus and this increases the chances of misdiagnosis. They say the incubation period of Nipah infection is 4 to 14 days and symptoms include fever, headache, convulsions, and respiratory and neurological problems.

According to Pandey, authorities should increase the surveillance of the animals and people with suspected infections, increase the study of fruit bats and animals to see if they have the virus or not and launch an awareness drive against the risks.

The Health Ministry said that there is no treatment for the Nipah virus at present. Health workers provide symptomatic treatments only.

“Practicing hand washing regularly with soap and water, avoiding direct contact with sick animals, avoiding blood or bloody fluids of sick animals are some of the ways to prevent Nipah infection,” said spokesperson Paudel.

Paudel, however, said that Nepal is at high risk does not mean that we should start worrying and the ministry has just sensitized the agencies concerned about the possible risks.