Nipah virus infection
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IdentityTop of page
Preferred Scientific Name
- Nipah virus infection
International Common Names
- English: nipah virus in pigs- exotic
OverviewTop of page
Between late 1998 and 1999, the spread of a new disease of pigs was recorded in pig farms in peninsular Malaysia. It was characterized by a pronounced respiratory and neurological syndrome, sometimes accompanied by the sudden death of sows and boars. The disease appeared to have a close association with an epidemic of viral encephalitis among workers on pig farms. The outbreak was first noted in late September 1998 and by mid-June 1999, more than 265 encephalitis cases, including 105 deaths, had been reported in Malaysia and 11 cases of encephalitis or respiratory illness with one death had been reported in Singapore. A previously unrecognized paramyxovirus was later identified from this outbreak; this virus was related to, but distinct from, the Hendra virus discovered in Australia in 1994. [Hendra virus affected 21 horses and two humans in Brisbane, Australia with 14 horses and one human dying as a result (Hooper et al., 2000).] On a previously infected farm, 95% of the pigs had Nipah virus antibodies. Antibodies have also been found in horses, dogs, cats and fruit bats, but not in rodents. The control measures currently in force include screening and slaughter of infected pigs. The new virus was named Nipah and was confirmed by molecular characterization to be the agent responsible for the disease in both humans and pigs.
It is thought that the disease may have originated from fruit bats, and antibodies to the virus have been found in Pteropus vampyrus, Pteropus hypomenalus, and occasionally in Eoncteris spelaea and Cynopterus brachuotis (Yob et al., 2001). The most likely route of dissemination is from fruit bats to pigs and from pigs to humans, horses, cats and dogs (Hooper et al., 2000).
Hosts/Species AffectedTop of page
The disease has been found in pigs and man in Malaysia. Antibodies to the virus have also been found in fruit bats, horses, cats, and dogs.
DistributionTop of page
The disease has occurred in pigs and man in peninsular Malaysia (Mohd Nor et al., 2000), and in man in Singapore (Chew et al., 2000). Surveys in Australia have not found the virus or evidence of the virus (Black et al., 2001).
Distribution TableTop of page
The distribution in this summary table is based on all the information available. When several references are cited, they may give conflicting information on the status. Further details may be available for individual references in the Distribution Table Details section which can be selected by going to Generate Report.
|Continent/Country/Region||Distribution||Last Reported||Origin||First Reported||Invasive||Reference||Notes|
|Afghanistan||No information available||OIE, 2009|
|Armenia||No information available||OIE, 2009|
|Azerbaijan||Disease never reported||OIE, 2009|
|Bahrain||Disease never reported||OIE, 2009|
|Bangladesh||Disease not reported||OIE, 2009|
|Bhutan||Disease never reported||OIE, 2009|
|Cambodia||No information available||OIE, 2009|
|China||Disease never reported||OIE, 2009|
|-Hong Kong||No information available||OIE, 2009|
|India||No information available||OIE, 2009|
|Indonesia||No information available||OIE, 2009|
|Iran||Disease never reported||OIE, 2009|
|Iraq||Disease never reported||OIE, 2009|
|Israel||Disease never reported||OIE, 2009|
|Japan||Disease never reported||OIE, 2009|
|Jordan||No information available||OIE, 2009|
|Kazakhstan||No information available||OIE, 2009|
|Korea, Republic of||Disease never reported||OIE, 2009|
|Kuwait||Disease never reported||OIE, 2009|
|Kyrgyzstan||No information available||OIE, 2009|
|Laos||Disease not reported||OIE, 2009|
|Lebanon||Disease never reported||OIE, 2009|
|Malaysia||Disease not reported||OIE, 2009|
|-Peninsular Malaysia||Present||Mohd et al., 2000; Sahani et al., 2001|
|Mongolia||No information available||OIE, 2009|
|Myanmar||Disease never reported||OIE, 2009|
|Nepal||Disease never reported||OIE, 2009|
|Oman||Disease never reported||OIE, 2009|
|Pakistan||No information available||OIE, 2009|
|Philippines||Disease never reported||OIE, 2009|
|Qatar||No information available||OIE, 2009|
|Saudi Arabia||Disease never reported||OIE, 2009|
|Singapore||Disease never reported||NULL||Chew et al., 2000; OIE, 2009|
|Sri Lanka||Disease never reported||OIE, 2009|
|Syria||Disease not reported||OIE, 2009|
|Tajikistan||Disease not reported||OIE, 2009|
|Thailand||Disease never reported||OIE, 2009|
|Turkey||No information available||OIE, 2009|
|United Arab Emirates||No information available||OIE, 2009|
|Vietnam||No information available||OIE, 2009|
|Yemen||No information available||OIE, 2009|
|Algeria||No information available||OIE, 2009|
|Angola||Disease never reported||OIE, 2009|
|Benin||No information available||OIE, 2009|
|Botswana||Disease never reported||OIE, 2009|
|Burkina Faso||No information available||OIE, 2009|
|Chad||No information available||OIE, 2009|
|Congo||No information available||OIE, 2009|
|Djibouti||Disease never reported||OIE, 2009|
|Egypt||No information available||OIE, 2009|
|Eritrea||No information available||OIE, 2009|
|Ethiopia||No information available||OIE, 2009|
|Gabon||No information available||OIE, 2009|
|Gambia||No information available||OIE, 2009|
|Ghana||No information available||OIE, 2009|
|Guinea||No information available||OIE, 2009|
|Guinea-Bissau||No information available||OIE, 2009|
|Kenya||No information available||OIE, 2009|
|Lesotho||Disease never reported||OIE, 2009|
|Madagascar||Disease never reported||OIE, 2009|
|Malawi||No information available||OIE, 2009|
|Mali||No information available||OIE, 2009|
|Mauritius||Disease never reported||OIE, 2009|
|Morocco||No information available||OIE, 2009|
|Mozambique||No information available||OIE, 2009|
|Namibia||No information available||OIE, 2009|
|Nigeria||Disease never reported||OIE, 2009|
|Rwanda||No information available||OIE, 2009|
|Senegal||No information available||OIE, 2009|
|South Africa||No information available||OIE, 2009|
|Sudan||Disease never reported||OIE, 2009|
|Swaziland||No information available||OIE, 2009|
|Tanzania||No information available||OIE, 2009|
|Togo||No information available||OIE, 2009|
|Tunisia||Disease never reported||OIE, 2009|
|Uganda||Disease never reported||OIE, 2009|
|Zambia||No information available||OIE, 2009|
|Zimbabwe||Disease never reported||OIE, 2009|
|Canada||Disease never reported||OIE, 2009|
|Greenland||Disease never reported||OIE, 2009|
|Mexico||Disease never reported||OIE, 2009|
|USA||Disease never reported||OIE, 2009|
Central America and Caribbean
|Belize||Disease never reported||OIE, 2009|
|Costa Rica||Disease never reported||OIE, 2009|
|Cuba||Disease never reported||OIE, 2009|
|Dominican Republic||Disease never reported||OIE, 2009|
|El Salvador||Disease never reported||OIE, 2009|
|Guadeloupe||No information available||OIE, 2009|
|Guatemala||Disease never reported||OIE, 2009|
|Haiti||Disease never reported||OIE, 2009|
|Honduras||Disease never reported||OIE, 2009|
|Jamaica||No information available||OIE, 2009|
|Martinique||Disease never reported||OIE, 2009|
|Nicaragua||Disease never reported||OIE, 2009|
|Panama||Disease never reported||OIE, 2009|
|Argentina||Disease never reported||OIE, 2009|
|Bolivia||Disease never reported||OIE, 2009|
|Brazil||Disease never reported||OIE, 2009|
|Chile||Disease never reported||OIE, 2009|
|Colombia||Disease never reported||OIE, 2009|
|Ecuador||Disease never reported||OIE, 2009|
|French Guiana||No information available||OIE, 2009|
|Peru||Disease never reported||OIE, 2009|
|Uruguay||Disease never reported||OIE, 2009|
|Venezuela||Disease never reported||OIE, 2009|
|Albania||Disease never reported||OIE, 2009|
|Austria||No information available||OIE, 2009|
|Belarus||No information available||OIE, 2009|
|Belgium||Disease not reported||OIE, 2009|
|Bulgaria||Disease never reported||OIE, 2009|
|Croatia||Disease never reported||OIE, 2009|
|Cyprus||Disease never reported||OIE, 2009|
|Czech Republic||Disease never reported||OIE, 2009|
|Denmark||Disease never reported||OIE, 2009|
|Estonia||No information available||OIE, 2009|
|Finland||Disease never reported||OIE, 2009|
|France||Disease never reported||OIE, 2009|
|Germany||Disease never reported||OIE, 2009|
|Greece||Disease not reported||OIE, 2009|
|Hungary||Disease never reported||OIE, 2009|
|Iceland||Disease never reported||OIE, 2009|
|Ireland||Disease never reported||OIE, 2009|
|Italy||No information available||OIE, 2009|
|Latvia||Disease never reported||OIE, 2009|
|Liechtenstein||Disease not reported||OIE, 2009|
|Lithuania||Disease never reported||OIE, 2009|
|Luxembourg||Disease never reported||OIE, 2009|
|Macedonia||Disease never reported||OIE, 2009|
|Malta||Disease never reported||OIE, 2009|
|Montenegro||Disease never reported||OIE, 2009|
|Netherlands||Disease never reported||OIE, 2009|
|Norway||Disease never reported||OIE, 2009|
|Poland||No information available||OIE, 2009|
|Portugal||Disease never reported||OIE, 2009|
|Romania||No information available||OIE, 2009|
|Russian Federation||No information available||OIE, 2009|
|Serbia||Disease never reported||OIE, 2009|
|Slovakia||Disease never reported||OIE, 2009|
|Slovenia||Disease never reported||OIE, 2009|
|Spain||Disease never reported||OIE, 2009|
|Sweden||Disease never reported||OIE, 2009|
|Switzerland||Disease never reported||OIE, 2009|
|UK||Disease not reported||OIE, 2009|
|Ukraine||Disease never reported||OIE, 2009|
|Australia||Disease never reported||OIE, 2009|
|French Polynesia||Disease never reported||OIE, 2009|
|New Caledonia||Disease never reported||OIE, 2009|
|New Zealand||Disease never reported||OIE, 2009|
PathologyTop of page
The major pathological signs were bronchopneumonia with syncytium formation in the respiratory alveoli. Some pigs also showed meningitis. There was evidence of some generalized vascular involvement in pigs (as occurs in the human disease): localization of the virus in pigs tended to be in respiratory epithelium rather than in neurons (Hooper, 2001). Nipah virus in pigs was also epitheliotropic in respiratory epithelium and thus contagious (Hooper, 2001).
DiagnosisTop of page
Rapid immune plaque assays have been developed to quantify Nipah virus and detect neutralizing antibodies to the virus. A modification of the rapid immune plaque assay was used (Crameri et al., 2002) to detect antibodies to Nipah virus in a panel of porcine field sera from Malaysia and the results showed good agreement between the immune plaque assay and a traditional serum neutralization test. After methanol fixation, plates can be stored for up to 7 months and may be used in the immune plaque assay to complement the ELISA screening of sera for antibodies to Nipah virus. At present, all ELISA-positive sera are subject to confirmatory serum neutralization tests. Use of the immune plaque assay may reduce the number of sera requiring confirmatory neutralization testing for Nipah virus antibodies under biohazard level 4 conditions by identifying those that generate false positive in the ELISA. Daniels et al. (2001) reviewed the diagnosis of Nipah.
List of Symptoms/SignsTop of page
|Digestive Signs / Anorexia, loss or decreased appetite, not nursing, off feed||Sign|
|Digestive Signs / Dysphagia, difficulty swallowing||Sign|
|Digestive Signs / Excessive salivation, frothing at the mouth, ptyalism||Sign|
|Digestive Signs / Tongue protrusion||Sign|
|Digestive Signs / Tongue weakness, paresis, paralysis||Sign|
|General Signs / Ataxia, incoordination, staggering, falling||Sign|
|General Signs / Dysmetria, hypermetria, hypometria||Sign|
|General Signs / Fever, pyrexia, hyperthermia||Pigs:All Stages||Sign|
|General Signs / Inability to stand, downer, prostration||Sign|
|General Signs / Paraparesis, weakness, paralysis both hind limbs||Sign|
|General Signs / Sudden death, found dead||Sign|
|General Signs / Trembling, shivering, fasciculations, chilling||Sign|
|Nervous Signs / Dullness, depression, lethargy, depressed, lethargic, listless||Sign|
|Nervous Signs / Excitement, delirium, mania||Sign|
|Nervous Signs / Head pressing||Sign|
|Nervous Signs / Hyperesthesia, irritable, hyperactive||Sign|
|Nervous Signs / Seizures or syncope, convulsions, fits, collapse||Sign|
|Nervous Signs / Tetany||Sign|
|Nervous Signs / Tremor||Sign|
|Reproductive Signs / Abortion or weak newborns, stillbirth||Sign|
|Respiratory Signs / Coughing, coughs||Sign|
|Respiratory Signs / Dyspnea, difficult, open mouth breathing, grunt, gasping||Sign|
|Respiratory Signs / Epistaxis, nosebleed, nasal haemorrhage, bleeding||Sign|
|Respiratory Signs / Increased respiratory rate, polypnea, tachypnea, hyperpnea||Sign|
|Respiratory Signs / Sneezing, sneeze||Pigs:All Stages||Diagnosis|
Disease CourseTop of page
The main clinical sign in pigs is respiratory disease with severe cough. Some cases show nervous signs resulting in death. As with Hendra virus, Nipah virus induced syncytial cells in vascular tissues and they were primarily vasotropic and/or neurotropic, generating interstitial pneumonia or encephalitis. Nipah virus in pigs was also epitheliotropic in respiratory epithelium and thus contagious (Hooper, 2001).
EpidemiologyTop of page
The most likely spread of the virus is from fruit bats to pigs and from pigs to man, horses and cats and dogs. In transmission trials, 5- to 6-week-old pigs were challenged with 50,000 TCID50 of the virus isolated from human patients. Those pigs infected via the oral route did not develop disease while those infected via the subcutaneous route developed respiratory and nervous signs (Hooper, 2001).
Impact: EconomicTop of page
In a study of the economic impact of three exotic diseases on the pig industry of Australia (classical swine fever, Nipah virus and porcine reproductive and respiratory syndrome), scenarios involving either an epidemic event (in which the outbreaks were confined to selected regions and were eradicated) or an endemic situation (in which the diseases became established in Australia) were examined. Based only on loss of sales and disposal costs, epidemics resulted in regional losses in income of the order of AUS$10-30 million (16-37%), depending on disease and region. If any of these diseases became established, opportunity losses in gross national pig income of 5-11% per year would occur, with classical swine fever the most serious of the three diseases. Establishment of any of the diseases would lead to rapid structural change in the pig industry, with concomitant social and economic dislocation in regional Australia (Garner et al., 2001). The economic importance of surveillance of the virus in Indonesia has also recently been studied (Arjosos et al., 2001).
Zoonoses and Food SafetyTop of page
In humans, infection with the virus can cause encephalitis, fever, headaches, altered levels of consciousness, and pneumonia. Infection is confined mainly to abattoir workers and pig farmers. There is no evidence of human-to-human transmission. In a study of 94 patients, 52 (55%) had a reduced level of consciousness and prominent brain-stem dysfunction. Distinctive clinical signs included segmental myoclonus, areflexia and hypotonia, hypertension and tachycardia, and thus suggest the involvement of the brain stem and the upper cervical spinal cord. The initial cerebrospinal fluid findings were abnormal in 75% of patients. Antibodies against Hendra virus were detected in serum or cerebrospinal fluid in 76% of 83 patients tested. Thirty patients (32%) died after rapid deterioration in their condition. An abnormal doll's-eye reflex and tachycardia were factors associated with a poor prognosis. Death was probably due to severe brain-stem involvement. Neurologic relapse occurred after initially mild disease in three patients. Fifty patients (53%) recovered fully, and 14 (15%) had persistent neurologic deficits (Goh et al., 2000).
Disease TreatmentTop of page
In humans the drug ribavirin was used on infected patients with some success (Chong et al., 2001). 140 patients were studied, including 54 patients who were managed before the availability of ribavirin or refused treatment as control. There were 45 deaths (32%) in the ribavirin group; 29 deaths (54%) occurred in the controls. This represents a 36% reduction in mortality (p = 0.011). There was no associated serious side effect. No treatment has been identified for pigs: because of the threat to human health, infected animals are slaughtered.
Prevention and ControlTop of page
At present the control measures used for Nipah virus are serological diagnosis followed by slaughter of infected herds.
ReferencesTop of page
Arjoso S, Wuryadi S, Windyaningsih C, Winoto IL, Heriyanto A, Ksiazek TG, Campbell JR, Burans JP, Corwin AL, 2001. The economic imperative of Nipah virus surveillance in Indonesia. Transactions of the Royal Society of Tropical Medicine and Hygiene, 95(4):368-369.
Black PF, Cronin JP, Morrissy CJ, Westbury HA, 2001. Serological examination for evidence of infection with Hendra and Nipah viruses in Queensland piggeries. Australian Veterinary Journal, 79(6):424-426; 12 ref.
Chan YP, Chua KB, Koh CL, Lim ME, Lam SK, 2001. Complete nucleotide sequences of Nipah virus isolates from Malaysia. Journal of General Virology, 82(9):2151-2155.
Chew MH, Arguin PM, Shay DK, Goh KT, Rollin PE, Shieh WJ, Zaki SR, Rota PA, Ling AE, Ksiazek TG, Chew SK, Anderson LJ, 2000. Risk factors for Nipah virus infection among abattoir workers in Singapore. Journal of Infectious Diseases, 181(5):1760-1763.
Chong HT, Kamarulzaman A, Tan CT, Goh KJ, Thayaparan T, Kunjapan SR, Chew NK, Chua KB, Lam SK, 2001. Treatment of acute Nipah encephalitis with ribavirin. Annals of Neurology, 49(6):810-813.
Chua KB, Bellini WJ, Rota PA, Harcourt BH, Tamin A, Lam SK, Ksiazek TG, Rollin PE, Zaki SR, Shieh W, Goldsmith CS, Gubler DJ, Roehrig JT, Eaton B, Gould AR, Olson J, Field H, Daniels P, Ling AE, Peters CJ, Anderson LJ, Mahy BW, 2000. Nipah virus: a recently emergent deadly paramyxovirus. Science, 26;288(5470):1432-1435.
Crameri G, Wang LinFa, Morrissy C, White J, Eaton BT, 2002. A rapid immune plaque assay for the detection of Hendra and Nipah viruses and anti-virus antibodies. Journal of Virological Methods, 99(1/2):41-51.
Daniels P, Ksiazek, T, Eaton, BT, 2001. Laboratory diagnosis of Nipah and Hendra virus infections. Microbes and Infection, 3(4):289-95.
Garner MG, Whan IF, Gard GP, Phillips D, 2001. The expected economic impact of selected exotic diseases on the pig industry of Australia. Revue Scientifique et Technique (OIE), 20(3):671-685.
Goh KJ, Tan CT, Chew NK, Tan PS, Kamarulzaman A, Sarji SA, Wong KT, Abdullah BJ, Chua KB, Lam SK, 2000. Clinical features of Nipah virus encephalitis among pig farmers in Malaysia. New England Journal of Medicine, 27;342(17):1280-1281.
Harcourt BH, Tamin A, Halpin K, Ksiazek TG, Rollin PE, Bellini WJ, Rota PA, 2001. Molecular characterization of the polymerase gene and genomic termini of Nipah virus. Virology, 15;287(1):192-201.
Hooper PT, 2001. New fruit bat viruses affecting horses, pigs, and humans. In: Brown C, Bolin C, eds. Emerging diseases of animals. Washington DC, USA: ASM Press. ISBN 1-55581-201-5.
Hooper PT, Gould AR, Hyatt AD, Braun MA, Kattenbelt JA, Hengstberger SG, Westbury HA, 2000. Identification and molecular characterization of Hendra virus in a horse in Queensland. Australian Veterinary Journal, 78(4):281-282.
Hooper PT, Williamson MM, 2000. Hendra and Nipah virus infections. Veterinary Clinics of North America, Equine Practice. 16(3):597-603.
Mohd Nor MN, Gan CH, Ong BL, 2000. Nipah virus infection of pigs in peninsular Malaysia. Revue Scientifique et Technique - Office International des Epizooties (Special issue: An update on zoonoses [coordinated by Pastoret, P. P.]) 19(1):160-165.
OIE, 2009. World Animal Health Information Database - Version: 1.4. World Animal Health Information Database. Paris, France: World Organisation for Animal Health. http://www.oie.int
Sahani M, Parashar UD, Ali R, Das P, Lye MS, Isa MM, Arif MT, Ksiazek TG, Sivamoorthy M, 2001. Nipah virus infection among abattoir workers in Malaysia, 1998-1999. International Journal of Epidemiology, 30(5):1017-1020.
Yob JM, Field H, Rashdi AM, Morrissy C, van der Heide B, Rota P, bin Adzhar A, White J, Daniels P, Jamaluddin A, Ksiazek T, 2001. Nipah virus infection in bats (order Chiroptera) in peninsular Malaysia. Emerging Infectious Diseases, 7(3):439-441.
Distribution MapsTop of page
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