A recent outbreak in southern India has turned the global health spotlight on a little-known but deadly virus with the potential to become a pandemic.
The Nipah virus, which generally spreads from bats or pigs to humans, is associated with respiratory problems and inflammation of the brain that can progress to a coma and death. As many as three in four infected patients die from the virus, and there is no vaccine or cure, according to the World Health Organization. At least 13 people in the southern Indian state of Kerala have died from Nipah in the recent outbreak, according to news reports.
In an interview with the Stanford Woods Institute for the Environment, Stanford epidemiologist and Nipah expert Stephen Luby, MD, described how a strain of the virus could adapt to more efficiently spread between humans, increasing the risk of sparking a pandemic:
Characteristics that might increase the risk of person-to-person transmission would be a virus that has a stronger tendency to move to the respiratory tract in high numbers. It is conceivable that the virus could acquire a mutation that would enhance this capacity. One concern is that any time a virus infects a human, it is in an environment that selects for survival in that context.
Luby said hospital-based transmission poses a significant concern for Nipah and other infectious agents. Reducing that risk would require addressing difficult problems with supplies, behavior and accountability in health facilities of developing countries, he said, adding:
Investing in research to develop and test new strategies for sustaining improved infection control practices in low-income country hospitals would be a particularly useful area for research. It would also be useful to enhance surveillance, so we have a better idea about where the human cases are occurring, how many there are, what strains are involved and what pathway the virus is using to infect people.
Though no vaccine exists for Nipah, Luby said the Coalition for Epidemic Preparedness Innovations recently announced plans to fund the development of one. He and other Stanford researchers have published a number of studies on the virus. As noted in the article:
Among other Nipah research, Stanford scientists have illustrated potential pathways between people and bat secretions, shown Nipah contaminating hospital surfaces and piloted a way of preventing transmission. Stanford epidemiologist and Nipah expert Stephen Luby has co-authored recent work linking changes in temperature with the virus’s spread from bats to humans and examining the impact of behavioral changes that reduce the likelihood of people consuming potentially virus-contaminated tree sap.
Photo of Stephen Luby courtesy of Stanford Woods Institute for the Environment