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. 2024 Mar;96(3):e29559.
doi: 10.1002/jmv.29559.

Clinico-epidemiological presentations and management of Nipah virus infection during the outbreak in Kozhikode district, Kerala state, India 2023

Anoop Kumar As  1 , Rima R Sahay  2 , Chandni Radhakrishnan  3 , Shihabudheen P  4 , Sathishkumar Kandath  1 , Deepak Y Patil  2 , Anita M Shete  2 , Shamsudheen M  4 , Gayathri Ramakrishnan  3 , Anitha Puduvail Moorkoth  3 , Nivedita Gupta  5 , Pragya D Yadav  2 , Sheela Godbole  2 , Lathika Velichapat Ramakrishnan  6 , Shameer Vadekkandiyil  3 , Danish Ekkalayil  3 , Nithasha V  4 , Anukumar Balakrishnan  7 , Niyas K Pullor  3 , Neelakandhan Asokan  3 , Reena Kalathil Joseph  6 , Priyanka R Nair  4 , Sreejayan Meethale Purayil  3 , Thomas Mathew  8 , Rajaram Kizhakkekandiyil  6 , Jayesh Kumar Poovullathil  3 , Kannan Sabarinath Ps  2 , Ullas Pt  2 , Kalpana George  3 , Asma Rahim  3 , Surendra Kumar  2 , Siba S  7 , Sreelekshmy Mohandas  2 , Lekshmi S Rajan  2 , Shamin Punnath Ramachandran  6 , Seethu Ponnu Thampi  9 , Ashadevi  3 , Thekkumkara Surendran Anish  10 , Priya Chandran  3 , Anuja Mohan  3 , Bindu Vadakkayil  3 , Shaji Cheriya Koroth  6 , Nimin Hafeez  3 , Rajasi Ranjini Sasi  3 , Minu Abraham  6
Affiliations

Clinico-epidemiological presentations and management of Nipah virus infection during the outbreak in Kozhikode district, Kerala state, India 2023

Anoop Kumar As et al. J Med Virol. 2024 Mar.

Abstract

India experienced its sixth Nipah virus (NiV) outbreak in September 2023 in the Kozhikode district of Kerala state. The NiV is primarily transmitted by spillover events from infected bats followed by human-to-human transmission. The clinical specimens were screened using real-time RT-PCR, and positive specimens were further characterized using next-generation sequencing. We describe here an in-depth clinical presentation and management of NiV-confirmed cases and outbreak containment activities. The current outbreak reported a total of six cases with two deaths, with a case fatality ratio of 33.33%. The cases had a mixed presentation of acute respiratory distress syndrome and encephalitis syndrome. Fever was a persistent presentation in all the cases. The Nipah viral RNA was detected in clinical specimens until the post-onset day of illness (POD) 14, with viral load in the range of 1.7-3.3 × 104 viral RNA copies/mL. The genomic analysis showed that the sequences from the current outbreak clustered into the Indian clade similar to the 2018 and 2019 outbreaks. This study highlights the vigilance of the health system to detect and effectively manage the clustering of cases with clinical presentations similar to NiV, which led to early detection and containment activities.

Keywords: Kerala‐India; Nipah virus; acute respiratory distress syndrome; encephalitis; outbreak; secondary cases; spillover.

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References

REFERENCES

    1. Joshi J, Shah Y, Pandey K, et al. Possible high risk of transmission of the Nipah virus in South and South East Asia: a review. Trop Med Health. 2023;51:44. doi:10.1186/s41182-023-00535-7
    1. Chua KB, Goh KJ, Wong KT, et al. Fatal encephalitis due to Nipah virus among pig‐farmers in Malaysia. Lancet. 1999;354:1257‐1259. doi:10.1016/S0140-6736(99)04299-3
    1. Epstein JH, Anthony SJ, Islam A, et al. Nipah virus ecology and infection dynamics in its bat reservoir, Pteropus medius, in Bangladesh. Int J Infect Dis. 2016;53:20‐21. doi:10.1016/j.ijid.2016.11.056
    1. Chadha MS, Comer JA, Lowe L, et al. Nipah virus‐associated encephalitis outbreak, Siliguri, India. Emerging Infect Dis. 2006;12(2):235‐240. doi:10.3201/eid1202.051247
    1. Arankalle VA, Bandyopadhyay BT, Ramdasi AY, et al. Genomic characterization of Nipah virus, West Bengal, India. Emerging Infect Dis. 2011;17(5):907‐909. doi:10.3201/eid1705.100968

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