Aster MIMS, General Hospital, Kozhikode, Kerala, India.
Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India.
J Med Virol. 2024 Mar;96(3):e29559. doi: 10.1002/jmv.29559.
India experienced its sixth Nipah virus (NiV) outbreak in September 2023 in the Kozhikode district of Kerala state. The NiV is primarily transmitted by spillover events from infected bats followed by human-to-human transmission. The clinical specimens were screened using real-time RT-PCR, and positive specimens were further characterized using next-generation sequencing. We describe here an in-depth clinical presentation and management of NiV-confirmed cases and outbreak containment activities. The current outbreak reported a total of six cases with two deaths, with a case fatality ratio of 33.33%. The cases had a mixed presentation of acute respiratory distress syndrome and encephalitis syndrome. Fever was a persistent presentation in all the cases. The Nipah viral RNA was detected in clinical specimens until the post-onset day of illness (POD) 14, with viral load in the range of 1.7-3.3 × 10 viral RNA copies/mL. The genomic analysis showed that the sequences from the current outbreak clustered into the Indian clade similar to the 2018 and 2019 outbreaks. This study highlights the vigilance of the health system to detect and effectively manage the clustering of cases with clinical presentations similar to NiV, which led to early detection and containment activities.
2023 年 9 月，印度喀拉拉邦科泽科德区发生第六次尼帕病毒（NiV）疫情。尼帕病毒主要通过受感染蝙蝠的溢出事件传播，然后再传播给人类。临床标本采用实时 RT-PCR 进行筛查，阳性标本采用下一代测序进一步鉴定。本文详细描述了确诊尼帕病毒病例的临床表现和管理以及疫情控制活动。本次疫情报告了 6 例病例，其中 2 例死亡，病死率为 33.33%。病例表现为急性呼吸窘迫综合征和脑炎综合征的混合症状。所有病例均持续发热。在发病后第 14 天（POD），临床标本中均检测到尼帕病毒 RNA，病毒载量范围为 1.7-3.3×10 拷贝/mL。基因组分析显示，本次疫情序列与 2018 年和 2019 年疫情的印度分支聚类相似。本研究强调了卫生系统的警惕性，以发现和有效管理临床表现类似于尼帕病毒的病例群集，从而实现了早期检测和控制活动。
