Taiwan is bracing for the possible spread of a novel and potentially deadly henipavirus that spreads from animals to humans
At least 35 people in China have become infected with a novel henipavirus that apparently spreads from animals to humans, setting off alarm bells in neighboring Taiwan over a potentially dangerous pathogen.
Taiwanese laboratories will need to establish standardized testing procedures to identify the Langya henipavirus (LayV), Chuang Jen-hsiang, deputy director of Taiwan’s Centers for Disease Control (CDC), told reporters on Sunday. Genome sequencing of the virus is expected to be completed within about one week, he said.
Chuang made his comments three days after the New England Journal of Medicine posted a study on the newly discovered virus, which was detected in China’s Shandong and Henan provinces. All of the affected patients had high fevers, while at least half were also experiencing fatigue, coughing, loss of appetite and a drop in white blood cells.
More than one-third of patients suffered liver failure, and 8% had kidney failure. The study said LayV is part of the Paramyxoviridae family of negative-strand RNA viruses, which can cause “fatal disease.” Its emergence comes as public health officials around the world are still dealing with the Covid-19 pandemic, which has reportedly killed more than 6.4 million people.
Henipaviruses belong to the family of paramyxoviruses. Two species have been identified to be zoonotic, causing disease in animals. These are the Hendra virus (HeV) and the Nipah virus (NiV). They produce severe and often fatal illness in humans and horses.
HeV infection in horses, and then in humans, was first reported in 1994 in Australia. In contrast, NiV infection was first observed in pigs and subsequently in humans in 1998, in Malaysia. In Bangladesh, henipavirus infection was traced independently of contact with infected animals.
Fruit bats (Pteropus species, also called ‘flying foxes’) are the natural hosts of henipaviruses. The Hendra virus is probably transmitted to horses, which are the main intermediate hosts, through the ingestion of food contaminated with the droppings, urine or other excretions of infected fruit bats. The bats themselves do not show any clinical signs of illness. Transmission of HeV to man occurs through close contact with infected horses, probably through their respiratory secretions and urine.
NiV is carried from pigs, which are the main intermediate hosts, to humans, via aerosols, or direct contact with infected respiratory secretions, saliva or urine, or surfaces contaminated by these secretions. Pigs may have acquired the infection via fruits half-eaten by bats, and contaminated by the virus. Other possible intermediate hosts are dogs, cats, horses and goats.
In some cases NiV transmission has been independent of direct contact with livestock, through the ingestion of sap from the date palm, which was contaminated by bat excretions. In other cases the NiV infection was transmitted from the infected excretions of pigs to abattoir and farm workers in contact with the animals. A high rate of human to human spread by NiV was seen in an outbreak in Bangladesh, unlike earlier outbreaks in Malaysia.
The disease manifests in 4-20 days or 5-12 days, for HeV and NiV infection respectively. It presents as fever with acute encephalitis, or as an acute influenza-like illness leading to severe respiratory illness, or as meningitis. The mortality ranges from 40-70% for NiV infection, and 50% with HeV. It is highest among those with acute encephalitis. Survivors have severe residual disabilities, such as incoordination, muscular weakness and difficulty with thought processing and mental functions. Others show paralysis of the eye muscles, with resultant visual problems.
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