Nipah virus infection among abattoir workers in Malaysia, 1998–1999

Abstract

Nipah infection was not widespread among abattoir workers in Malaysia and was linked to exposure to pigs. Since it may be difficult to identify Nipah-infected pigs capable of transmitting virus by clinical symptoms, using personal protective equipment, conducting surveillance for Nipah infection on pig farms which supply abattoirs, and avoiding handling and processing of potentially infected pigs are presently the best strategies to prevent transmission of Nipah virus in abattoirs.

Qualitative Release Assessment to Estimate the Likelihood of Henipavirus Entering the United Kingdom

“…Most patients with Nipah encephalitis in Malaysia were pig farmers. The virus isolates obtained from both human patients and sick pigs showed identical nucleotide sequence [11] and therefore pigs were implicated as the primary source of human infection. Over one million pigs were culled to control the outbreak [10].…”

“…A Hendra-like virus, subsequently named Nipah Virus was identified as the etiologic agent [10]. Between September 1998 and May 1999, 265 encephalitis patients, which included 105 deaths [3], were reported in three states of Malaysia [11]. Most patients with Nipah encephalitis in Malaysia were pig farmers.…”

Henipavirus Pathogenesis in Human Respiratory Epithelial Cells

“…To date, NiV has been responsible for more than 500 human cases, with mortality rates ranging from 40% (in Malaysia) (13) to 100% (in Bangladesh and India) (6,11,14). The natural hosts of henipaviruses are fruit bats (Pteropus species) (15)(16)(17), and transmission of these viruses from bats to humans may be direct or via an intermediate host like horses or pigs for HeV and NiV transmission, respectively (2,15,(18)(19)(20)(21)(22)(23). Interestingly, respiratory symptoms such as cough and difficulty breathing were reported for about 70% of NiV-B-infected and less than 30% of NiV-M-infected patients (24).…”

Risk Factors for Nipah Virus Encephalitis in Bangladesh1

“…In contrast to the patients in the Malaysia and Singapore outbreaks (5,16,17,25,26), most of the Bangladesh population (and all of the case-patients included in this study; data not shown) are practicing Muslims who do not consume pork and who avoid contact with pigs. None of the case-patients and controls in our study population reported any contact with pigs or pig excreta, so it is unlikely that these animals played a role in this outbreak.…”

“…Ten deaths were reported among 12 ill persons with symptoms compatible with NiVE, resulting in a case-fatality ratio of 83% (9,23). Although previous outbreaks of NiVE outside Bangladesh involved primarily men and women >25 years of age Risk Factors for Nipah Virus Encephalitis in Bangladesh 1 (5,16,17,19,26), most (75%) patients in this outbreak were boys <15 years of age. We describe a matched case-control study that was conducted to characterize the epidemiology of NiVE and, specifi cally, to determine if risk for NiVE was associated with contact with animals; an environmental exposure, activity, or behavior; or contact with other NiVE patients during the 2004 NiVE outbreak in Goalando township.…”