The Ministry of Health has issued a professional document "Guidelines for diagnosis and treatment of Nipah virus diseases", uniformly applied at medical examination and treatment facilities nationwide.
According to the Ministry of Health, the Nipah virus disease is an acute infectious disease, capable of transmitting from animals to humans and from person to person. The Nipah virus was first discovered in 1998 in Malaysia, then recorded many sporadic but frequent outbreaks in Bangladesh, India, Singapore and the Philippines.
The disease usually progresses severely with manifestations of encephalitis, acute pneumonia, the mortality rate ranges from 40-75%, or leaves serious neurological sequelae. Nipah virus is classified as a group A infectious disease, with the potential to cause a pandemic and is on the World Health Organization (WHO)'s priority list.
Nipah virus is a single-stranded RNA virus belonging to the family Paramyxoviridae, Henipavirus genus. The natural host is the fruit-eating bat Pteropus - carrying the virus but not showing symptoms. The intermediate host can be pigs, sometimes horses or other livestock.
The two main virus strains recorded include:
NiV-Malaysia: mainly transmitted from animals to humans, low human-to-human transmission.
NiV-Bangladesh/NiV-India: higher virulence, easily transmitted between people when exposed to secretions.
The routes of transmission include: Direct contact with infected animals or secretions (urine, saliva). Eating food contaminated with bat excretes (rasp, fruit). Transmission from person to person through respiratory secretions, urine or vomiting. The virus can spread through droplets when coughing or sneezing. People with respiratory symptoms are assessed as having a higher risk of transmission.
The incubation period is usually from 3-14 days, rarely can last up to 45 days.
Onset symptoms include high fever, headache, muscle pain, sore throat, vomiting, diarrhea. The whole-blown stage may appear: Conscience disorders, confusion, disorientation. Seizures, weakness or paralysis of limbs. Cough, shortness of breath, rapidly progressing respiratory failure.
Severe cases may include multiple organ failure, heart failure, kidney failure, gastrointestinal bleeding, sepsis. About 20% of survivors have long-term neurological sequelae or recurrent encephalitis after many months - many years.
Guidance requires strict compliance with regulations on sampling, preservation and transportation of specimens. The main tests include: Real-time RT-PCR/ gene sequencing to detect viral RNA (respiratory fluids, blood, urine, cerebrospinal fluids). ELISA serology to detect antibodies.
The suspected case is a person with epidemiological factors and appropriate symptoms or ELISA positive. The identified case must have evidence of Nipah virus RNA detection.
The Ministry of Health emphasizes: There is currently no specific treatment and no vaccine to prevent the disease. Treatment principles include:
Hospitalization, absolute isolation for all suspected/identified cases.
Strictly control infection.
Active supportive treatment and symptomatic treatment.
In symptomatic treatment:
Use paracetamol to reduce fever, NSAIDs are contraindicated due to the risk of bleeding/Rey's syndrome.
Respiration support, mechanical ventilation when needed.
Anti-convulsant, controls increased intracranial pressure.
Antibiotics should only be used when there is a secondary infection.
Maintain fluid-electrolyte balance.
preventing the path of transmission.
