CHANGAROTH — On May 3, 2018, Muhammad Sabith awoke with a fever while staying with his parents in this village near the southwest coast of India.
Once authorities here were aware of the Nipah diagnosis, they quickly isolated everyone they could find who had been near him or other known contacts. While those precautions stopped that particular outbreak, the case also underscored the fast and aggressive path the pathogen can take.
Pragya Yadav, the lead scientist on Nipah research at India’s National Institute of Virology, said the expansion of human settlement in Kerala and worldwide has led to habitat loss, declining biodiversity and migration of animals closer to people, “which eventually helps the virus to jump from bats to humans.”
Quick growth, the Reuters analysis shows, made conditions ripe for spillover across 83% of Kerala at the time of the Nipah outbreak, up from 58% in 2002. The Reuters analysis found the risk of spillover in the 25 sq km area around Sabith’s family home rose precipitously in the two years before his illness, placing the area in the top 1.5% of locales worldwide most conducive to a bat-borne virus infecting humans.
A search of the neighborhood led to a colony, near their house, of flying foxes, a common fruit bat. A so-called megabat, the flying fox has a five-foot wingspan and a canine face. It is found throughout the Asian tropics. Testing by Yadav’s lab at the National Institute of Virology found Nipah in 13 of 52 flying foxes the scientists captured near Sabith’s house. Human and bat strains of the viruses were 97.
Scientists who have studied the virus told Reuters they don’t know why more recent outbreaks have been more lethal. The Kerala strain is different from those that appeared in Bangladesh and Malaysia, Yadav said, but it’s not clear yet how that affects the virus’s infectiousness, deadliness or clinical course.
Around each outbreak, runaway development of the local economy had paved a pathway for a spillover. In each case, the virus found it.But the spillovers of recent decades have illustrated a versatility the virus wields as a pathogen: its ability to infect cells that possess so-called ephrin-B receptors. These receptors regulate what gets in or out of cells that line vital organs and the central nervous system.
Because many victims died of brain inflammation, public health officials initially suspected Japanese encephalitis, a mosquito-borne disease with similar symptoms. They fogged the region with insecticides, but the virus continued to spread. In March 1999, scientists analyzed the spinal fluid of a victim from the town of Kampung Sungai Nipah. Kaw Bing Chua, a Malaysian virologist, identified the pathogen, later named Nipah after the village.
In addition to home tree taps, date palm juice is collected on plantations. With infrared cameras, the scientists filmed flying foxes at area plantations licking syrup with their long, pink tongues – and their saliva and urine dripping into the buckets beneath.Article content His parents told Reuters they had never heard of Nipah. “Nothing could make up for or console this loss,” said his father, Mohammad Sanwar Hossain, a 33-year-old day laborer.Article content
“In the name of development, we degraded the landscapes which are ecologically fragile,” report co-author T.V. Ramachandra told Reuters. “We made the region more vulnerable.” After the 2018 spillover, public health officials began a campaign to dissuade residents from eating fruit with bite marks or doing anything that could disturb flying fox colonies. But residents say the bats have become increasingly difficult to avoid.
Over the next week, he began hallucinating and shaking so violently that his entire bed trembled. He told Reuters he remembers nothing between May 27, four days after his first symptoms, and June 9, the day he awoke in intensive care. It was his birthday. Recently, his home and those of neighbors were demolished to make way for the widening of a national highway.Article content
The statement from Chief Minister Vijayan’s office described outbreak readiness as a high priority. His administration set up Nipah monitoring stations at medical centers after the 2018 spillover and launched a campaign to improve hospital preparedness after the outbreak a year later.
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