Nipah virus infection is to be officially listed as a category 5 notifiable infectious disease in Taiwan in March, while clinical treatment guidelines are being formulated, the Centers for Disease Control (CDC) said yesterday.
With Nipah infections being reported in other countries and considering its relatively high fatality rate, the centers on Jan. 16 announced that it would be listed as a notifiable infectious disease to bolster the nation’s systematic early warning system and increase public awareness, the CDC said.
Bangladesh reported four fatal cases last year in separate districts, with three linked to raw date palm sap consumption, CDC Epidemic Intelligence Center Director Guo Hung-wei (郭宏偉) said.
Photo: Hou Chia-yu, Taipei Times
Since the first recognized case in Bangladesh in 2001, human infections have been detected almost every year, he said.
Between 2001 and last year, the South Asian country recorded 357 Nipah infections and 241 deaths, corresponding to an overall case fatality rate of about 73 percent, he said.
Among them, human-to-human transmission accounted for about 29 percent of the cases, he added.
In India, five cases — all healthcare workers at a hospital — had been reported in the eastern state of West Bengal this year as of Sunday, and about 100 contacts had been quarantined, Guo said.
India also detected its first case in 2001 in West Bengal, while its southern state of Kerala has reported nine outbreaks since 2018, but there has not been large-scale outbreak in India, he said.
The five hospital infections in India were traced to a patient hospitalized last year, who died of suspected Nipah virus infection and had drunk raw date palm sap before the onset of symptoms, CDC Director-General Philip Lo (羅一鈞) said.
Two nurses who took care of the patient were infected, Lo said.
Local media reported that authorities collected samples from nine fruit bats and 24 date palm sap containers for testing, and Nipah antibodies were detected in one bat, suggesting prior exposure, he said.
Nipah is a zoonotic virus that can be transmitted to humans by direct contact with infected animals — mainly fruit bats, but also pigs, and can also be transmitted by contaminated food, such as date palm sap contaminated by bats, or close human-to-human contact, Lo said.
Its early symptoms often include fever, headache, muscle soreness, vomiting and a sore throat, and can progress to dizziness, sleepiness, altered consciousness and acute encephalitis, he said.
Some people might experience severe pneumonia and severe respiratory complications, with a fatality rate between 40 and 75 percent, he added.
There are currently no vaccines or drugs to treat the disease, but animal studies have suggested that remdesivir, an antiviral medication used to treat COVID-19, was effective for treating infection in monkeys, while there are also studies on using ribavirin, an antiviral used to treat hepatitis C, to treat Nipah virus infection, Lo said.
There is low risk of large-scale community outbreak, and no exported cases were reported in people who visited countries where cases have been reported, but considering the high fatality rate, the CDC has asked National Taiwan University Hospital to formulate clinical treatment guidelines, he said.
The CDC also issued a notice to healthcare facilities to report any suspected case and send samples for testing, while airport quarantine measures would remain the same, Lo said.
People do not have to be concerned, but should avoid direct contact with bats or pigs, and avoid drinking raw date palm sap or damaged soft fruit, such as mangoes, or juice that could be contaminated by bats when traveling to countries where the
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