TY - JOUR
T1 - Outbreak Investigation of Nipah Virus Disease in Kerala, India, 2018
AU - Nipah Investigators People and Health Study Group
AU - Arunkumar, Govindakarnavar
AU - Chandni, Radhakrishnan
AU - Mourya, Devendra T.
AU - Singh, Sujeet K.
AU - Sadanandan, Rajeev
AU - Sudan, Preeti
AU - Bhargava, Balram
N1 - Funding Information:
Financial support. This work was supported by the Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, Government of India (file nos. 5/8/7/15/2010– ECD– I and VIR/1/2015/ECD-I) to Dr G. Arunkumar, Manipal Centre for Virus Research, Manipal Academy of Higher Education.
Publisher Copyright:
© 2019 The Author(s).
PY - 2019/5/24
Y1 - 2019/5/24
N2 - 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.
AB - 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.
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U2 - 10.1093/infdis/jiy612
DO - 10.1093/infdis/jiy612
M3 - Article
C2 - 30364984
AN - SCOPUS:85066960608
SN - 0022-1899
VL - 219
SP - 1867
EP - 1878
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 12
ER -
