Outbreak Investigation of Nipah Virus Disease in Kerala, India, 2018.


Journal

The Journal of infectious diseases
ISSN: 1537-6613
Titre abrégé: J Infect Dis
Pays: United States
ID NLM: 0413675

Informations de publication

Date de publication:
24 05 2019
Historique:
received: 11 08 2018
accepted: 13 10 2018
pubmed: 27 10 2018
medline: 25 2 2020
entrez: 27 10 2018
Statut: ppublish

Résumé

Nipah Virus (NiV) is a highly fatal emerging zoonotic virus and a potential threat to global health security. Here we describe the characteristics of the NiV outbreak that occurred in Kerala, India, during May-June 2018. We used real-time reverse transcription polymerase chain reaction analysis of throat swab, blood, urine, and cerebrospinal fluid specimens to detect NiV. Further, the viral genome was sequenced and subjected to phylogenetic analysis. We conducted an epidemiologic investigation to describe the outbreak and elucidate the dynamics of NiV transmission. During 2-29 May 2018, 23 cases were identified, including the index case; 18 were laboratory confirmed. The lineage of the NiV responsible for this outbreak was closer to the Bangladesh lineage. The median age of cases was 45 years; the sex of 15 (65%) was male. The median incubation period was 9.5 days (range, 6-14 days). Of the 23 cases, 20 (87%) had respiratory symptoms. The case-fatality rate was 91%; 2 cases survived. Risk factors for infection included close proximity (ie, touching, feeding, or nursing a NiV-infected person), enabling exposure to droplet infection. The public health response included isolation of cases, contact tracing, and enforcement of hospital infection control practices. This is the first recorded NiV outbreak in South India. Early laboratory confirmation and an immediate public health response contained the outbreak.

Sections du résumé

BACKGROUND
Nipah Virus (NiV) is a highly fatal emerging zoonotic virus and a potential threat to global health security. Here we describe the characteristics of the NiV outbreak that occurred in Kerala, India, during May-June 2018.
METHODS
We used real-time reverse transcription polymerase chain reaction analysis of throat swab, blood, urine, and cerebrospinal fluid specimens to detect NiV. Further, the viral genome was sequenced and subjected to phylogenetic analysis. We conducted an epidemiologic investigation to describe the outbreak and elucidate the dynamics of NiV transmission.
RESULTS
During 2-29 May 2018, 23 cases were identified, including the index case; 18 were laboratory confirmed. The lineage of the NiV responsible for this outbreak was closer to the Bangladesh lineage. The median age of cases was 45 years; the sex of 15 (65%) was male. The median incubation period was 9.5 days (range, 6-14 days). Of the 23 cases, 20 (87%) had respiratory symptoms. The case-fatality rate was 91%; 2 cases survived. Risk factors for infection included close proximity (ie, touching, feeding, or nursing a NiV-infected person), enabling exposure to droplet infection. The public health response included isolation of cases, contact tracing, and enforcement of hospital infection control practices.
CONCLUSION
This is the first recorded NiV outbreak in South India. Early laboratory confirmation and an immediate public health response contained the outbreak.

Identifiants

pubmed: 30364984
pii: 5144922
doi: 10.1093/infdis/jiy612
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1867-1878

Commentaires et corrections

Type : CommentIn

Informations de copyright

© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Auteurs

Govindakarnavar Arunkumar (G)

Department of Health Research, Ministry of Health and Family Welfare, Government of India.
Manipal Centre for Virus Research, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka, India.

Radhakrishnan Chandni (R)

Department of Health and Family Welfare, Government of Kerala, India.
Department of Emergency Medicine, Government Medical College, Kozhikode, Kerala, India.

Devendra T Mourya (DT)

Department of Health Research, Ministry of Health and Family Welfare, Government of India.
National Institute of Virology, Pune, Maharashtra, India.

Sujeet K Singh (SK)

Department of Health and Family Welfare, Ministry of Health and Family Welfare, Government of India.
National Centre for Disease Control, Delhi, India.

Rajeev Sadanandan (R)

Department of Health and Family Welfare, Government of Kerala, India.

Preeti Sudan (P)

Department of Health and Family Welfare, Ministry of Health and Family Welfare, Government of India.

Balram Bhargava (B)

Department of Health Research, Ministry of Health and Family Welfare, Government of India.

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