Nipah Virus Contamination of Hospital Surfaces during Outbreaks, Bangladesh, 2013-2014

Abstract

Nipah virus (NiV) has been transmitted from patient to caregivers in Bangladesh presumably through oral secretions. We aimed to detect whether NiV-infected patients contaminate hospital surfaces with the virus. During December 2013-April 2014, we collected 1 swab sample from 5 surfaces near NiV-infected patients and tested surface and oral swab samples by real-time reverse transcription PCR for NiV RNA. We identified 16 Nipah patients; 12 cases were laboratory-confirmed and 4 probable. Of the 12 laboratory-confirmed cases, 10 showed NiV RNA in oral swab specimens. We obtained surface swab samples for 6 Nipah patients; 5 had evidence of NiV RNA on >1 surface: 4 patients contaminated towels, 3 bed sheets, and 1 the bed rail. Patients with NiV RNA in oral swab samples were significantly more likely than other Nipah patients to die. To reduce the risk for fomite transmission of NiV, infection control should target hospital surfaces.

Keywords: Bangladesh; Hospital surface contamination; Nipah virus; United States; bats; encephalitis; hospital-acquired infection; infection control; paramyxoviruses; viral RNA shedding; viruses.

Figure 1

Number of blood samples, oral swab samples, and surface swab samples collected and tested from encephalitis patients identified in hospitals, Bangladesh, December 2013–April 2014.

Figure 2

Timing of Nipah virus detection in oral swab and surface swab samples in relation to illness onset for 12 patients with laboratory-confirmed Nipah identified in hospitals, Bangladesh, December 2013–April 2014. Nearby surface swabs were not collected for 6 patients (nos. 7–12).