The Health Ministry advisory on Nipah virus

The Health Ministry has released an advisory on Nipah virus for the general public as well as healthcare workers. Although the govt. has said that “the Nipah virus disease is not a major outbreak and is only a local occurrence”, yet fears abound in the general public. Stories of suspected cases of Nipah are being reported from other states – Himachal Pradesh and Karnataka. Yesterday, I had mentioned about social ostracism of healthcare workers caring for the affected persons. So, this health advisory is very opportune.

Here are salient points from the advisory, which includes general information about the disease and preventive measures.

General information

• Nipah virus, which commonly affects animals such as bats, pigs, dogs, horses, etc. can spread from animals to humans and can sometimes cause serious illness among humans.
• Spread of Nipah virus to humans may occur after close contact with other Nipah infected people, infected bats, or infected pigs.
• Bat secretions laden with virus can infect people during fruit tree climbing, eating/handling contaminated fallen fruits or consuming raw date palm sap/juice or toddy, the advisory mentioned.
• Human-to-human infection can occur from close contact with persons affected with Nipah at home while providing care or close contact and in hospital setting if appropriate personal protective equipments are not used.

For the general public

• The general public should avoid consuming raw date palm sap or toddy, half-eaten fruits from the ground and refrain from entering into abandoned wells and eat only washed fruits.
• Bodies of those who died due to the disease should be handled in accordance with the government advisory. During this emotional moment, traditional rituals and practices may need to be modified to prevent the exposure of family members to the disease.
• People who are exposed to areas inhabited by fruit bats/ articles contaminated by secretions such as unused wells, fruit orchards, etc. are likely to be at higher risk of infections. 
• Persons with direct contact with sick pigs or their contaminated tissues, persons in close contact with a Nipah virus affected deceased during burial or cremation rituals or health care workers having direct contact with probable or confirmed cases without using standard precautionary measures are also at a high risk of developing the infection.

For healthcare personnel

• Healthcare personnel should wash hands thoroughly with soap and water for 20 seconds after contact with a sick patient, practice precautions for infection control while handling Nipah cases (suspected/ confirmed), limiting use of injections and sharp objects. 
• For aerosol generating procedures, personal protective equipment (PPE) such as individual gowns (impermeable), gloves, masks and goggles or face shields and shoe cover and the procedure should be performed in airborne isolation room.
• All non-dedicated, non-disposable medical equipment used for patient care should be cleaned and disinfected as per manufacturers' instructions and hospital policies.
• If the use of sharp objects cannot be avoided, ensure that precautions are observed like never replace the cap on a used needle, never direct the point of a used needle towards any part of the body, do not remove used needles from disposable syringes by hand, and do not bend, break or otherwise manipulate used needles by hand, never re-use syringes or needles, dispose of syringes, needles, scalpel blades and other sharp objects in appropriate, puncture-resistant containers. 
• Ensure that containers for sharps objects are placed as close as possible to the immediate area where the objects are being used (point of use') to limit the distance between use and disposal, and ensure the containers remain upright at all times.

(Source: PTI, May 24, 2018)

Dr KK Aggarwal

Padma Shri Awardee
Vice President CMAAO
Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Immediate Past National President IMA