A virus with the potential to escalate into the sort of widespread health crisis that COVID-19 has presented is circulating in South-East Asia.
There are outbreaks of the virus already in Bangladesh, India, Malaysia and Singapore, a report by Gavi, the Vaccine Alliance has cautioned.
‘Nipah’ is capable of killing as many as three in four persons who contract it with a case fatality rate ranging from 40 to 75 percent.
Patients could die before they get the chance to transmit to others, and despite that, the virus has another dangerous feature of five to 14 days of incubation period which could allow mutation and easy spread among people.
Some governments classify the virus as bioterrorism threat and limit the laboratories allowed to culture and study it.
It’s not as new as COVID-19
In 2018, an outbreak in Kerala, southern India killed 17 out of 19 infected persons at a death rate of 89 percent.
Nevertheless, in 2019, a better preparedness including an extensive contact tracing system was deployed quickly to test 329 people who had come in contact with another case in a young student, preventing further spread. There were no deaths.
How it spreads
The Nipah virus lives among the family of fruit bats. It can spread to humans, often through eating or drinking products contaminated by fruit bat droppings.
Bats, for instance, occupy date trees, and consumption of date products can lead to infection.
It also easily infects a wide variety of animals – an outbreak among farmers in Malaysia in 1998 originated in pigs, who had previously been infected by bats.
The disease can also spread from human to human, and the theory is that the virus can travel in respiratory secretions and saliva, such as that expelled by coughing. Most infections seem to have come from infected patients who had breathing problems.
The virus can cause acute respiratory infection and inflammation of the brain, which can lead to a coma or death.
Symptoms include fever, headaches, muscle pain, vomiting and sore throat. This can be followed by dizziness, drowsiness and altered consciousness.
One in five people who survive can develop seizure disorders and experience personality changes.
The main tests used are real-time polymerase chain reaction (RT-PCR) from bodily fluids and antibody detection via enzyme-linked immunosorbent assay (ELISA).
Other tests used include PCR and virus isolation by cell culture. These tests are often not well suited for use in remote and rural settings, where most outbreaks occur and where containment capabilities are lacking.
Are there vaccines or treatments, or ongoing R&D?
There are no existing vaccines or treatments, but a phase 1 clinical study of a Nipah virus vaccine candidate (HeV-sG-V) started in February 2020 and is expected to be completed in September 2021.
The Coalition for Epidemic Preparedness Innovations (CEPI) had invested $25 million in 2018 to kick start an initial safety study that is run by Auro Vaccines LLC and led by PATH, and conducted at the Cincinnati Children’s Hospital Medical Center in Cincinnati, USA.
The vaccine will be tested in healthy adults aged 18-49 years to assess the safety and how well the vaccine triggers an immune response.