Key facts

Nipah virus is a zoonotic pathogen that can cause severe disease in both animals and humans.
It was first identified in Malaysia in 1998, where it caused an outbreak among pigs and subsequently spread to humans. Since then, there have been subsequent outbreaks in India and Bangladesh.
Its natural host are fruit bats of the Pteropodidae family and pigs can serve as intermediate hosts.
The virus can cause severe respiratory and neurological symptoms and death (fatality rate of 40% - 75%).
There is no treatment or vaccine available for either people or animals. The primary treatment for humans is supportive care.

People living in regions with previous Nipah virus outbreaks including parts of Bangladesh and India.
Farmers and people working with or handling pigs in endemic regions.
Individuals in close contact with infected patients are at increased risk of acquiring the virus.

Children
Elderly
People with long-term health problems like diabetes, heart or lung disease
People with a weakened immune system (e.g. due to HIV, poor nutrition, or certain medicines)

What can you do to prevent and control an epidemic?

Identify and isolate suspected pigs
Avoid direct contact with identified natural reservoir hosts such as fruit bats
Pig feed and pig shed should be protected against bats when feasible.
Establish an animal health/wildlife surveillance system, using a One Health approach, to detect Nipah cases and provide early warning for veterinary and human public health authorities.

Use appropriate Personal Protective Equipment (PPE) when caring for infected patients
Gloves and other protective clothing should be worn while handling sick animals or their tissues, and during slaughtering and culling procedures.
As much as possible, people should avoid being in contact with infected pigs.
Regular hand washing should be carried out after caring for or visiting sick people.

Keep date palm sap and other fresh food products away from bats
Date palm juice should be boiled, and other fruits should be washed thoroughly and peeled before consumption
Fruits with signs of bites should be discarded
Monitoring the community and identifying sick people
Identify community members who have suspected Nipah virus infection based on the community case definition

Rapidly detect and refer severe cases to health facilities early
Provide psychosocial support to the sick person and their family members
Social mobilisation and behaviour change
Find out the specific advice being given by health and other relevant authorities
Model following this advice and inform community members of current health practice advice
Offer support and encouragement to follow the advice
Try to gain understanding about if and why health practice advice is not being followed
With the guidance of your supervisor and health authorities, work with communities to overcome barriers to following health advice and recommended practices

Make a map of the community.
Mark the following information on the map:
- How many people have fallen sick with Nipah virus disease? Where?
- How many people have died? Where? When?
- Who and where are the vulnerable people?
- Where are the local health facilities and services? (include traditional healers)
Record the following information on the back of the map:
- When did people start to fall sick with Nipah virus disease?
- How many people live in the affected community?How many are children under five years old?
- What are the community’s habits, practices and beliefs about food safety and hygiene?
- What are the community’s habits, practices and beliefs about caring for and feeding sick people? Consider any differences in roles and responsibilities between men and women.
  - When babies and infants are sick, do women continue to breastfeed them?
- Are children badly affected by the Nipah virus? Are there other groups (specific ages, occupations, geographic areas, etc.) that are badly affected?
- Is a social mobilization or health promotion programme in place?
- Which sources do people use/trust the most for information?
  - Are there rumours or misinformation about Nipah virus? What are the rumours?

01. Community-based surveillance 02. Community mapping 03. Communicating with the community 04. Community referral to health facilities 05. Volunteer protection and safety 06. Personal protection equipment (PPE) for highly infectious diseases 12. Managing fever 19. Psychosocial support 20. Isolating sick people 29. Hygiene promotion 31. Good food hygiene 34. Handwashing with soap 36. Vector and reservoir control 43. Social mobilization and behaviour change 44. Dealing with rumors 45. Psychological First Aid (PFA)