Nipah virus spreads in India. Should PH tighten borders?

Reports of the Nipah virus outbreak in India are making people in various countries vigilant, especially as it can be deadly.

According to the World Health Organization (WHO), fruit bats are the “natural hosts” or the ones that carry the Nipah virus, a zoonotic disease that can be transmitted between animals and humans.

“There is no apparent disease in fruit bats,” the WHO said. “The virus is highly contagious in pigs. Pigs are infectious during the incubation period, which lasts from [four] to 14 days.”

Aside from pigs, the Nipah virus can also infect other domestic animals such as horses, goats, sheep, cats, and dogs.

It was observed, during previous outbreaks globally, that humans were infected by having “direct contact with sick pigs or their contaminated tissues” or by eating fruit products “contaminated with urine or saliva from infected fruit bats.”

Human-to-human transmission happens through “close contact with people’s secretions and excretions.”

In India, about 100 people have been under quarantine after five healthcare workers in West Bengal state were infected early this month.

In the Philippines, a Nipah virus outbreak occurred in 2014, when 17 individuals in Sultan Kudarat contracted the disease by “eating horse meat and being in contact with a sick person.”

With the current outbreak in India, infectious disease expert Dr. Rontgene Solante said there should be a stronger health check in the country’s borders for those entering from India.

“The government should be doing screening for people who are coming from West Bengal, and probably the Bureau of Quarantine will also be doing some health checks during [the] arrival of tourists, particularly from this particular area,” Solante told Rappler.

“Every tourist coming from India or [those] specifically from India — they will have to be screened, spot checking of temperature, and then monitoring them for the first onset of symptoms. They should be telling the authorities [about their symptoms] just like how we did before with COVID-19,” he added.

Solante proposed that those coming from India who have symptoms should declare the areas in India where they have traveled to.

Other countries like Thailand, Nepal, and Taiwan have heightened their health screenings for the Nipah virus.

The Department of Health (DOH) said it is prepared to address the Nipah virus, saying it is “not new to us.”

“After 2014, the Nipah virus was no longer seen, and the DOH continues to monitor through the epidemiology bureau,” agency spokesperson and Assistant Secretary Albert Domingo said, noting that updated guidelines on responding to the virus were released in 2023.

What to look out for

The WHO said infected people may be asymptomatic, meaning signs and symptoms do not manifest.

But others may initially experience fever, headaches, muscle pain, vomiting, and sore throat. These symptoms may be followed by indications of acute encephalitis — the inflammation of the brain — like dizziness, drowsiness, altered consciousness, and neurological signs.

An infected individual may also suffer from atypical pneumonia and severe respiratory issues.

“Encephalitis and seizures occur in severe cases, progressing to coma within 24 to 48 hours,” the WHO said.

To date, there are no drugs and vaccines that can be used against the Nipah virus.

“Intensive supportive care is recommended to treat severe respiratory and neurologic complications,” the WHO said.

The case fatality rate, the WHO noted, is about 40% to 75%.

To determine diagnosis of the Nipah virus, a person has to undergo tests. But Solante said the tests are “not readily accessible and available in the Philippines.”

“I think only some [laboratories] like RITM (Research Institute for Tropical Medicine) can do the test at the moment,” he said.

Not a COVID-like situation

Solante said a COVID-like situation, in which the virus spreads rapidly, would not happen because Nipah virus is not highly transmissible.

“You have a high load of the virus in your body for you to transmit the virus to another person,” the expert said. “You need to be symptomatic, your symptoms should be very severe for you to transmit the infection.”

But since initial symptoms of the virus are “nonspecific,” it can be a roadblock in containing the disease, the WHO said.

“The diagnosis is often not suspected at the time of presentation. This can hinder accurate diagnosis and creates challenges in outbreak detection, effective and timely infection control measures, and outbreak response activities,” the organization explained.

To reduce the risks of getting infected with the Nipah virus, the DOH said people should avoid bats or other sick animals.

“It is best to eat meat approved by the National Meat Inspection Service or NMIS, and always cook food well,” Domingo said. – Rappler.com