Transmission of Nipah Virus — 14 Years of Investigations in Bangladesh

Nipah virus is a highly virulent zoonotic pathogen. In this report from Bangladesh, which included 40% of the world’s known cases, the risk factors for human-to-human transmission were evaluated. No asymptomatic cases were identified. Increased respiratory symptoms in the patient and prolonged close...

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Published inThe New England journal of medicine Vol. 380; no. 19; pp. 1804 - 1814
Main Authors Nikolay, Birgit, Salje, Henrik, Hossain, M. Jahangir, Khan, A.K.M. Dawlat, Sazzad, Hossain M.S, Rahman, Mahmudur, Daszak, Peter, Ströher, Ute, Pulliam, Juliet R.C, Kilpatrick, A. Marm, Nichol, Stuart T, Klena, John D, Sultana, Sharmin, Afroj, Sayma, Luby, Stephen P, Cauchemez, Simon, Gurley, Emily S
Format Journal Article
LanguageEnglish
Published United States Massachusetts Medical Society 09.05.2019
Subjects
Adolescent
Adult
Age Factors
Animals
Bangladesh
Bangladesh - epidemiology
Binomial distribution
Body Fluids
Body Fluids - virology
Child
Contact Tracing
Disease transmission
Disease Transmission, Infectious
Disease Transmission, Infectious - prevention & control
Epidemics
Fatalities
Female
Health surveillance
Henipavirus Infections
Henipavirus Infections - epidemiology
Henipavirus Infections - prevention & control
Henipavirus Infections - transmission
Hospitals
Humans
Hypotheses
Illnesses
Infections
Infectious diseases
Infectivity
Life Sciences
Male
Mathematics
Medical laboratories
Middle Aged
Nipah Virus
Outbreaks
Patients
Public health
Respiration
Risk Factors
Statistics
Young Adult
Zoonoses
Zoonoses - transmission
Bangladesh
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Abstract Nipah virus is a highly virulent zoonotic pathogen. In this report from Bangladesh, which included 40% of the world’s known cases, the risk factors for human-to-human transmission were evaluated. No asymptomatic cases were identified. Increased respiratory symptoms in the patient and prolonged close contact from caregivers were associated with secondary transmission.
AbstractList BackgroundNipah virus is a highly virulent zoonotic pathogen that can be transmitted between humans. Understanding the dynamics of person-to-person transmission is key to designing effective interventions.MethodsWe used data from all Nipah virus cases identified during outbreak investigations in Bangladesh from April 2001 through April 2014 to investigate case-patient characteristics associated with onward transmission and factors associated with the risk of infection among patient contacts.ResultsOf 248 Nipah virus cases identified, 82 were caused by person-to-person transmission, corresponding to a reproduction number (i.e., the average number of secondary cases per case patient) of 0.33 (95% confidence interval [CI], 0.19 to 0.59). The predicted reproduction number increased with the case patient’s age and was highest among patients 45 years of age or older who had difficulty breathing (1.1; 95% CI, 0.4 to 3.2). Case patients who did not have difficulty breathing infected 0.05 times as many contacts (95% CI, 0.01 to 0.3) as other case patients did. Serologic testing of 1863 asymptomatic contacts revealed no infections. Spouses of case patients were more often infected (8 of 56 [14%]) than other close family members (7 of 547 [1.3%]) or other contacts (18 of 1996 [0.9%]). The risk of infection increased with increased duration of exposure of the contacts (adjusted odds ratio for exposure of >48 hours vs. ≤1 hour, 13; 95% CI, 2.6 to 62) and with exposure to body fluids (adjusted odds ratio, 4.3; 95% CI, 1.6 to 11).ConclusionsIncreasing age and respiratory symptoms were indicators of infectivity of Nipah virus. Interventions to control person-to-person transmission should aim to reduce exposure to body fluids. (Funded by the National Institutes of Health and others.)
Nipah virus is a highly virulent zoonotic pathogen that can be transmitted between humans. Understanding the dynamics of person-to-person transmission is key to designing effective interventions.BACKGROUNDNipah virus is a highly virulent zoonotic pathogen that can be transmitted between humans. Understanding the dynamics of person-to-person transmission is key to designing effective interventions.We used data from all Nipah virus cases identified during outbreak investigations in Bangladesh from April 2001 through April 2014 to investigate case-patient characteristics associated with onward transmission and factors associated with the risk of infection among patient contacts.METHODSWe used data from all Nipah virus cases identified during outbreak investigations in Bangladesh from April 2001 through April 2014 to investigate case-patient characteristics associated with onward transmission and factors associated with the risk of infection among patient contacts.Of 248 Nipah virus cases identified, 82 were caused by person-to-person transmission, corresponding to a reproduction number (i.e., the average number of secondary cases per case patient) of 0.33 (95% confidence interval [CI], 0.19 to 0.59). The predicted reproduction number increased with the case patient's age and was highest among patients 45 years of age or older who had difficulty breathing (1.1; 95% CI, 0.4 to 3.2). Case patients who did not have difficulty breathing infected 0.05 times as many contacts (95% CI, 0.01 to 0.3) as other case patients did. Serologic testing of 1863 asymptomatic contacts revealed no infections. Spouses of case patients were more often infected (8 of 56 [14%]) than other close family members (7 of 547 [1.3%]) or other contacts (18 of 1996 [0.9%]). The risk of infection increased with increased duration of exposure of the contacts (adjusted odds ratio for exposure of >48 hours vs. ≤1 hour, 13; 95% CI, 2.6 to 62) and with exposure to body fluids (adjusted odds ratio, 4.3; 95% CI, 1.6 to 11).RESULTSOf 248 Nipah virus cases identified, 82 were caused by person-to-person transmission, corresponding to a reproduction number (i.e., the average number of secondary cases per case patient) of 0.33 (95% confidence interval [CI], 0.19 to 0.59). The predicted reproduction number increased with the case patient's age and was highest among patients 45 years of age or older who had difficulty breathing (1.1; 95% CI, 0.4 to 3.2). Case patients who did not have difficulty breathing infected 0.05 times as many contacts (95% CI, 0.01 to 0.3) as other case patients did. Serologic testing of 1863 asymptomatic contacts revealed no infections. Spouses of case patients were more often infected (8 of 56 [14%]) than other close family members (7 of 547 [1.3%]) or other contacts (18 of 1996 [0.9%]). The risk of infection increased with increased duration of exposure of the contacts (adjusted odds ratio for exposure of >48 hours vs. ≤1 hour, 13; 95% CI, 2.6 to 62) and with exposure to body fluids (adjusted odds ratio, 4.3; 95% CI, 1.6 to 11).Increasing age and respiratory symptoms were indicators of infectivity of Nipah virus. Interventions to control person-to-person transmission should aim to reduce exposure to body fluids. (Funded by the National Institutes of Health and others.).CONCLUSIONSIncreasing age and respiratory symptoms were indicators of infectivity of Nipah virus. Interventions to control person-to-person transmission should aim to reduce exposure to body fluids. (Funded by the National Institutes of Health and others.).
Nipah virus is a highly virulent zoonotic pathogen that can be transmitted between humans. Understanding the dynamics of person-to-person transmission is key to designing effective interventions. We used data from all Nipah virus cases identified during outbreak investigations in Bangladesh from April 2001 through April 2014 to investigate case-patient characteristics associated with onward transmission and factors associated with the risk of infection among patient contacts. Of 248 Nipah virus cases identified, 82 were caused by person-to-person transmission, corresponding to a reproduction number (i.e., the average number of secondary cases per case patient) of 0.33 (95% confidence interval [CI], 0.19 to 0.59). The predicted reproduction number increased with the case patient's age and was highest among patients 45 years of age or older who had difficulty breathing (1.1; 95% CI, 0.4 to 3.2). Case patients who did not have difficulty breathing infected 0.05 times as many contacts (95% CI, 0.01 to 0.3) as other case patients did. Serologic testing of 1863 asymptomatic contacts revealed no infections. Spouses of case patients were more often infected (8 of 56 [14%]) than other close family members (7 of 547 [1.3%]) or other contacts (18 of 1996 [0.9%]). The risk of infection increased with increased duration of exposure of the contacts (adjusted odds ratio for exposure of >48 hours vs. ≤1 hour, 13; 95% CI, 2.6 to 62) and with exposure to body fluids (adjusted odds ratio, 4.3; 95% CI, 1.6 to 11). Increasing age and respiratory symptoms were indicators of infectivity of Nipah virus. Interventions to control person-to-person transmission should aim to reduce exposure to body fluids. (Funded by the National Institutes of Health and others.).
Nipah virus is a highly virulent zoonotic pathogen. In this report from Bangladesh, which included 40% of the world’s known cases, the risk factors for human-to-human transmission were evaluated. No asymptomatic cases were identified. Increased respiratory symptoms in the patient and prolonged close contact from caregivers were associated with secondary transmission.
Author Khan, A.K.M. Dawlat
Kilpatrick, A. Marm
Klena, John D
Daszak, Peter
Ströher, Ute
Afroj, Sayma
Cauchemez, Simon
Pulliam, Juliet R.C
Nichol, Stuart T
Sultana, Sharmin
Luby, Stephen P
Gurley, Emily S
Salje, Henrik
Hossain, M. Jahangir
Nikolay, Birgit
Rahman, Mahmudur
Sazzad, Hossain M.S
Author_xml – sequence: 1
  givenname: Birgit
  surname: Nikolay
  fullname: Nikolay, Birgit
  organization: From the Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, Centre National de la Recherche Scientifique, Paris (B.N., H.S., S.C.); the Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia (M.J.H.); the Infectious Diseases Division, icddr,b, (M.J.H., A.K.M.D.K., H.M.S.S., S.A., E.S.G.), and the Institute of Epidemiology Disease Control and Research (M.R., S.S.) — both in Dhaka, Bangladesh; the Kirby Institute, University of New South Wales, Sydney (H.M.S.S.); the EcoHealth Alliance, New York (P.D.); the Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta (U.S., S.T.N., J.D.K.); the South African DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa (J.R.C.P.); the Department of Ecology and Evolutionary Biology, University of California, Santa Cruz (A.M.K.), and the Infectious Diseases and Geographic Medicine Division, Stanford University, Stanford (S.P.L.) — both in California; Auburn University, Auburn, AL (S.A.); and the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.S.G.)
– sequence: 2
  givenname: Henrik
  surname: Salje
  fullname: Salje, Henrik
  organization: From the Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, Centre National de la Recherche Scientifique, Paris (B.N., H.S., S.C.); the Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia (M.J.H.); the Infectious Diseases Division, icddr,b, (M.J.H., A.K.M.D.K., H.M.S.S., S.A., E.S.G.), and the Institute of Epidemiology Disease Control and Research (M.R., S.S.) — both in Dhaka, Bangladesh; the Kirby Institute, University of New South Wales, Sydney (H.M.S.S.); the EcoHealth Alliance, New York (P.D.); the Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta (U.S., S.T.N., J.D.K.); the South African DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa (J.R.C.P.); the Department of Ecology and Evolutionary Biology, University of California, Santa Cruz (A.M.K.), and the Infectious Diseases and Geographic Medicine Division, Stanford University, Stanford (S.P.L.) — both in California; Auburn University, Auburn, AL (S.A.); and the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.S.G.)
– sequence: 3
  givenname: M. Jahangir
  surname: Hossain
  fullname: Hossain, M. Jahangir
  organization: From the Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, Centre National de la Recherche Scientifique, Paris (B.N., H.S., S.C.); the Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia (M.J.H.); the Infectious Diseases Division, icddr,b, (M.J.H., A.K.M.D.K., H.M.S.S., S.A., E.S.G.), and the Institute of Epidemiology Disease Control and Research (M.R., S.S.) — both in Dhaka, Bangladesh; the Kirby Institute, University of New South Wales, Sydney (H.M.S.S.); the EcoHealth Alliance, New York (P.D.); the Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta (U.S., S.T.N., J.D.K.); the South African DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa (J.R.C.P.); the Department of Ecology and Evolutionary Biology, University of California, Santa Cruz (A.M.K.), and the Infectious Diseases and Geographic Medicine Division, Stanford University, Stanford (S.P.L.) — both in California; Auburn University, Auburn, AL (S.A.); and the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.S.G.)
– sequence: 4
  givenname: A.K.M. Dawlat
  surname: Khan
  fullname: Khan, A.K.M. Dawlat
  organization: From the Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, Centre National de la Recherche Scientifique, Paris (B.N., H.S., S.C.); the Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia (M.J.H.); the Infectious Diseases Division, icddr,b, (M.J.H., A.K.M.D.K., H.M.S.S., S.A., E.S.G.), and the Institute of Epidemiology Disease Control and Research (M.R., S.S.) — both in Dhaka, Bangladesh; the Kirby Institute, University of New South Wales, Sydney (H.M.S.S.); the EcoHealth Alliance, New York (P.D.); the Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta (U.S., S.T.N., J.D.K.); the South African DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa (J.R.C.P.); the Department of Ecology and Evolutionary Biology, University of California, Santa Cruz (A.M.K.), and the Infectious Diseases and Geographic Medicine Division, Stanford University, Stanford (S.P.L.) — both in California; Auburn University, Auburn, AL (S.A.); and the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.S.G.)
– sequence: 5
  givenname: Hossain M.S
  surname: Sazzad
  fullname: Sazzad, Hossain M.S
  organization: From the Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, Centre National de la Recherche Scientifique, Paris (B.N., H.S., S.C.); the Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia (M.J.H.); the Infectious Diseases Division, icddr,b, (M.J.H., A.K.M.D.K., H.M.S.S., S.A., E.S.G.), and the Institute of Epidemiology Disease Control and Research (M.R., S.S.) — both in Dhaka, Bangladesh; the Kirby Institute, University of New South Wales, Sydney (H.M.S.S.); the EcoHealth Alliance, New York (P.D.); the Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta (U.S., S.T.N., J.D.K.); the South African DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa (J.R.C.P.); the Department of Ecology and Evolutionary Biology, University of California, Santa Cruz (A.M.K.), and the Infectious Diseases and Geographic Medicine Division, Stanford University, Stanford (S.P.L.) — both in California; Auburn University, Auburn, AL (S.A.); and the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.S.G.)
– sequence: 6
  givenname: Mahmudur
  surname: Rahman
  fullname: Rahman, Mahmudur
  organization: From the Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, Centre National de la Recherche Scientifique, Paris (B.N., H.S., S.C.); the Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia (M.J.H.); the Infectious Diseases Division, icddr,b, (M.J.H., A.K.M.D.K., H.M.S.S., S.A., E.S.G.), and the Institute of Epidemiology Disease Control and Research (M.R., S.S.) — both in Dhaka, Bangladesh; the Kirby Institute, University of New South Wales, Sydney (H.M.S.S.); the EcoHealth Alliance, New York (P.D.); the Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta (U.S., S.T.N., J.D.K.); the South African DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa (J.R.C.P.); the Department of Ecology and Evolutionary Biology, University of California, Santa Cruz (A.M.K.), and the Infectious Diseases and Geographic Medicine Division, Stanford University, Stanford (S.P.L.) — both in California; Auburn University, Auburn, AL (S.A.); and the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.S.G.)
– sequence: 7
  givenname: Peter
  surname: Daszak
  fullname: Daszak, Peter
  organization: From the Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, Centre National de la Recherche Scientifique, Paris (B.N., H.S., S.C.); the Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia (M.J.H.); the Infectious Diseases Division, icddr,b, (M.J.H., A.K.M.D.K., H.M.S.S., S.A., E.S.G.), and the Institute of Epidemiology Disease Control and Research (M.R., S.S.) — both in Dhaka, Bangladesh; the Kirby Institute, University of New South Wales, Sydney (H.M.S.S.); the EcoHealth Alliance, New York (P.D.); the Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta (U.S., S.T.N., J.D.K.); the South African DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa (J.R.C.P.); the Department of Ecology and Evolutionary Biology, University of California, Santa Cruz (A.M.K.), and the Infectious Diseases and Geographic Medicine Division, Stanford University, Stanford (S.P.L.) — both in California; Auburn University, Auburn, AL (S.A.); and the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.S.G.)
– sequence: 8
  givenname: Ute
  surname: Ströher
  fullname: Ströher, Ute
  organization: From the Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, Centre National de la Recherche Scientifique, Paris (B.N., H.S., S.C.); the Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia (M.J.H.); the Infectious Diseases Division, icddr,b, (M.J.H., A.K.M.D.K., H.M.S.S., S.A., E.S.G.), and the Institute of Epidemiology Disease Control and Research (M.R., S.S.) — both in Dhaka, Bangladesh; the Kirby Institute, University of New South Wales, Sydney (H.M.S.S.); the EcoHealth Alliance, New York (P.D.); the Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta (U.S., S.T.N., J.D.K.); the South African DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa (J.R.C.P.); the Department of Ecology and Evolutionary Biology, University of California, Santa Cruz (A.M.K.), and the Infectious Diseases and Geographic Medicine Division, Stanford University, Stanford (S.P.L.) — both in California; Auburn University, Auburn, AL (S.A.); and the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.S.G.)
– sequence: 9
  givenname: Juliet R.C
  surname: Pulliam
  fullname: Pulliam, Juliet R.C
  organization: From the Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, Centre National de la Recherche Scientifique, Paris (B.N., H.S., S.C.); the Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia (M.J.H.); the Infectious Diseases Division, icddr,b, (M.J.H., A.K.M.D.K., H.M.S.S., S.A., E.S.G.), and the Institute of Epidemiology Disease Control and Research (M.R., S.S.) — both in Dhaka, Bangladesh; the Kirby Institute, University of New South Wales, Sydney (H.M.S.S.); the EcoHealth Alliance, New York (P.D.); the Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta (U.S., S.T.N., J.D.K.); the South African DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa (J.R.C.P.); the Department of Ecology and Evolutionary Biology, University of California, Santa Cruz (A.M.K.), and the Infectious Diseases and Geographic Medicine Division, Stanford University, Stanford (S.P.L.) — both in California; Auburn University, Auburn, AL (S.A.); and the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.S.G.)
– sequence: 10
  givenname: A. Marm
  surname: Kilpatrick
  fullname: Kilpatrick, A. Marm
  organization: From the Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, Centre National de la Recherche Scientifique, Paris (B.N., H.S., S.C.); the Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia (M.J.H.); the Infectious Diseases Division, icddr,b, (M.J.H., A.K.M.D.K., H.M.S.S., S.A., E.S.G.), and the Institute of Epidemiology Disease Control and Research (M.R., S.S.) — both in Dhaka, Bangladesh; the Kirby Institute, University of New South Wales, Sydney (H.M.S.S.); the EcoHealth Alliance, New York (P.D.); the Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta (U.S., S.T.N., J.D.K.); the South African DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa (J.R.C.P.); the Department of Ecology and Evolutionary Biology, University of California, Santa Cruz (A.M.K.), and the Infectious Diseases and Geographic Medicine Division, Stanford University, Stanford (S.P.L.) — both in California; Auburn University, Auburn, AL (S.A.); and the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.S.G.)
– sequence: 11
  givenname: Stuart T
  surname: Nichol
  fullname: Nichol, Stuart T
  organization: From the Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, Centre National de la Recherche Scientifique, Paris (B.N., H.S., S.C.); the Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia (M.J.H.); the Infectious Diseases Division, icddr,b, (M.J.H., A.K.M.D.K., H.M.S.S., S.A., E.S.G.), and the Institute of Epidemiology Disease Control and Research (M.R., S.S.) — both in Dhaka, Bangladesh; the Kirby Institute, University of New South Wales, Sydney (H.M.S.S.); the EcoHealth Alliance, New York (P.D.); the Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta (U.S., S.T.N., J.D.K.); the South African DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa (J.R.C.P.); the Department of Ecology and Evolutionary Biology, University of California, Santa Cruz (A.M.K.), and the Infectious Diseases and Geographic Medicine Division, Stanford University, Stanford (S.P.L.) — both in California; Auburn University, Auburn, AL (S.A.); and the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.S.G.)
– sequence: 12
  givenname: John D
  surname: Klena
  fullname: Klena, John D
  organization: From the Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, Centre National de la Recherche Scientifique, Paris (B.N., H.S., S.C.); the Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia (M.J.H.); the Infectious Diseases Division, icddr,b, (M.J.H., A.K.M.D.K., H.M.S.S., S.A., E.S.G.), and the Institute of Epidemiology Disease Control and Research (M.R., S.S.) — both in Dhaka, Bangladesh; the Kirby Institute, University of New South Wales, Sydney (H.M.S.S.); the EcoHealth Alliance, New York (P.D.); the Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta (U.S., S.T.N., J.D.K.); the South African DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa (J.R.C.P.); the Department of Ecology and Evolutionary Biology, University of California, Santa Cruz (A.M.K.), and the Infectious Diseases and Geographic Medicine Division, Stanford University, Stanford (S.P.L.) — both in California; Auburn University, Auburn, AL (S.A.); and the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.S.G.)
– sequence: 13
  givenname: Sharmin
  surname: Sultana
  fullname: Sultana, Sharmin
  organization: From the Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, Centre National de la Recherche Scientifique, Paris (B.N., H.S., S.C.); the Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia (M.J.H.); the Infectious Diseases Division, icddr,b, (M.J.H., A.K.M.D.K., H.M.S.S., S.A., E.S.G.), and the Institute of Epidemiology Disease Control and Research (M.R., S.S.) — both in Dhaka, Bangladesh; the Kirby Institute, University of New South Wales, Sydney (H.M.S.S.); the EcoHealth Alliance, New York (P.D.); the Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta (U.S., S.T.N., J.D.K.); the South African DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa (J.R.C.P.); the Department of Ecology and Evolutionary Biology, University of California, Santa Cruz (A.M.K.), and the Infectious Diseases and Geographic Medicine Division, Stanford University, Stanford (S.P.L.) — both in California; Auburn University, Auburn, AL (S.A.); and the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.S.G.)
– sequence: 14
  givenname: Sayma
  surname: Afroj
  fullname: Afroj, Sayma
  organization: From the Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, Centre National de la Recherche Scientifique, Paris (B.N., H.S., S.C.); the Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia (M.J.H.); the Infectious Diseases Division, icddr,b, (M.J.H., A.K.M.D.K., H.M.S.S., S.A., E.S.G.), and the Institute of Epidemiology Disease Control and Research (M.R., S.S.) — both in Dhaka, Bangladesh; the Kirby Institute, University of New South Wales, Sydney (H.M.S.S.); the EcoHealth Alliance, New York (P.D.); the Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta (U.S., S.T.N., J.D.K.); the South African DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa (J.R.C.P.); the Department of Ecology and Evolutionary Biology, University of California, Santa Cruz (A.M.K.), and the Infectious Diseases and Geographic Medicine Division, Stanford University, Stanford (S.P.L.) — both in California; Auburn University, Auburn, AL (S.A.); and the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.S.G.)
– sequence: 15
  givenname: Stephen P
  surname: Luby
  fullname: Luby, Stephen P
  organization: From the Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, Centre National de la Recherche Scientifique, Paris (B.N., H.S., S.C.); the Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia (M.J.H.); the Infectious Diseases Division, icddr,b, (M.J.H., A.K.M.D.K., H.M.S.S., S.A., E.S.G.), and the Institute of Epidemiology Disease Control and Research (M.R., S.S.) — both in Dhaka, Bangladesh; the Kirby Institute, University of New South Wales, Sydney (H.M.S.S.); the EcoHealth Alliance, New York (P.D.); the Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta (U.S., S.T.N., J.D.K.); the South African DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa (J.R.C.P.); the Department of Ecology and Evolutionary Biology, University of California, Santa Cruz (A.M.K.), and the Infectious Diseases and Geographic Medicine Division, Stanford University, Stanford (S.P.L.) — both in California; Auburn University, Auburn, AL (S.A.); and the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.S.G.)
– sequence: 16
  givenname: Simon
  surname: Cauchemez
  fullname: Cauchemez, Simon
  organization: From the Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, Centre National de la Recherche Scientifique, Paris (B.N., H.S., S.C.); the Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia (M.J.H.); the Infectious Diseases Division, icddr,b, (M.J.H., A.K.M.D.K., H.M.S.S., S.A., E.S.G.), and the Institute of Epidemiology Disease Control and Research (M.R., S.S.) — both in Dhaka, Bangladesh; the Kirby Institute, University of New South Wales, Sydney (H.M.S.S.); the EcoHealth Alliance, New York (P.D.); the Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta (U.S., S.T.N., J.D.K.); the South African DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa (J.R.C.P.); the Department of Ecology and Evolutionary Biology, University of California, Santa Cruz (A.M.K.), and the Infectious Diseases and Geographic Medicine Division, Stanford University, Stanford (S.P.L.) — both in California; Auburn University, Auburn, AL (S.A.); and the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.S.G.)
– sequence: 17
  givenname: Emily S
  surname: Gurley
  fullname: Gurley, Emily S
  organization: From the Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, Centre National de la Recherche Scientifique, Paris (B.N., H.S., S.C.); the Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia (M.J.H.); the Infectious Diseases Division, icddr,b, (M.J.H., A.K.M.D.K., H.M.S.S., S.A., E.S.G.), and the Institute of Epidemiology Disease Control and Research (M.R., S.S.) — both in Dhaka, Bangladesh; the Kirby Institute, University of New South Wales, Sydney (H.M.S.S.); the EcoHealth Alliance, New York (P.D.); the Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta (U.S., S.T.N., J.D.K.); the South African DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa (J.R.C.P.); the Department of Ecology and Evolutionary Biology, University of California, Santa Cruz (A.M.K.), and the Infectious Diseases and Geographic Medicine Division, Stanford University, Stanford (S.P.L.) — both in California; Auburn University, Auburn, AL (S.A.); and the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.S.G.)
BackLink https://www.ncbi.nlm.nih.gov/pubmed/31067370$$D View this record in MEDLINE/PubMed
https://pasteur.hal.science/pasteur-03326039$$DView record in HAL
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Snippet Nipah virus is a highly virulent zoonotic pathogen. In this report from Bangladesh, which included 40% of the world’s known cases, the risk factors for...
Nipah virus is a highly virulent zoonotic pathogen that can be transmitted between humans. Understanding the dynamics of person-to-person transmission is key...
BackgroundNipah virus is a highly virulent zoonotic pathogen that can be transmitted between humans. Understanding the dynamics of person-to-person...
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SourceType Open Access Repository
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StartPage 1804
SubjectTerms Adolescent
Adult
Age Factors
Animals
Bangladesh
Bangladesh - epidemiology
Binomial distribution
Body Fluids
Body Fluids - virology
Child
Contact Tracing
Disease transmission
Disease Transmission, Infectious
Disease Transmission, Infectious - prevention & control
Epidemics
Fatalities
Female
Health surveillance
Henipavirus Infections
Henipavirus Infections - epidemiology
Henipavirus Infections - prevention & control
Henipavirus Infections - transmission
Hospitals
Humans
Hypotheses
Illnesses
Infections
Infectious diseases
Infectivity
Life Sciences
Male
Mathematics
Medical laboratories
Middle Aged
Nipah Virus
Outbreaks
Patients
Public health
Respiration
Risk Factors
Statistics
Young Adult
Zoonoses
Zoonoses - transmission
Title Transmission of Nipah Virus — 14 Years of Investigations in Bangladesh
URI https://nejm.org/doi/full/10.1056/NEJMoa1805376
https://www.ncbi.nlm.nih.gov/pubmed/31067370
https://www.proquest.com/docview/2221966948
https://www.proquest.com/docview/2231896261
https://pasteur.hal.science/pasteur-03326039
https://pubmed.ncbi.nlm.nih.gov/PMC6547369
Volume 380
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