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

2018; Oxford University Press; Volume: 219; Issue: 12 Linguagem: Inglês

10.1093/infdis/jiy612

1537-6613

Govindakarnavar Arunkumar, Chandni Radhakrishnan, Devendra T. Mourya, Sujeet Kumar Singh, Rajeev Sadanandan, Preeti Sudan, Balram Bhargava, Raman Gangakhedkar, Nivedita Gupta, Balram Bhargava, Devendra T. Mourya, Pragya D. Yadav, Anita M. Shete, Reema Sahay, A. B. Sudeep, Sumit Bharadwaj, AP Sugunan, Manickam Ponnaiah, Tarun Bhatnagar, Manoj Murhekar, Govindakarnavar Arunkumar, Jazeel Abdulmajeed, Sushama Aswathyraj, Santhosha Devadiga, Anup Jayaram, N Sudheesh, Jagdesh Anitha, Sudandiradas Robin, Sasidharanpillai Sabeena, Muhammed Shakir, Pattanaik Sarthak, Suresh Prabhu, Hindol Maity, Shahin Sheik, C Shilpa, Kavitha Karunakaran, Aithal Anjali, Sanjeeva Kumar, Sudhakar K. Venkatesh, P Ravindran, Sujeet Kumar Singh, Naveen Gupta, Sanket Kulkarni, K Raghu, M.K. Showkath Ali, Ruchi Jain, Ramesh Chandra, Jai Kiran, Pradeep Khasnobis, Smita Jain, S Eswara Reddy, Rajeev Sadanandan, Anantapalli Naveen, C M Arjun, N. Rajendran, Akhilesh Kumar, K V Latheesh, E Bijoy, Devi Asha, Mohamed Ismaïl, Ariyari Sukumaran, Fettle Amar, K Sakeena, Vasudevan Jayasree, K J Reena, R L Sarita, Kesavendra Kumar, M K Sreejith, Kevin Kuriakose, Beena Philomina, Seethu Ponnuthambi, M P Lilabi, Thomas Bina, Chandni Radhakrishnan, K G Sajeeth Kumar, V R Rajendran, R Gopakumar, C J Michael, Pillaveetil Sathyadas Indu, A. Mohandas, Arun Zachariah, Urbano José, Amit K. Meena, Narayanan Devadasan, A Sreenivas Kumar, Abdul Ghafur,

Mosquito-borne diseases and control

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.