Nipah Virus Outbreak IN Kerala-2018

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Nipah Virus Outbreak IN Kerala-2018

Postby ramana » 24 May 2018 04:41

Folks there is an outbreak of Nipah Virus in Kerala.
Please be aware and take measures to protect yourself and family.

What is Nipah Virus

Its a fruit bat virus that has skipped to people.
In Kerala could be from palm trees. Not clear.

Also help with donations etc. the affected people.

PS: Some might say why this thread in this forum?

Because we care. And everything is strategic until we find out.

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby UlanBatori » 24 May 2018 05:07

Reading the news on this, there is the usual perfect storm of confusion compounded by official ignorance and pompous Experts. All assumptions are up for verification.


Known facts:
F1. The main evidence to-date is that there were 2 fairly swift deaths (too short a time from diagnosis of serious illness, to death) in a hospital in Malloostan.
F2. A nurse (Smt. Lini) who attended to these people also caught whatever it was and died very quickly. She knew she was going, she managed to write a fairly coherent note to her husband.

Now the rest:

1. A total of 10 deaths have been ascribed to this. I question it: c b lo
2. At least one case where this was feared, was diagnosed as diphtheria.

3. What is the Nipah Virus? Is it known from the past or just discovered? Is it something that could be dropped off in say a well by the ISI? Like Surat Plague is now very well accepted to have been a deliberate attack.
4. What is the evidence that it IS the "Nipah virus"? One girl in the evil who were feared to have the killer virus, have been found negative.
5. What is the evidence that it is a fruit bat virus? The National Arbor whatever people are strongly criticizing this assumption.
6. Some officials claimed that the infection came from bats that lived inside a well which had (presumably) contaminated groundwater. Others have pooh-poohed this claiming that only Insect Bats live in wells.
7. A Professor this-that (unrelated to anyone who has actually seen much less treated a victim) opened his mouth and that is being quoted in the media. I think his utterings are BS.
8. Another report said if it was spread by bats it would be far wider spread by now. Same report said bats are territorial, stay inside 50km radius.
9. Someone (ophishial) claimed that all 10 victims to-date had some contact with other victims, so it was spread through contact (air? Handling same water tumbler? Ate at same place? Contact is not claimed to be sexual or intimate)
10. Spread through air suspected.
11. Cases have been reported in Northeast and East India as well as Malloostan. So how did that spread?

So all news reports so far are Berkeley-Stanford. Motives include hurting fruit business, tourism. I wouldn't be surprised if all coming from/through Malloostan face quarantine in the very near future. Expanding to all of India.

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby UlanBatori » 24 May 2018 05:12

FirstPost.com
Kerala locks down village

Sooppikkada has been locked down, and advisories have been set up on food and hygiene habits; besides families staying close to the affected dwellings have been evacuated to safer places and domestic animals are being kept under observation..."It is now a local epidemic. It may become a local epidemic in other nearby areas; (but) we are trying our best to contain it from spreading," said Rajeev Sadanandan, additional chief secretary at the Department of Health and Family Welfare. "Now, the disease is being spread by people to people contact. All suspected cases are being treated for Nipah," he said. But despite precautionary measures, authorities concerned are yet to identify reasons on how the disease that was hitherto identified only in the eastern and northeastern parts of the country, spread to Kerala.
"We have to believe that bats migrate long distances. If not then how did it spread to Thailand from Malaysia and then to Bangladesh and West Bengal?" According to the World Health Organisation (WHO), Nipah is capable of infecting pigs and other domestic animals and there are no vaccines available for the disease; the primary treatment for infected humans is through intensive supportive care. Nipah, which was first identified during an outbreak in Kampung Sungai Nipah, Malaysia in 1998, is primarily carried by fruit bats of the Pteropodidae family. The virus can spread through other mediums including human to human contact as well. In Malaysia, pigs were the intermediate hosts; in subsequent Nipah outbreaks, no intermediate hosts were identified. Several people had lost their lives to Nipah in Bangladesh in 2004 after consuming date palm saps contaminated by fruit bats and there were a few other outbreaks in and around the region. In 2006, the virus had raised concerns in Siliguri, West Bengal, a state where the first case had been detected as early as 2001. But most of these cases were said to have resulted from human to human contact. "We don’t want to take any chances. However, we can only confirm on all cases being Nipah or not after we get reports from the National Institute of Virology in Pune," said Sadanandan, and confirmed that three of four persons who died of fever in Kozhikode district, were infected by the Nipah virus.

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby UlanBatori » 24 May 2018 05:17

Kerala govt advisory against travel to 4 northern districts.
With 10 deaths due to the deadly Nipah virus being reported so far from northern Kerala, the state government on Wednesday issued an advisory, asking travellers to avoid visiting the four districts of Kozhikode, Malappuram, Waynad and Kannur.


From Livemint.com (I have nooo idea what that is and where they get their rumors so UBCN cannot certify the standard of the rumors)
What is the Nipah virus infection?
The infection causes severe diseases in both animals and humans. The natural hosts of the virus are fruit bats. The virus has also been isolated from environmental samples of bat urine and partially eaten fruit in Malaysia. Due to the migratory habit of the locally abundant fruit bats in South Asia, Nipah outbreaks occur more in this region. Transmission of Nipah virus to humans may occur after direct contact with infected bats, infected pigs or from other people infected with the virus.
Is this the first reported Nipah virus outbreak?
No. Previous outbreaks have been reported in India, Bangladesh, Thailand, Cambodia, the Philippines, Laos and Malaysia. NiV was first identified during an outbreak of disease in Kampung Sungai Nipah, Malaysia, in 1998. On this occasion, pigs were the intermediate hosts. However, in subsequent Nipah virus outbreaks, there were no intermediate hosts. In Bangladesh in 2004, humans were infected with Nipah virus after consuming date palm sap that had been contaminated by infected fruit bats.
Who are the major carriers of the virus?
Bats shed the virus in their excrement and secretions, but they are symptomless carriers. NiV is highly contagious among pigs and is spread by coughing.
What are the symptoms of the infection? How is it treated?
NiV infection in humans has a range of effects, from asymptomatic infection to acute respiratory distress syndrome and fatal encephalitis. The primary treatment is intensive supportive care. Treatment is focused on managing fever and the neurological symptoms. Ribavirin may alleviate the symptoms of nausea, vomiting, and convulsions.
How can it be prevented?
As options for treatment are limited, the focus should be on prevention. Strategies include preventing farm animals from eating fruit contaminated by bats and avoiding consumption of contaminated date palm sap. Healthcare workers caring for patients should put in place standard precautions including washing hands. Wearing a gown, mask, cap and gloves is also recommended.

So they show a bunch of ppl standing around gawking while two people in Andromeda Strain costumes explain. :roll: :roll: Only in India!

Also, why call it a Fruit Bat Virus when it is actually worst in pigs?
Last edited by UlanBatori on 24 May 2018 05:29, edited 1 time in total.

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby UlanBatori » 24 May 2018 05:24


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Re: Nipah Virus Outbreak IN Kerala-2018

Postby UlanBatori » 24 May 2018 05:27

What UBCN gathers is that there is **NO** confirmation of the virus. In all cases, samples are reported to have been sent to the National Center for Something Or Other and they are "awaiting results". Maybe by next week, which is next month.

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby UlanBatori » 24 May 2018 05:39

This is the only basis seen so far for claiming it is the Nipah virus:

Kozhikode/Thiruvananthapuram: The cause of death of two people, ostensibly suffering from fever, in Kozhikode has now been confirmed to be due to the Nipah virus (NiV), spread by fruit bats and causing severe disease in both animals and humans, a top official said on Sunday.
Kerala Health Secretary Rajiv Sadanandan told IANS that they have now got the confirmation from the National Institute of Virology, Pune.

'A central team of the Indian Council of Medical Research is arriving at Kozhikode tomorrow (Monday) {presumably those in the Andromeda Strain Costumes? I hope! }. There is no reason for any panic at all, as this can be managed and we have already started our work towards that. There was a similar issue in Bangladesh and it has been managed well. We have already informed the Centre about this,' he said.
While three members of a family at Perambara in Kozhikode died within weeks after what seemed to be common fever aggravated quickly, two more family members were being treated at the Medical College hospital and one of them has also tested positive.


Was the "confirmation" based on testing samples, or on looking up symptoms? I wonder. Why do I wonder?

Earlier in the day, state Health Minister K.K. Shailaja said the cause of death of the three family members was being ascertained.

'The samples were first sent to a laboratory in Manipal and it suggested that it was a rare virus... after that for detailed tests, the samples have been sent to the National Institute of Virology and the results are awaited...," she told media at Kochi.


So when the Secretary said he HAS GOT CONFIRMATION from Pune, is that a yes, or an "expected by Monday when they come to work"?

No update seen on that on Monday.

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby chanakyaa » 24 May 2018 05:46

What a unfortunate timing when schools in the wyestern hemisphere are over and desis are about to begin their pilgrimage back to the dear homeland.

Nipah Infection

CDC: Nipah Virus

Lessons from the Nipah virus outbreak in Malaysia.

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby UlanBatori » 24 May 2018 06:44

The thing to note above is that in all cases except that of Nurse Lini Pudussery, the victim had been ill with flu-like symptons for "weeks". So the anxiety about this virus must be set in context of the statistics for flu deaths. This is from August 2017:

2,200,000 people affected by fever, 420 deaths

Health Minister KK Shylaja informed the state Assembly that of the total deaths due to fever, 74 people died due to H1N1 and 24 persons to dengue. Kerala | Press Trust of India | Updated: August 10, 2017 15:52 IST


Also:
Over16,000 people lost their lives on Kerala roads over past four years
Be it unscientific alignment, lack of width of roads, rash driving or scant regard for rules, fatal mishaps are a daily occurrence. Express examines. Published: 01st April 2018 05:35 AM | Last Updated: 01st April 2018 05:40 AM |

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby Acmo » 24 May 2018 11:01

Here are the facts afaik, most are substantiated, a few are from the chaiwallas at MoHFW, Kendra Sarkar.

1. NIV, Pune has confirmed the presence of Nipah virus in Kerala. https://timesofindia.indiatimes.com/city/pune/niv-rules-out-further-spread-of-nipah-virus/articleshow/64263723.cms
"The scientists used real-time polymerase chain reaction (RT-PCR) method and IgM Elisa test to confirm the presence of Nipah virus in Kerala. “We used throat swab, urine and blood samples of suspected patients to confirm the presence of the virus,” Mourya said. "

2. The guys at NCDC have been mobilised and two teams have been sent so far. NDRF is on standby , most likely will not be needed. There was some talk of mass mobilisation of the Central Health Services (CHS) cadre (like at the time of avian flu) but it has died down in last 36 hours.

3. While this virus is indeed associated with poor prognosis; its spread can be limited easily as compared to some other goondas like Ebola. As per WHO, there have been 16 outbreaks in SE asia since 2001 till date with 280 cases in total and with 75% mortality. Also , every such outbreak has been limited to 3-4 contiguous districts at worst. So, no need for panic.

4. Human to human transmission of NiV has also been reported through close contact with people's secretions and excretions. Avoid close unprotected physical contact with suspected Nipah virus-infected people. Regular hand washing should be carried out after caring for or visiting sick people.

5. In short, situation under control.

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby SSridhar » 24 May 2018 11:57

Investigators took six months to identify virus [during 2001 in the Siliguri outbreak] - Afshan Yasmeen, The Hindu

When an outbreak of encephalitis occurred in Siliguri, West Bengal, in February 2001, investigators took nearly six months to conclude that it was a Nipah virus outbreak.

The outbreak caused panic among residents and was brought under control only after 45 lives were lost. Recalling how the outbreak was handled then, N. Devadasan, Director of Institute of Public Health, who led the World Health Organisation’s investigation team then, said there was no need to panic as the infection was not air borne unlike H1N1 or SARS.

Speaking to The Hindu on Wednesday, he said the Siliguri outbreak was investigated by a team drawn from the All-India Institute of Medical Sciences, New Delhi; National Institute of Communicable Diseases, Delhi; National Institute of Virology (NIV), Pune; and the WHO country office.

“The WHO’s assistance was sought as tests at NIV, Pune, did not reveal definitive results. Though initial laboratory investigations indicated the outbreak to be due to non-exanthematous measles, subsequent epidemiological and laboratory investigations including those conducted at CDC, Atlanta, U.S., found the infection similar to the 1998-1999 outbreak of severe febrile encephalitis among pig farmers in Malaysia. This was caused by the emerging Nipah virus then,” Dr. Devadasan recalled.

He said all the cases that were interviewed had a definite history of exposure to an infected case.

There was no association with factors like travel outside Siliguri, visit by guests from outside the town,contact with animals/birds including pigs, exposure to any new or old insecticide or homeopathic remedies during one month prior to date of onset in the cases.

“We concluded the infection could spread from person to person only if there was close contact with body fluids of the infected person,” he explained.

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby SSridhar » 24 May 2018 12:36

In 2001, doctors in Siliguri did not know it was a Nipah outbreak - Shiv Sahay Singh, The Hindu
N.B. Debnath has vivid memories of January and February 2001, when Siliguri town in north Bengal recorded the first outbreak of Nipah virus in the country.

“We had no idea what the virus was and everyday we (the doctors) thought that we will all die,” Dr. Debnath said. Of the 49 people who died during the viral epidemic, he recollects only one name, Ajit Maity.

“Ajit Maity was a colleague and cardiologist, who died of the virus. He had treated patients at a nursing home in Siliguri from where the outbreak is supposed to have spread,” he said.

Years later publications by scientists at the National Institute of Virology (NIV) Pune put the number case-fatality ratio as high as 74%. Researchers had described it as an illness with symptoms of fever associated with “altered sensorium.”

Asok Bhattacharya, Mayor of Siliguri Municipal Corporation who was the Minister for Urban Development in the Left Front government in 2001, echoed the same views as the doctors and said that the viral infection started from a private nursing home in Siliguri.

“People started leaving the town. The roads were deserted and even doctors started to run away. We had to get about 30 doctors from Kolkata to tackle the situation,” Mr. Bhattacharya said.

The research publication available on the Siliguri outbreak says the transmission of the virus occurred in healthcare settings through contact with infected persons and epidemiological features were similar to the Nipah outbreaks in Bangladesh. The first cases of infection were recorded in the last week of January 2011 {sic, 2001} , peaked in the second week of February and no case was recorded after February 23.

Doctors said that it was isolation of infected patients that helped them control the situation in weeks. As far as treatment was concerned, they followed protocols for encephalitis. Most of the deaths occurred among hospitalised patients, family of the patients, and medical staff of four hospitals in Siliguri town.

Meanwhile the State Health Department held a meeting on Wednesday and decided to issue a precautionary advisory.

“We have no cases reported from the State, but we want to remain alert,” Ajay Chakraborty, Director of Health Services said.

Advisory letters have been sent to the Chief Medical Officer of Health and will be made public on Thursday, he said.

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby jaysimha » 24 May 2018 12:41

Shri J P Nadda assures all support to Kerala Government to manage Nipah Virus; Sends a multi-disciplinary Central team to investigate the outbreak
http://pib.nic.in/newsite/PrintRelease. ... lid=179431

http://pib.nic.in/newsite/PrintRelease. ... lid=179453
Shri J P Nadda reviews Nipah Virus cases in Kerala

Situation under control; no cause for panic: J P Nadda

Activities undertaken by the Expert Central Technical team in Kerala for management of Nipah Virus Disease
http://pib.nic.in/newsite/PrintRelease. ... lid=179504


http://pib.nic.in/newsite/PrintRelease. ... lid=179502
NDMA reviews preparedness to tackle Nipah virus outbreak in Kerala

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby SSridhar » 24 May 2018 14:22


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Re: Nipah Virus Outbreak IN Kerala-2018

Postby ramana » 24 May 2018 21:16

Comparing to 2001 is unfortunate as no one suspected it could be the Nipah virus.

From what I read Malaysia was first to report the Nipah virus and it is named after a village there.
The virus is hosted in fruit bats specifically.
In Malaysia the fruit bats half eaten fruit were fed to village animals and spread to humans from there.
The control was to clear the villages of adjacent fruit trees to ensure separation.

In India, the Siliguri outbreak shows proximity to the Malay peninsula. So takes times for the bats to migrate.

My hunch is Rohingjya refugee settlements could be source of this outbreak in Kerala.

The four northern districts are minority strongholds.

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby Rudradev » 24 May 2018 21:26

Also in 2001, confirmatory tests such as RT-PCR were not commonplace, and the equipment and reagents needed to conduct these were not widely available to institutions in India. You need RT-PCR to positively confirm the DNA or RNA signature of a particular virus (earlier techniques like ELISA generally target proteins, not genomes, so they are not always as specific).

These days everybody can do it.

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby mappunni » 24 May 2018 21:30


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Re: Nipah Virus Outbreak IN Kerala-2018

Postby Sridhar K » 24 May 2018 21:42

Last time I visited Kerala in 2016 on a temple tour, I had unusually a large number of bat sightings, but my trip was south of Guruvayur though. May be resident Keralites can confirm if that is normal

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby ramana » 24 May 2018 21:44



This is just usual cheap politics.
Don't be distracted.

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby ramana » 24 May 2018 21:45

Rudradev,
I would like someone to confirm the Nipah virus they found in Kerala is same strain as in Siliguri and in Malayasia.

Can we ask the twitter scientist community?

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby Rudradev » 24 May 2018 22:25

Ramana,

Here is the published data from the Siliguri outbreak

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3373078/

It is very difficult to confirm whether a virus is exactly the same strain because as a general rule, viruses mutate fast and still retain their infectivity.

Nonetheless:

Sequence analysis confirmed that the PCR products were derived from NiV RNA (Figures 3 and ​and4).4). Partial N-gene sequences (159 nt) from 2 of 5 Siliguri samples were identical, and the other 3 sequences differed by no more than 1 nt, although unresolved sequence heterogeneity occurred at 2 positions (A or G) in 3 of the Siliguri N-gene sequences (Figure 3). Comparison of the Siliguri N-gene sequences to the N-gene sequences from NiV samples isolated in Bangladesh in 2004 and Malaysia in 1999 showed an overall level of nucleotide identity of 97.5%. Siliguri N-gene sequences were more closely related to the N-gene sequence from the Bangladesh isolate than to the sequences from the Malaysian isolates. Two of the Siliguri N-gene sequences were identical to the Bangladesh N-gene sequence

Comparison of the partial M gene sequence amplified from the specimens from Siliguri to the M gene sequences from NiV isolated in Malaysia and Bangladesh (Figure 4) showed identity at 302 (94%) of 320 nt positions. Again, the Siliguri M gene sequences were more closely related to the M gene sequences from Bangladesh (99% identity) than to the sequences from Malaysia (94% identity).


...

The main reservoir for NiV is believed to be fruit bats of the genus Pteropus. NiV was isolated from fruit bats in Malaysia and Cambodia, and seropositive bats have been detected in other parts of Southeast Asia (7–10). In the Malaysian outbreak, commercially raised pigs were believed to be intermediate hosts. Presumably, the pigs were infected by virus shed from fruit bats and then transmitted the virus to humans. Although fruit bats with antibodies to NiV were captured in the outbreak areas of Bangladesh, no intermediate animal host was identified. In Bangladesh, NiV might have been transmitted to humans by direct contact with bats or indirectly by contact with material contaminated by bats. Person-to-person spread was also noted during the 2004 NiV outbreak in Faridpur, Bangladesh (4,5). The range of Pteropus giganteus, one of the flying foxes commonly found in south Asia (18), includes West Bengal. Therefore, the range of the proposed natural reservoir for NiV extends into northeastern India, and since the geographic features of West Bengal are similar to those of Bangladesh, environmental circumstances that favor transmission of NiV to humans would likely also be found in West Bengal.

Many of the epidemiologic features of the outbreak in Siliguri were similar to those of the recent NiV outbreaks in Bangladesh. In Bangladesh, no intermediate animal host was identified, whereas in Siliguri studies to detect an intermediate host were not conducted. In Siliguri, no samples were obtained from local wildlife or domestic animals. In both outbreaks, transmission occurred in healthcare settings through contact with infected persons.

...

Sequence analysis of PCR products confirmed NiV RNA. Unfortunately, no virus was isolated, and only limited sequence data could be obtained from the available clinical material. Analysis of the limited sequence data suggested that the NiV strains associated with the outbreak were more closely related to NiV isolated in Bangladesh than to NiV isolated in Malaysia. These data extend the previous observation that viruses circulating in different areas have unique genetic signatures (10,14) and suggest that these strains may have co-evolved within local natural reservoirs.

To our knowledge, NiV infection has not occurred previously in India; however, given the proximity of Siliguri to the areas of Bangladesh that experienced NiV outbreaks in 2001, 2002, and 2004, the outbreak is not surprising. Given the distribution of the locally abundant P. giganteus, the apparent natural reservoir of NiV in this area, outbreaks of NiV will likely continue to occur in Bangladesh and northern India.


To sum up:
1) Siliguri outbreak was more closely related to Bangladesh strain than Malaysia strain.
2) Intermediate animal hosts were identified in Malaysia, but not in Bangladesh. No test was conducted in Siliguri to check for intermediate animal hosts.
3) By contrast, it is established that in Bangladesh and Siliguri, transmission of NiV definitely occurred through human-to-human contact (of bodily fluids from infected subjects).
4) Strains of NiV appear to correlate with local reservoirs of infection. Hence it is VERY odd that it should suddenly turn up in Kerala which (unlike Siliguri/Bangladesh) is not contiguous with any known local reservoir of NiV.

We have not seen published data on the Kerala outbreak (I doubt if any is available). We know that NiV CAN spread from human-to-human, especially in the settings of healthcare wards, even potentially in the absence of an intermediate animal host (such as fruit bat or pig).

If it is shown that Kerala strain had significant genetic similarity to a SE-asian (Rakhine or thereabouts) strain, that would be consistent with the possibility that it was brought to Kerala by Rohingyas, and then spread to Indian healthcare workers who had contact with Rohingya patients they were treating.

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby ramana » 25 May 2018 00:13

Ok. I think its the refugee influx from Bangladesh being settled in deep forest on South India that is causing the outbreak.

This is my hypothesis.

Also see Nat Inst Virology, Pune has confirmed via PCR tests NIV strain

1. NIV, Pune has confirmed the presence of Nipah virus in Kerala. https://timesofindia.indiatimes.com/cit ... 263723.cms

"The scientists used real-time polymerase chain reaction (RT-PCR) method and IgM Elisa test to confirm the presence of Nipah virus in Kerala. “We used throat swab, urine and blood samples of suspected patients to confirm the presence of the virus,” Mourya said. "


Now to compare this data to SIliguri data to confirm my hypothesis.

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby Rudradev » 25 May 2018 02:52

Once they make the data and analysis public, we can compare the strains in this sort of a scoring matrix:
https://www.ncbi.nlm.nih.gov/pmc/articl ... objectonly

Does anyone have access to Dr. Devendra Mourya at National Instt. of Virology, Pune?

Anand Ranganathan might know, he works in the infectious disease field as well.

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby ramana » 25 May 2018 03:34

From Whatsapp


Q : What is Nipah Virus ?

A : Nipah virus was initially discovered when it caused an outbreak of brain fever among pig farmers in Malaysia.

Q : Should I be worried ?

A : A little. As it is transmitted from person to person and there is no effective antiviral therapy for this infection .

Q : Who is at high risk ? How is it transmitted ?

A : 1. People working with pigs and consuming pigs.

2. Farmers who come in contact with bats.

3. Consuming Fruits which are already bitten by bat.

4. Contact with people who already have Nipah virus infection.

Q : What are the early symptoms ?

A : The initial presentation is non-specific, characterized by the sudden onset of fever, headache, muscle pain , nausea and vomiting. Neck rigidity and photophobia are also seen.
The disease rapidly progresses, with deterioration in consciousness *leading to coma within five to seven days.*

Q :How is it diagnosed ?

A : The rdiagnosis is by ELISA which is currently done at National institute of Virology, Pune.

Q : How is it treated ?

A : Supportive care is the mainstay of treatment and infected patients may require intensive care monitoring.
*THERE IS NO APPROVED SPECIFIC THERAPY FOR THIS INFECTION* . So prevention is the only cure !

Q : How do i prevent it ?

A : 1. Avoid contact with pigs and pig handlers .

2. Maintain personal hygeine and intensive hand washing practices

3. *Avoid consuming raw fruits,* Consume only well cooked, clean, home made food till the outbreak settles down.

4. Preferably use N95 mask while travelling or working in public places to avoid person to person transmission.

5. Be aware of the symptoms and report to the doctor immediately for early diagnosis and treatment.

Share this message with all your cared ones ,
*Together, we can fight and win !*

- Dr.Arjun.M.B, MD
Dr.R.M.L Hospital, New Delhi.
(National Nodal Centre for Control of yellow fever and other communicable diseases)

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby ramana » 26 May 2018 12:49


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Re: Nipah Virus Outbreak IN Kerala-2018

Postby SSridhar » 27 May 2018 07:38

I was planning to go to Guruvayoor in the second week of June accompanying a young kid coming to India on vacation. Now, in a dilemma. Let me wait & watch.

Meanwhile, Kerala government advisory against travelling to 4 northern districts
". . . the state government on Wednesday issued an advisory, asking travellers to avoid visiting the four districts of Kozhikode, Malappuram, Waynad and Kannur. Travelling to any part of Kerala is safe. However, if travellers wish to be extra cautious, they may avoid the four districts"


Nipah Virus: India Turns to Australia For Antibody That Might Neutralise It!
In a bid to halt the spread of the deadly Nipah Virus in Kerala, the Indian Council for Medical Research (ICMR) has sought help from Australia, where an antibody against the virus was found to be effective in tests. “We have asked them to give their monoclonal antibody for conducting a test in India to find out if it can neutralise the Nipah virus in humans. In Australia, it has only been tried in-vitro (outside a living body, in artificial conditions, usually a test tube) and has been found to be effective. But it has not been tested on humans,” Dr Balram Bhargava, ICMR Director General told The Free Press Journal.

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby SSridhar » 27 May 2018 08:00

Another Nipah virus death in Kerala takes toll to 13 - IANS
KOZHIKODE: Even as the incidence of fresh cases of Nipah virus came down, a woman under treatment at the Kozhikode Medical College hospital passed away on Saturday, taking the death toll in Kerala to 13, officials said.

A majority of the deaths have been reported from Kozhikode, while others were in the nearby Malappuram district. Close to 200 patients in these two districts are being treated in hospitals, with 26 under observation and three who have tested positive under intensive treatment.

Five medical professionals are being sent to Delhi for an intensive course at the Safdarjung Hospital to learn the treatment protocols. Nipah virus is transmitted to humans through infected fruit bats, pigs or other Nipah-infected people.

With test results showing that a particular variety of bats, found in and around Kozhikode and mostly at the worst-affected Perambara town, is not carrying the virus, a special team from Pune is arriving to see how they can take samples from other varieties of bats also found in this district.

A police probe, initiated to find out the travel itinerary of the virus’ first victim Sabith, found out that he never visited Malaysia but had been in the United Arab Emirates, from where he had returned in October last year.

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby habal » 27 May 2018 08:48

A police probe, initiated to find out the travel itinerary of the virus’ first victim Sabith, found out that he never visited Malaysia but had been in the United Arab Emirates, from where he had returned in October last year.


Is he even alive, because only he can solve the mystery. May be he was exposed to some malaysian or indonesian expat who carried the virus back in UAE.

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby SSridhar » 27 May 2018 11:43

habal wrote:Is he even alive, because only he can solve the mystery. May be he was exposed to some malaysian or indonesian expat who carried the virus back in UAE.

But, that was way back in October and the incubation period is only a fortnight. He is the very first victim.

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby ramana » 27 May 2018 12:17

It's not from.bats in Kerala but human contact.


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Re: Nipah Virus Outbreak IN Kerala-2018

Postby SSridhar » 27 May 2018 18:28

Man 26 dies of Nipah infection - Toll 14 - The Hindu
A 26-year-old undergoing treatment for Nipah virus infection died on Sunday at a private hospital in Kerala’s Kozhikode district. His name was given as Abin of Palazhi near Kozhikode.

The total number of deaths has risen to 14 now.

16 under observation

Two more persons whose blood and body samples were tested positive for the infection are undergoing treatment at the Government Medical College Hospital, Kozhikode. Sixteen are under observation at the hospital now.

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby ramana » 28 May 2018 00:05

Dr. ArunKumar replied that they expect gene data in a few days.
Let's see.

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby disha » 28 May 2018 00:40

If the number of new cases is decreasing, then this outbreak is contained. Further this outbreak is due to direct contact.

Hopefully, it will help desis value clean practices. And burden of other diseases will come down as well.

I have some travel plans in that area soon and hence monitoring on a daily basis!

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby SSridhar » 30 May 2018 13:09

ramana wrote:Ok. I think its the refugee influx from Bangladesh being settled in deep forest on South India that is causing the outbreak.

This is my hypothesis . . . .

Now to compare this data to SIliguri data to confirm my hypothesis.


Nipah outbreak in Kerala traced to Bangladesh strain of virus - Umesh Isalkar, ToI
PUNE: Scientists at the National Institute of Virology (NIV) here have confirmed that the Bangladesh strain of Nipah virus (NiV) is responsible for the current outbreak in Kerala. They reached the conclusion after decoding the full genome of the virus drawn from the throat swab sample of an infected patient.

The Nipah virus has two strains — Malaysia (NiVM) and Bangladesh (NiVB)
. Both the strains have high fatality rates, between 60% and 85%, the scientists said.

“Sequencing of the genetic make-up of the virus revealed that the Indian Nipah virus genome is genetically similar to the Bangladesh strain,” senior scientist and NIV-Pune director Devendra Mourya told TOI on Tuesday. Both the strains have more or less an equal mortality rate and are responsible for local outbreaks. “No study has so far proved that the Bangladesh strain is more lethal or pathogenic than the Malaysia strain,” Mourya said.

Nipah was first reported in Bangladesh’s Meherpur district as a cause of an outbreak of encephalitis in 2001. Since then, Nipah outbreaks have been reported almost every year in some districts of the neighbouring country.

“Studies in Bangladesh have revealed that consumption of palm sap infected with bat urine and saliva was mostly responsible for the transmission of the infection from bats to humans and then humans to humans as well,” NIV scientist Pragya Yadav said.


Thirteen people have died of Nipah in Kerala since the outbreak of the virus earlier this month.

A central team comprising experts from the National Centre for Disease Control (NCDC), All India Institute of Medical Sciences (AIIMS) and the NIV has visited the Government Medical College in Kozhikode to understand gaps in the hospital’s infection control measures and medical management.

“Our specialized team is working with the central team on the field and also at the hospital to contain the outbreak. They are also working in and around houses of people diagnosed with the infection in the beginning to find the possible links of infection,” Mourya said.

The samples of bats found in the well of a house in Perambra, considered the epicentre of the outbreak in Kerala, tested negative for the virus at the designated laboratory in Bhopal. “The bats whose samples were tested at the Bhopal lab were not fruit bats (Pteropus giganteus). This particular species is the only known reservoir for the virus to date,” Mourya said.

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby kvraghav » 30 May 2018 14:13

^^^
Is there any chance that illegal immigrants are involved? Most of the south indian farm workforce has been bangaladeshis now, moreso in the case of muslim ownership farms of kerala and coorg.

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby ramana » 30 May 2018 21:47

SS,

When we meet you can pat me on the back.


So Kerala secularism has brought ruin to Kerala again.

This one is on Pinnarayi alone as being the CM he is in charge of the State and accountable.

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby Rudradev » 30 May 2018 22:56

Take a bow Ramana garu.

I think we can rule out zoonotic transfer. Even in Bangladesh it was difficult to find fruit bats that were actual carriers of NiV (they only found some bats which had antibody-based immunity to NiV, which suggests exposure but doesn't conclusively prove it).

Even if they HAD found bats carrying NiV in Bangladesh... no way any bats from Bangladesh migrated all the way to Kerala in this short a span of time.

Humans on the other hand...

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby ramana » 31 May 2018 06:53

I think every instance of encephalitis in India since 2001 should be mapped and confirmed to ensure it wasn't #NipahVirus. @JPNadda please setup taskforce. And include @rajnathsingh officials.

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Re: Nipah Virus Outbreak IN Kerala-2018

Postby ramana » 31 May 2018 06:57

Can we do this?
First list all cases of Encephalitis reported. Locate them on map. Add month and year.
Bonus locate reports of BD refugee settlements on same map.


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