Nipah virus infection outbreak with nosocomial and corpse-to-human transmission, Bangladesh

• Published in: Emerging infectious diseases Vol. 19; no. 2; pp. 210 - 217
• Main Authors: Sazzad, Hossain M S, Hossain, M Jahangir, Gurley, Emily S, Ameen, Kazi M H, Parveen, Shahana, Islam, M Saiful, Faruque, Labib I, Podder, Goutam, Banu, Sultana S, Lo, Michael K, Rollin, Pierre E, Rota, Paul A, Daszak, Peter, Rahman, Mahmudur, Luby, Stephen P
• Format: Journal Article
• Language: English
• Published: United States U.S. National Center for Infectious Diseases 01.02.2013; Centers for Disease Control and Prevention
• Subjects: Adolescent; Adult; Arecaceae; Bangladesh - epidemiology; Beverages; Burial; Cadaver; Case-Control Studies; Child; Child, Preschool; Cross Infection - mortality; Cross Infection - transmission; Cross Infection - virology; Disease Outbreaks; Disease transmission; Distribution; encephalitis; Encephalitis, Viral - mortality; Encephalitis, Viral - transmission; Encephalitis, Viral - virology; Epidemiological Monitoring; Female; Genetic aspects; Health aspects; Henipavirus Infections - mortality; Henipavirus Infections - transmission; Henipavirus Infections - virology; Humans; Identification and classification; Infectious Disease Transmission, Patient-to-Professional; Male; Middle Aged; Nipah; Nipah Virus; NiV; nosocomial; outbreak; Physicians; Risk Factors; Young Adult; Bangladesh
• ISSN: 1080-6040; 1080-6059
• DOI: 10.3201/eid1902.120971

Active Nipah virus encephalitis surveillance identified an encephalitis cluster and sporadic cases in Faridpur, Bangladesh, in January 2010. We identified 16 case-patients; 14 of these patients died. For 1 case-patient, the only known exposure was hugging a deceased patient with a probable case, while another case-patient's exposure involved preparing the same corpse for burial by removing oral secretions and anogenital excreta with a cloth and bare hands. Among 7 persons with confirmed sporadic cases, 6 died, including a physician who had physically examined encephalitis patients without gloves or a mask. Nipah virus-infected patients were more likely than community-based controls to report drinking raw date palm sap and to have had physical contact with an encephalitis patient (29% vs. 4%, matched odds ratio undefined). Efforts to prevent transmission should focus on reducing caregivers' exposure to infected patients' bodily secretions during care and traditional burial practices.