Author:
Yadav Pragya D.,Sahay Rima R.,Balakrishnan Anukumar,Mohandas Sreelekshmy,Radhakrishnan Chandni,Gokhale Mangesh D.,Balasubramanian R.,Abraham Priya,Gupta Nivedita,Sugunan A. P.,Khobragade Rajan,George Kalpana,Shete Anita,Patil Savita,Thankappan Ullas Padinjaremattathil,Dighe Hitesh,Koshy Jijo,Vijay Vivek,Gayathri R.,Kumar P. Jayesh,Rahim Asma,Naveen A.,Nair Sarala,Rajendran V. R.,Jayasree V.,Majumdar Triparna,Jain Rajlaxmi,Viswanathan Prasanth,Patil Deepak Y.,Kumar Abhinendra,Nyayanit Dimpal A.,Sarkale Prasad,Waghmare Ashwini,Baradkar Shrikant,Gawande Pranita,Bodke Poonam,Kalele Kaumudi,Yemul Jyoti,Dhaigude Sachin,Holepannawar Manjunath,Gopale Sanjay,Chopade Ganesh,Ray Shilpa,Waghmare Priyanka,Narayan Jitendra,Mathapati Basavaraj,Kadam Manoj,Kumar Abhimanyu,Suryawanshi Annasaheb,Jose Beena Philomina,Sivadas Saritha,Akash N. P.,Vimisha T. V.,Keerthi K. V.
Abstract
We report here a Nipah virus (NiV) outbreak in Kozhikode district of Kerala state, India, which had caused fatal encephalitis in a 12-year-old boy and the outbreak response, which led to the successful containment of the disease and the related investigations. Quantitative real-time reverse transcription (RT)-PCR, ELISA-based antibody detection, and whole genome sequencing (WGS) were performed to confirm the NiV infection. Contacts of the index case were traced and isolated based on risk categorization. Bats from the areas near the epicenter of the outbreak were sampled for throat swabs, rectal swabs, and blood samples for NiV screening by real-time RT-PCR and anti-NiV bat immunoglobulin G (IgG) ELISA. A plaque reduction neutralization test was performed for the detection of neutralizing antibodies. Nipah viral RNA could be detected from blood, bronchial wash, endotracheal (ET) secretion, and cerebrospinal fluid (CSF) and anti-NiV immunoglobulin M (IgM) antibodies from the serum sample of the index case. Rapid establishment of an onsite NiV diagnostic facility and contact tracing helped in quick containment of the outbreak. NiV sequences retrieved from the clinical specimen of the index case formed a sub-cluster with the earlier reported Nipah I genotype sequences from India with more than 95% similarity. Anti-NiV IgG positivity could be detected in 21% of Pteropus medius (P. medius) and 37.73% of Rousettus leschenaultia (R. leschenaultia). Neutralizing antibodies against NiV could be detected in P. medius. Stringent surveillance and awareness campaigns need to be implemented in the area to reduce human-bat interactions and minimize spillover events, which can lead to sporadic outbreaks of NiV.
Subject
Public Health, Environmental and Occupational Health