Health officials in India are trying to stop the spread of yet another serious infectious disease. Over the weekend, a 12-year-old boy died from an infection caused by the Nipah virus, a highly lethal germ spread from bats or contaminated food that can also spread between people. Hundreds of people potentially exposed to the boy have been contacted, monitored, or placed under quarantine, including his close family.
According to CBS News, the boy—a resident in the southern state of Kerala—had been hospitalized with a high fever a week earlier. His condition quickly worsened and he developed encephalitis, or serious brain swelling. Blood tests confirmed that he had Nipah, and by Sunday, he passed away.
Nipah is a zoonotic disease that primarily spreads from certain species of fruit bats (the bats are healthy carriers). This can happen through humans coming into close contact with infected bats, but also through food, usually fruit, contaminated with their urine or saliva. The virus can also infect pigs that can then infect humans. Human to human transmission through close contact with an infected person’s bodily fluids is possible, too. The virus is a distant relative of the viruses responsible for Ebola and other hemorrhagic fevers.
Nipah can be difficult to diagnose because its initial symptoms tend to be vague, often resembling a cold, while some may not experience any at all. These symptoms can show up within a few days of exposure and include fever, headaches, and body aches. In serious cases, as with the boy, the infection can eventually harm the brain, leading to encephalitis and rapidly developing symptoms like seizures, disorientation, and coma. There is no specific treatment or vaccine for Nipah, and the fatality rate in past outbreaks has ranged from 40% to over 90%. Survivors may have also long-term symptoms and there is evidence that the infection can lie dormant months to years after the initial exposure.
The first known outbreak of Nipah occurred in Sungai Nipah, a village in Malaysia, in 1998 (the source there was infected pigs). Unlike covid-19, Nipah hasn’t spread too far beyond where it was first discovered, and only several hundred cases have ever been reported. But outbreaks have periodically appeared throughout Malaysia, Bangladesh, Singapore, and India, and public health experts do worry that it has the potential to cause large epidemics in the future, especially if it someday mutated into a strain more transmissible between people (not such an uncommon thing for a virus to do, as we’ve painfully learned recently). In 2018, a Nipah outbreak in Kerala, India left at least 17 people dead.
This concern over Nipah has led local health authorities to contract trace 188 people suspected of having come into contact with the boy, as of Monday this week. At least 20 of these contacts are considered high risk and are currently being quarantined. According to CBS News, there have been additional infections identified, though no other details have been made available yet.
Most outbreaks of Nipah have been small, with the largest so far being the first one that sickened over 300 people and killed about 100. In 2019, the Kerela government successfully contained a potential outbreak before it reached anyone else besides the initial case. But Kerala is still dealing with the pandemic, which could complicate its efforts. Unfortunately, this case is also a reminder that covid-19 is far from the only potential viral threat out there.