Uttam Maharjan

The news that the Nipah virus has emerged in India has startled the health authorities in Nepal. In Kerala, one of the states of India, a boy succumbed to the infection caused by the Nipah virus the other day. The concern is valid as Nepal and India share a long, porous border. So if precautionary measures are not taken in time, the Nipah virus may spread to our country. That is why, the Ministry of Health and Population has urged the people to stay alert.

The Nipah virus is a zoonotic disease; it is transmitted from animals to humans. Human-to-human transmission is also reported. Fruit bats, also known as flying foxes, belonging to the family Pteropodae are responsible for the incidence of the disease. Fruit bats live in trees near crowded places like markets, temples, schools and tourist spots. They prefer to live in date palm trees, so consumption of date palm sap contaminated by such bats may lead to the Nipah virus. The Nipah virus is spread through the saliva or urine of fruit bats. It is transmitted to pigs, cats, dogs, goats, sheep, horses, etc. and then to humans. It is transmitted to humans when they come into close contact with such infected animals or when they consume the food contaminated by fruit bats.

Incubation period
The incubation period of the Nipah virus is five to 14 days. But in some extreme cases, it could be up to 45 days. This means that an infected person can transmit the disease to others for up to 45 days. The higher the incubation period, the riskier the situation becomes. Further, the disease can infect a larger variety of animals, which is a matter of concern for epidemiologists.
The symptoms of the Nipah virus are fever for three days to two weeks, a cough, a headache, myalgia, a sore throat, nausea, vomiting, difficulty eating and respiratory problems. It can also cause encephalitis and acute respiratory infection, leading to dizziness, drowsiness, confusion, a coma and ultimately death. The Nipah virus is less contagious than COVID-19 but more fatal. The mortality rate of COVID-19 is two per cent against that of the Nipah virus at up to 75 per cent. Twenty per cent of the survivors of the Nipah virus suffer from neurological problems, leading to seizures and personality changes.

The Nipah virus first emerged in Malaysia in 1998. Since then, the disease has broken out in South and Southeast Asia. The disease broke out in Bangladesh in 2004 owing to the consumption of date palm sap contaminated by fruit bats. In 2018, the disease killed 17 out of 19 patients in Kerala. The disease was ascribed to the contamination of the water of a family’s well by dead fruit bats. As many as 260 people have succumbed to the disease so far. The disease erupts regularly on the India-Bangladesh border. Research shows that fruit bats found in Bangladesh have the Nipah virus.

The Nipah virus pandemic has not been reported till now. If the disease assumes pandemic proportions, it will kill far more people than the COVID-19 pandemic because the fatality rate of the former is far higher at up to 75 per cent. The Nipah virus and the coronavirus are both zoonotic diseases. Owing to the deadly nature of the Nipah virus, it has been recognised as one of the ten deadly diseases by the World Health Organisation (WHO).
As per the WHO), no treatment or vaccine has been found for the Nipah virus. So the patients of the disease are kept on palliative/supportive care. That is why extra precaution needs to be taken to avoid the disease. As the disease may attack people working with animals like pigs, goats or sheep, such people should take precautionary measures such as wearing gloves and masks and frequently washing hands with soap and water. Bat droppings are used as fertiliser on farms. So farmers and agricultural workers are vulnerable to the disease. People should wash fruit properly before consuming it, eat well-cooked vegetables, keep cowsheds and farms clean, drink boiled water and wear masks in public places as precautionary measures.

Climate change
Climate change and destruction of the habitats of fruit bats have given rise to the incidence of the Nipah virus. This has helped new zoonotic strains of the virus to emerge. Further, increased exposure of people to the Nipah virus through fruit bats allows the virus to mutate. Mutation of the Nipah virus, as in the case of the coronavirus, poses a further threat to man.

Therefore, it is imperative to take steps towards preventing and controlling the Nipah virus. People should be made aware of how risky it would be to directly expose themselves to the Nipah virus or sources thereof. The habitats of fruit bats should be preserved. Such habitats include forests and pastureland, among others. If an outbreak of the Nipah virus occurs, then surveillance should be conducted to identify cases without delay and at the same time contact tracing needs to be carried out to identify the people coming into contact with the infected people.

The Nipah virus has not emerged in Nepal yet. However, the possibility of the disease hitting the country cannot be ruled out as the disease has surfaced in India. Cross-border movement of people between these two countries is huge. So the government should take concrete steps to stop the spread of the disease to the country before it is too late. As the country is already overwhelmed by the COVID-19 pandemic, it may be arduous for the country to face the burden of the disease.

(Former banker, Maharjan has been regularly writing on contemporary issues for this daily since 2000. uttam.maharjan1964@gmail.com)