What is Nipah and how does it spread?

Kerala was on high alert after a 12-year-old boy died of the deadly Nipah virus in Kozhikode, early this month. The State ramped up efforts to stop a potential outbreak, as health officials began to trace contacts and isolate hundreds of people who came into contact with the boy.

The virus has an estimated fatality rate of between 40% and 75%, according to the World Health Organisation (WHO), making it deadlier than the coronavirus.

The state dealt with Nipah in 2018, when more than a dozen people died from the virus. This time around, the concern is compounded by the fact that the state has grabbed national headlines in recent weeks for seeing the highest number of daily COVID-19 cases across India.

Nipah is a rare viral infection. Infected patients show symptoms of fever and respiratory problems in the early stages that quickly advance to fatal encephalitis (inflammation of the brain). Fruit bats or flying foxes of the Pteropodidae family are the natural host of the Nipah virus.

The WHO has listed Nipah as among the 10 priority pathogens requiring urgent research. The organisation takes into consideration the virus' ability to trigger lethal outbreaks and the non-availability of drugs against it.

What is Nipah?

Nipah is a zoonotic disease (zoonotic is a disease transmitted to humans from animals), spread by bats, pigs and infected people, according to the WHO. Outbreaks have been reported in Southeast Asia since 1998, when the virus was first identified in Malaysia. The 1998-99 outbreak spread from pigs to humans in Malaysia. It caused severe respiratory illness in pigs and encephalitic disease in humans. It killed 100 people and affected thousands of pigs. The Nipah virus has a mortality rate of 75%, according to the WHO.

How does it spread?

Fruit bats, the natural host of the Nipah virus, show no signs of infection. However, the virus spreads through the bats saliva or excreta. Humans and animals such as pigs become infected through contact or ingestion of materials contaminated with saliva or urine of such bats. In 2004, in Bangladesh, humans became infected after consuming date palm sap that had been contaminated by infected fruit bats. Humans also get affected when they come in contact with infected pigs or when they consume the meat of the animal. Human-to-human transmission happens through body fluids, including nasal or respiratory droplets, urine, or blood. Such transmission was recorded in Siliguri, West Bengal, in 2001, and in the 2018 outbreak in Kerala. In Siliguri, 75% of cases occurred among hospital staff or visitors.

What are the symptoms?

Symptoms typically present one to two weeks after exposure to the virus. Initial symptoms are flu-like. They include fever, headache, respiratory problems and muscle pain. This may be followed by neurological signs such as disorientation and dizziness. In severe cases, the infection can cause encephalitis, which is the inflammation of the brain, and eventually death. Survivors can have long-term neurological issues such as a seizure disorder or personality changes, according to the WHO.

What can be done to diagnose it?

According to the U.S. Centers for Disease Control and Prevention (CDC), during the early stages of the illness, laboratory testing can be conducted using real-time polymerase chain reaction (RT-PCR) from throat and nasal swabs, cerebrospinal fluid, urine, and blood. Later in the course of illness and after recovery, testing for antibodies is conducted using an enzyme-linked immunosorbent assay (ELISA).

What is the treatment?

There are no drugs or vaccine available against Nipah. The primary treatment is supportive care. Rest, hydration, and treatment of symptoms are advised. Individuals infected need to be hospitalised and isolated to avoid spread of disease to others. Identifying potential victims, testing them and treating them as early as possible are the way forward.

What should you do to protect yourself from Nipah?

  • Avoid exposure to animals such as bats and pigs.
  • Avoid eating fruits bitten by bats or that may have been contaminated by them.
  • Avoid contact with infected people.
  • Maintain personal hygiene. Practise handwashing regularly with soap and water.
  • Consume only well-cooked, home-made food.
  • Spread awareness among your friends and family members.

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What is endemicity?

Dr. Soumya Swaminathan, the chief scientist at the World Health Organization, recently said that India seems to be "entering some stage of endemicity". What does that mean?

According to the US Centers for Disease Control and Prevention (CDC), in the endemic stage "the disease will remain dormant in a particular region or country. If the conditions become favourable it flares up and spreads among people." Common flu and malaria are examples of endemic stage diseases.

Endemicity simply means that the spread of the disease has started to slow down and there may not be widespread cases. The disease transmission continues and people still get infected, but not at a level that causes public health concern. However, localised peaks can be expected in some areas.

The complete endemic stage of any disease can be reached only when a large section of the population becomes immune to a disease either through vaccination or through antibodies acquired from a prior infection. India has a long way to go before reaching that stage. So, it is important to stay cautious and continue to wear masks, sanitise hands and avoid crowded places.

In February 2021, a study published in the Nature journal indicated that the SARS-CoV-2 virus is set to, become endemic and would continue to circulate in pockets of the global population. The Nature survey shows many scientists expect the virus that causes COVID-19 to pose less danger over time. This means, the virus is here to stay and we have to learn to live with it.

Did you know?

  • An epidemic is a disease that affects a large number of people within a community, population, or region.
  • A pandemic is an epidemic that's spread over multiple countries or continents.
  • An outbreak is a sudden increase in the number of endemic cases.

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What is dental visit?

Brushing your teeth several times a day and eating healthy foods are two ways to keep your teeth healthy and white. Another thing you can do is visit your dentist at least once a year.

At the dentist’s surgery, you sit in a special chair. It moves all different ways so the dentist can look into your mouth easily. First, the dentist puts a little round mirror on a handle into your mouth. This helps the dentist see the sides of your teeth. To feel for cavities, or holes, in your teeth, the dentist uses tiny tools called explorers.

Your dentist or the hygienist then cleans your gums and cleans and polishes your teeth to make them shine.

If your dentist finds a cavity in one of your teeth, it will need to be cleaned and filled. Before filling your tooth, your dentist may give you an injection in the gum near the tooth that has the cavity. The injection makes the area numb, so you cannot feel any pain while the dentist works on your tooth.

Remember, that the teeth you begin to get when you are only six years old have to last you the rest of your life. Take good care of them. Ask your parents for a new toothbrush, toothpaste, and dental floss after each checkup.

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What nutrients do children need to stay healthy?

What are your favourite foods? Maybe you like fish, hamburgers, or scrambled eggs. These foods all can be part of a healthy diet. But they are not enough. That’s because they are all proteins. Your body needs many different kinds of nutrients to stay healthy.

The best way to get all the nutrients your body needs is to eat many different kinds of food each day. When you eat a variety of foods, you can get the vitamins and minerals your body needs.

Eating a variety of foods means eating bread, rice, and other grains, especially whole grains.

It means eating nuts and beans for protein. It may also mean eating meats, such as beef, fish, and chicken.

Dairy products like milk and cheese are also important for a healthy diet. This food group is especially important for younger people, whose bones are still growing.

Finally, a wide variety of vegetables and fruit is very important for health. These foods contain vitamins and minerals that are critical to our well-being.

Foods that come in a package usually have labels that tell you what is in the food. These labels can help you understand what food groups are contained in a given item. That helps you to look for items with more fruit or vegetables and fewer addictive and preservatives, for example.

Food labels also tell you how many fats, carbohydrates, and other nutrients are in one serving of that food. This helps you to choose foods that are lower in fat and sugar and higher in nutritional value.

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Why is it important to eat well?

Like a car, your body needs fuel to keep it running. Your body’s fuel is food.

Food contains the things your body needs for energy and to stay healthy. These include proteins, fats, and carbohydrates.

Proteins provide energy and help make muscles, skin and other organs, and blood. They also help your body to heal itself. You can get protein from animal foods such as meat, fish, and milk products. You also can get protein from certain beans and nuts.

Fats provide a lot of energy. Your body needs some fats, but not too many. You can get fats when you eat meat, butter, certain oils, and some plant foods such as nuts, olives, and avocados.

Carbohydrates are the body’s main source of energy. Many foods contain carbohydrates, including potatoes, pasta, and grains.

Food also contains vitamins and minerals. There are many different vitamins, such as vitamins A, C, and D. They all help keep your body healthy. Many fruits and vegetables have vitamins. There also are many different minerals, including calcium and iron. Calcium is good for your bones and teeth. Iron is good for your blood.

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