BIO3204 Zoonoses 27MAR2019

Nipah virus (barking pig syndrome)

● A newly emergent virus

● Animal species affected -pigs
● Discovered in Malaysia 1999 breakout

Pathogen

● Related to hendra virus

● Nipah is the second virus in the category of hendra virus
● High mortality rate 75% this is very different from hendra. Nipah is much more
dangerous,
● Like hendra most people who contract this virus had significant close contact
with pigs
● In pigs the typical symptom is respiratory problems, with discharge

NIV

● The glycoproteins has on the surface are the same as hendra

● Researchers have been able to isolate the receptor in the host cell that the virus
binds to
● Vaccine being designed to block the receptor: this would be effective for both
hendra and nipah
● Once the nipah virus infects the cell, the cell is driven to bind to other cells I.e.
multinucleated synciti

History

● 1998-99 reports of deaths in peninsular Malaysia

● Initially this was dismissed as it was thought it was Japanese encephalitis which
is common in the area
● However with 10 cases clustered they realised that they were dealing with a
new virus
● Nipah comes from of the name of village where it was discovered: Sungai Nipah
● See PowerPoint slide for useful timeline of the outbreak
○ The sudden outbreak caused panic
○ Mass culling of pigs
○ Villagers fled from the area
● Every major health organisation came to Malaysia to identify the transmission
and to explain the causes
● Economic impacts - Pork industry lost $450 million

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● Although the disease was stopped in Malaysia, some infected pigs had been
sold to Singapore and Bangladesh which is believed to have caused the virus
to spread
● Since 2001 the disease has been found in India and Bangladesh

Reservoir
● Flying foxes/fruit bats are the carriers of the virus (they are not affected by the
disease)
● Virus can be found in urine, or partially eaten fruit
● There is no known secondary host
● Researchers looked for link between the carriers (bats) and the infected pigs
and how the virus was passed

Current disease distribution

● Scientists are concerned that this virus will soon spread as the fruit bats have
a very wide range. There is a possibility this virus could spread much further
across Asia (potentially reaching Africa)

Transmission

● In the area much Rainforest was cleared for farming,

● Many farmers planted Fruit trees to provide food
● But these fruit trees attracted the bats into the area
● Researchers found that bats were dropping pieces of fruit near the pigs which
of course the pigs would eat
● Bats were also settling in the roofs of pig pens and spreading the disease to the
pigs through waste
● It was also found that Vets were also using same needle to take blood samples
from different pigs this helped to spread the virus to uninfected pigs

● In Malaysia there have been zero cases of person to person transmission

● But this has been confirmed in Bangladesh & India (nosocomial infections)
● Bat to person transmission again found in Bangladesh and India but not in
Malaysia… this is because they commonly drink unpasteurised fruit (palm) juice
which has been infected by bats

Epidemiology

● In pigs the disease causes major respiratory problems, they have extreme
difficulty breathing
● In Singapore 1469 people were screened only 1.5 % tested seropositive
● Workers in abattoirs were the most affected
● 12 cases were

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● But worryingly 10 people weee

2001 siliguri india

Several cases were treated THospital but the way the patients were treated in the
hospital me the disease spread quickly in the Hospital, which suggested the virus was
mutating extremely quickly

In banglad3sh 2005 some people lost consciousness shortly after consuming the palm
juice (44 cases -12 deaths)

In 2007 a religious leader infected his followers by kissing them which shows how
easily the disease can be spread.

At present we seem to be dealing with various strains of nipah which potentially makes
it much more difficult to deal with compared to hendra (1 known strain)

Nipah Philippines 2014

● Further evidence the virus is mutating at a very high rate
● 17 patients - 3 fatalities
● The virus was found in horses for the first time so it seems nipah

Human illness
● Incubation: typically 4-20 day but can be As little as 2 days & as long as 30
● Encephalitis; symptoms include dizziness, vomiting, can persist for 3-14 days
● Seizures; once these occur there is only 24-48 hours to live, leads to coma
(there is no way to reverse)
● there are also cases were people contract the disease but have no symptoms
until years later. This makes it very difficult to treat
● Asymptomatic - neurological deficits/memory loss

Disease in Animals

● Contagious in pigs
● Can be asymptomatic or high fever, so it is very difficult to identify
● Severe respiratory condition - cough(barking)
● Open mouth breathing,
○ Discharge from nose (can be bloody)
● Pregnant sows are more susceptible and are more likely to show neurological
symptoms including ataxia (difficulties moving due to problems with
coordination & balance)

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NiV in Other animals

● Only 1 cat has been naturally infected; symptoms = slight fever, some
respiratory issues
● Dogs
○ Display distemper like symptoms
○ Fever, nasal discharge
○ 95% mortality rate
○ Very similar rate to distemper in dogs

Sampling Procedure During Outbreak

● Samples sent securely to authorised labs. The same rule for sending any tissue
● Prosecution for those who do not follow these regulations
● These measures are crucial, they help to prevent the spread of disease

Diagnosis

● Category 4 lab necessary (high level)

● Important to identify different strains

Recommended Actions

● Authorities to be alerted immediately

● Quarantine for any outbreak on pig farm
● Dogs and cats must also be isolated
● Little contact with possibly infected animals
● These measure are designed to help the spread of Nipah virus

There are some concerns that Nipah could be weaponized as a biological weapon as
it can be aerosolized (hendra cannot)