00:00The Nipah scare in India has once again turned the spotlight on one of the world's deadliest viral infections.
00:07Rare, unpredictable and often severe, Nipah is a virus that commands attention every time a case emerges.
00:15With no approved vaccines and no specific antiviral treatment, even a handful of infections is enough to trigger concern.
00:24So over the next half an hour or so, we break down everything you need to know.
00:29What exactly is Nipah? How it spreads? How dangerous can it be?
00:34And why, health authorities are saying, there is no reason to panic just yet.
00:40Let's begin in West Bengal, where the young nurse has died now following the complications after the Nipah infection.
00:48The 25-year-old was amongst the two nursing staff who had tested positive earlier this year and were later
00:54declared recovered.
00:55But her health never fully stabilized.
00:59She remained critical, also required ventilation support and eventually suffered a cardiac arrest.
01:05Officials say the death cannot be attributed solely to the Nipah virus.
01:10However, they do acknowledge the infection significantly worsened her conditions and triggered a chain of complications here.
01:16But what exactly is Nipah? Let's dive into that now.
01:22It is a zoonotic virus, meaning it spreads from animals to humans and can also pass between two humans, people
01:30to people.
01:30It's also the natural host inside of a fruit bat or especially any kind of dropper species.
01:39Early symptoms also look like severe flu, fever, headache, muscle pain, vomiting, cough, sore throat and also breathing difficulty.
01:51In severe cases, Nipah can inflame the brain, causing encephalitis, organ failure and also life-threatening complications.
02:02Transmission usually happens through close contact with infected animals to their bodily fluids or, you know, their bodily fluids there.
02:12It can also occur through contaminated food, especially raw date palm sap.
02:17Now, human to human spread is also possible, particularly in hospitals or caregiving settings where close contact is just unavoidable,
02:27which is why we had two cases reported in West Bengal, both nurses.
02:30And also the diagnosis is done through something called RT-PCR testing.
02:34We all know that by now, thanks to COVID, using a throat swab, a nasal swab or sometimes a blood,
02:42urine or also, you know, some other fluids that are used for its testing.
02:46Later in the illness, the ELISA tests help detect the antibodies, which seem to be the only way forward.
02:54But when it comes to treatment, there is no specific antiviral therapy just yet.
03:01Care remains largely supportive, hydration, monitoring and intensive care when needed, which is why early detection and isolation are critical.
03:11NEPA is considered one of the deadliest infections known.
03:16Fertility rates range between 40 to 75 percent.
03:21That's very, very high.
03:22And nearly one in five survivors may experience long term neurological complications as well.
03:29The incubation period, well, that is typically between three to 14 days, where in some rare cases it may also
03:37extend for longer.
03:39And despite years of research, no approved vaccine currently exists.
03:45But here is the part experts want you to remember.
03:48This remains a contained situation, at least so far.
03:53So far, only two confirmed cases have been reported in India, including one linked to the recent deaths, like I
04:00said.
04:01Contact tracing has not found any wider spread.
04:04There is no evidence of community transmission just yet.
04:08NEPA spreads, remember, mainly through close contact.
04:12It is not primarily airborne, like the case of COVID was, which significantly reduces the risk of, you know, large
04:19scale outbreaks.
04:20But India has faced NEPA before.
04:23So we have some learnings there.
04:26Let's look at the cases earlier on.
04:28In 2001, West Bengal reported 66 cases, 45 of them died.
04:33In 2007, again, the state saw about five cases and also all five did not survive.
04:42In Kerala in 2018, the outbreak recorded 18 cases and 17 deaths.
04:47In 2023, Kerala again reported six cases and two deaths.
04:52In 2025, there were three cases and two deaths that were recorded and each time rapid contamination sort of, you
05:00know,
05:00and also what really helped in these cases was just containing them that helped from wider spread.
05:07So the issue here is to ensure that you detect early and you also isolate them early.
05:13Authorities are urging now simple precautions.
05:16Follow quarantine advice if used.
05:18Wear masks in high-risk settings.
05:20Wash your hands frequently.
05:22Maintain strict hygiene.
05:23Also, avoid consuming unwashed fruits.
05:27Do not drink raw date palm sap or even toddy.
05:32And in affected areas, limit unnecessary movement.
05:36NEPA, remember, is serious.
05:39Its fertility rate, you know, the fatality rate over there is very, very high.
05:43But right now, awareness and caution matter far more than panic.
05:49So that's everything you need to know about NEPA.
05:52But let's deep dive with our expert now on the program to get you more details on this one.
05:59Joining me next is Dr. Rajiv.
06:00Dr. Rajiv Jayadevan is the epidemiologist, author and co-chairman of the National IMA COVID Task Force
06:07and also the past president of the Indian Medical Association in Coaching.
06:10Thank you so much for your time.
06:12Dr. Rajiv, my first question is that in West Bengal, we had seen NEPA about 10 years ago.
06:20And then there were no cases reported in West Bengal.
06:23We largely saw cases in Kerala.
06:25This time, it's come back in West Bengal.
06:28And while we are constantly talking about two nurses, it has to come through a human source, right?
06:33Somebody infected with NEPA who could not be detected was in that hospital and gave it to the two nurses.
06:41Are we missing something in surveillance here to ensure and get to that zero patient, the first patient?
06:48Very good question. Since we've already covered the basics, I'll go directly to answer your question.
06:54Did the nurse pick the virus up from another person?
06:59It's entirely possible. We do not have a proof of that.
07:03But for our viewers, as they would have probably heard, the virus freely circulates in certain types of fruit bats,
07:11not all bats.
07:12And in areas where bats and human beings co-exist or they live together or they come into contact directly
07:20or indirectly,
07:21the virus gets a chance to jump onto man.
07:24And as you mentioned, the virus, once it infects man, it can spread to other people.
07:30And that is what makes NEPA dangerous, particularly from a community health standpoint.
07:35So where the first patient was, and that is really called a primary case, the first case.
07:42And commonly, because it is so serious and so severe, the first patient commonly is already dead by the time
07:52the outbreak is identified.
07:53We talked about the Siliguri outbreak 25 years ago in West Bengal, where a large number of people died.
08:00And the diagnosis was made in the prospect to initially suspect to be something else.
08:05A very large number of people died.
08:07And many of them were, in fact, relatives or close relatives or people who visited patients and healthcare workers who
08:16passed away.
08:17So clearly, it has the ability to spread within hospitals.
08:21And the Siliguri outbreak is also remarkable that it started in one hospital and spread to three others,
08:27which means that four hospitals in total were involved in that outbreak and with a mortality in the range of
08:3470 to 74 percent.
08:36So back to our question here.
08:39Yes, it is quite possible that a patient who got the virus from the bat one way or the other
08:45may have come to the hospital
08:47and the nurse may have looked after the person and may have picked up the virus from that person.
08:53So it is entirely possible we don't have proof of that.
08:56So that is the reason why such measures are needed to contain the outbreak.
09:03Yeah, and this is the worrying part because if the patient, I'm sure, had family, they were in touch as
09:07well.
09:08So this is why surveillance gets, like, really, really important in these cases.
09:12However, WHO was very early in sounding the alarm on this one.
09:16And they did, you know, go on to ensure that some 175 people were tested after that.
09:23Over 175, if I'm getting the number correct.
09:25And all of them have come, you know, clear so far, which is good news.
09:29But, you know, there's a question that always bugs me, Dr. Rajiv.
09:32Why are all these viruses found in Kerala?
09:36I have never understood.
09:38Is it the climate? Is it better surveillance?
09:42How is it that the genesis of all different peculiar viruses, it all comes from Kerala or now West Bengal
09:50as well?
09:51There are many reasons for this.
09:53First, a patient with NIPA does not come with a label, I have NIPA.
09:58Someone's got to discover it. Someone's got to find it.
10:01And that requires clinical suspicion, the ability to perform a test, the ability to report and confirm it with the
10:10reference laboratory in the country.
10:11So, Kerala, with its prior experience with several outbreaks, it is able to pick up outbreaks at a very early
10:20stage and contain it before it spreads to other people.
10:23And the way it's contained, as you mentioned, the contact list of the person is made.
10:29And each of these individuals are screened by questions and isolated if necessary, so that they do not get a
10:36chance to spread to other people.
10:37And after the period of isolation, as long as they remain healthy, they're free to leave.
10:42So, that's how outbreaks are contained.
10:45So, diagnostic acumen is what we call it.
10:49I'll put this in perspective.
10:52NIPA is one of several causes of what's called encephalitis.
10:55Encephalitis is, in plain English, it's brain infection.
10:59It's a very serious illness, brain infection.
11:02And brain infection is caused by several viruses and NIPA is one of the rare causes of encephalitis.
11:07So, not all instances of encephalitis do doctors send all the tests for all the viruses.
11:14So, for instance, if there's a NIPA outbreak in the region, doctors tend to spend time and effort in identifying
11:21NIPA as well.
11:23But otherwise, it's futile to test for NIPA for every case of suspected brain infection.
11:28So, that's really the reason why Kerala, in particular, has reported NIPA in the past.
11:35Second is Kerala as a travel hub, because a lot of people who work outside the state,
11:40in the rest of the country, as well as abroad.
11:43So, whatever infections are from, say, from the Middle East or...
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