The spread of Nipah virus (NiV) infection has become a major public health concern for Bangladesh, with thousands of people lacking the proper awareness about the deadly virus.
Epidemiologists and health specialists of the Directorate General of Health Services (DGHS) expressed their deep concerns and said a fresh outbreak of NiV could happen any moment with the arrival of winter.
Dr M Mushtuq Husain, principle scientific officer of Institute of Epidemiology, Disease Control and Research (IEDCR), told the Dhaka Tribune that top priority was being given to NiV, as the fatality rate from the disease was extremely high.
As a precaution to the disease, he urged people not to drink raw date palm sap (Khejurer Rosh).
The NiV – an enveloped RNA virus belonging to genus Henipavirus – is a highly pathogenic paramyxovirus, which is transmitted by the drinking of virus-contaminated raw date palm sap or through close physical contact with Nipah infected patients.
Human Nipah virus (NiV) infection was first recognized in a large outbreak of 276 reported cases in Malaysia and Singapore from September 1998 through May 1999.
As of May 15, 2013, there have been 21 fatalities out of 24 reported cases of NiV infection in Bangladesh since the beginning of 2013, according to IEDCR statistics.
These cases were from 13 different districts (Gaibandha, Jhinaidah, Kurigram, Kushtia, Magura, Manikganj, Mymensingh, Naogaon, Natore, Nilphamari, Pabna, Rajbari, and Rajshahi). The age distribution of cases was from 8 months to 60 years, while 16 cases were male and eight were females.
The NiV infection has a fatality rate of 78%, with 148 people out of the 189 reported cases between 2001 and May 2013 – succumbing to the disease.
Prof Dr Be-Nazir Ahmed, director of disease control at the DGHS, said an all-out preparation has been taken to overcome the high risk of the life threatening NiV disease.
The DGHS has been carrying out awareness campaign in the Nipah-prone areas, and holding meeting with local authorities and society elites to let them know about the risks of NiV.
Health messages about the NiV have also been prepared, especially for the people who sold raw date palm sap.
A list of date palm trees and its workers in 25 upazilas and villages in the Nipah-belt was being prepared for a programme to make Nipah-free villages, Dr Be-Nazir informed.
Dr Mushtuq from the IEDCR, meanwhile, said they had arranged a training programme titled “Communication for Behavioral Impact (COMBI) training and strategy for prevention of Nipah virus infection in Bangladesh” for 100 health education officers from 64 districts and 100 more medical officers and doctors from upazilla health complexes.
Moreover, the hospital-based surveillance at three medical colleges in Rangpur, Rajshahi and Faridpur, and two district sadar hospitals at Tangail and Rajbari – have been advised to send reports on the meningo-encephalitis diseases including: (1) Japanese Encephalitis, (2) Nipah, (3) Dengue, (4) Other bacterial causes of encephalitis.
The concerned surveillance physicians, directors and superintendants of the selected hospitals are responsible for conducting the surveillance locally and sending the reports bi-weekly.
It has been learnt that the median incubation period of the secondary cases that had a single exposure to Nipah case was nine days (range 6–11 days) but exposure to onset of illness varied from 6-16 days. The median incubation period following single intake of raw date palm sap to the onset of illness was 7 days (range: 2-12 days) in Bangladesh.