[Source: Emerging Infectious Diseases Journal, full text: (LINK). Abstract, edited.]

Nipah Virus Infection Outbreak with Nosocomial and Corpse-to-Human Transmission, Bangladesh

Hossain M.S. Sazzad, M. Jahangir Hossain, Emily S. Gurley, Kazi M.H. Ameen, Shahana Parveen, M. Saiful Islam, Labib I. Faruque, Goutam Podder, Sultana S. Banu, Michael K. Lo, Pierre E. Rollin, Paul A. Rota, Peter Daszak, Mahmudur Rahman, and Stephen P. Luby

Author affiliations: Author affiliations: icddr,b, Dhaka, Bangladesh (H.M.S. Sazzad, M.J. Hossain, E.S. Gurley, S. Parveen, M.S. Islam, L.I. Faruque, G. Podder, S.P. Luby); Institute of Epidemiology, Disease Control and Research, Dhaka (K.M.H. Ameen, S.S. Banu, M. Rahman); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (M.K. Lo, P.E. Rollin, P.A. Rota, S.P. Luby); EcoHealth Alliance, New York, New York, USA (P. Daszak)


Active Nipah virus encephalitis surveillance identified an encephalitis cluster and sporadic cases in Faridpur, Bangladesh, in January 2010. We identified 16 case-patients; 14 of these patients died. For 1 case-patient, the only known exposure was hugging a deceased patient with a probable case, while another case-patient’s exposure involved preparing the same corpse for burial by removing oral secretions and anogenital excreta with a cloth and bare hands. Among 7 persons with confirmed sporadic cases, 6 died, including a physician who had physically examined encephalitis patients without gloves or a mask. Nipah virus–infected patients were more likely than community-based controls to report drinking raw date palm sap and to have had physical contact with an encephalitis patient (29% vs. 4%, matched odds ratio undefined). Efforts to prevent transmission should focus on reducing caregivers’ exposure to infected patients’ bodily secretions during care and traditional burial practices.