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 Table of Contents  
CURRENT ILLNESS GUIDELINES
Year : 2018  |  Volume : 16  |  Issue : 2  |  Page : 76-77

Nipah Virus - Information and Guidelines


Date of Web Publication20-Jun-2018

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-4651.234837

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How to cite this article:
. Nipah Virus - Information and Guidelines. Curr Med Issues 2018;16:76-7

How to cite this URL:
. Nipah Virus - Information and Guidelines. Curr Med Issues [serial online] 2018 [cited 2019 Dec 14];16:76-7. Available from: http://www.cmijournal.org/text.asp?2018/16/2/76/234837

Background

There has been a Nipah virus encephalitis outbreak in Perambra, Calicut District of North Kerala. A NiV infection is a zoonotic disease of public health importance caused by a highly pathogenic paramyxovirus. Recurrent outbreaks have been reported from Bangladesh and Malaysia, and have caused small outbreaks in West Bengal in India in the past. Although fruit bats are the main reservoir of Nipah virus, nosocomial transmission is well documented. It has become imperative to develop strategies for triaging and patient management in our hospital if there is a suspected case. These guidelines will be helpful to detect suspected cases quickly and appropriate control measures can be initiated and may be modified according to the local situation.

When would you suspect?

Suspect Nipah virus infection in any patient who comes from North Kerala or travelled to that region in the past 3 weeks, with complaints of fever and headache, altered sensorium, seizures or cough and breathlessness.

How does it spread to humans?

  • From human to human through body fluids and droplets
  • Through fruits contaminated by infected fruit bat secretions
  • From infected animals through body fluids


Triage and management procedures

  • Once there is a suspected case of Nipah virus infection, call Infectious Diseases team
  • Isolate the case immediately and institute infection control precautions


Infection prevention and control measures

  • Adhere to standard infection control precautions for all patient-care activities and aerosol-generating procedures
  • Standard precautions assume that every person is potentially infected, which could be transmitted in the health-care setting. In this specific context, prevention of infection that could spread through contact and droplets include:


− Use of N95 facial mask

− Wearing gloves, goggles and gown

− Hand hygiene: Wash hands with soap and water or alcohol-based handrub, before and after patient contact

− Appropriate waste disposal.

− Appropriate cleaning of the linen, patient care equipment and environment

− Admit the patient in isolation ward.

Measures to be taken in the ward

  • Place the patient in isolation single room
  • Use of Personal Protective Equipment as above
  • Ensure respiratory hygiene/cough etiquette for patients and care givers
  • Practice minimum and essential handling of patients and equipment
  • Restrict all patient-care equipment to a single patient (if not possible; they must be cleaned and properly disinfected before reuse).
  • Clean the secretions and visible soiling with wet swabs frequently and discard in designated covered waste bins and sanitize hands
  • Decontaminate used clothes, utensils and other belongings according to protocol
  • Restrict movement of people within and outside the facility
  • Maintain a log of persons entering the patient's room.


Measures to be followed for sample collection

  • Laboratory personnel collecting and handling potentially NiV infected clinical specimens should wear appropriate PPE (gown, gloves, N95 mask and goggles)
  • When removing protective equipment, avoid any contact between the soiled items and any area of the face (i.e. eyes, nose or mouth)
  • Perform hand hygiene immediately after the removal of protective equipment
  • Place clinical specimens (e.g. CSF, blood etc) in clearly labelled containers
  • Triple layer packing should be done for all suspected clinical samples with bold labelling “Suspect Nipah virus infection” and should be delivered directly to designated specimen handling areas.


Compiled by the Hospital Infection Control Committee (HICC), Christian Medical College & Hospital, Vellore. The guidelines suggested may have to be modified according to the local situation.




 

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