The Director General of Health Services in Punjab has issued a directive to Chief Executive Officers (CEOs) of District Health Authorities (DHAs) for heightened vigilance and preventive measures.
Reporting and Monitoring
Timely reporting and monitoring of suspected NiV cases are crucial. DHAs are instructed to upload all such cases on the Disease Surveillance System (DSS). NIH guidelines are to be disseminated to both public and private hospitals.
Understanding Nipah Virus (NiV) Infection
NiV is an emerging zoonotic disease found in South-East Asia. It was first identified during an outbreak in Malaysia and Singapore in 1999. The virus causes severe illness in both animals and humans.
Clinical Presentation and Symptoms
NiV infection primarily leads to encephalitis, presenting symptoms such as fever, headache, muscle pain, nausea, vomiting, and progressing to drowsiness, confusion, and potentially coma. Some cases may exhibit respiratory or influenza-like symptoms.
The Infectious Agent: NiV Virus
NiV is classified under the Henipavirus genus within the Paramyxoviridae family.
Natural Hosts and Mode of Transmission
Fruit bats, specifically of the Pteropus genus (also known as flying-foxes), are the natural carriers of the virus. Transmission to humans can occur through contact with infected animals, consumption of contaminated fruits, and direct human-to-human contact.
Seasonality and Suspected Cases
Outbreaks tend to occur during winter and spring. Suspected cases are identified by respiratory symptoms, acute fever, altered mental state, seizures, or other neurological deficits, often linked to specific epidemiological factors.
Confirming NiV Cases: Lab Procedures
Confirmation of NiV cases involves various laboratory techniques including serology, histopathology, PCR, and virus isolation. Timely and consistent specimen collection is vital for accurate diagnosis
Treatment and Support
Currently, there’s no specific antiviral treatment or vaccination available for NiV. Supportive care is the mainstay, focusing on fever management and addressing neurological symptoms. Severe cases may require hospitalization and ventilatory support.
Risk Assessment in Pakistan
The overall risk of NiV occurrence in Pakistan is currently deemed low. Although no documented cases have been reported to date, the presence of potential host species and shared borders with India pose some risk.
Preventive Measures and Recommendations
- Thoroughly wash fruits before consumption to minimize potential contamination.
- Avoid consuming partially eaten fruits that may have been exposed to bat secretions.
- Steer clear of sick pigs and bats, especially in areas considered endemic.
Guidance for Healthcare Professionals
- Awareness of NiV signs and symptoms is crucial for healthcare providers.
- Standard infection control precautions should be strictly followed when dealing with suspected or confirmed NiV cases. Additional contact and droplet precautions are advised due to potential human-to-human transmission, especially in healthcare settings.
