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Bangladesh - 36 dead from Nipah Virus

Re: 19 died, others fall sick of unknown disease in Bangladesh- report it's Nipah

Re: 19 died, others fall sick of unknown disease in Bangladesh- report it's Nipah

Source: http://www.bdnews24.com/details.php?id=186437&cid=2

Killer virus identified as Nipah
Fri, Feb 4th, 2011 5:33 pm BdST

Dial 2000 from your GP mobile for latest news
Dhaka, Feb 4 (bdnews24.com) — The virus that has taken 14 lives in Hatibandha of Lalmonirhaat has been identified as the Nipah virus.

Locals claim the death toll was 19...

******************************************************************

Source: http://www.bdnews24.com/details.php?id=186448&cid=13

Killer virus is Nipah: IEDCR
Fri, Feb 4th, 2011 7:24 pm BdST

Dhaka, Feb 4 (bdnews24.com) — The virus that killed 14 people at Hatibandha Upazila in Lalmonirhat in the last four days has been identified as Nipah.

Director of the Institute of Epidemiology Diseases Control and Research (IEDCR) Mahmudur Rahman told reporters on Friday afternoon that they have been able to identify the virus through tests.

The outbreak of the virus was first marked a week back in the area. A team of IEDCR started working to identify the cause on Wednesday following a number of deaths.

The director also said 22 cases of infections have been recorded so far and 14 of them have died. The death toll was also confirmed by Hatibandha Upazila Executive Officer (UNO) Mohammad Ashrafuzzaman...
 
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Re: 19 died, others fall sick of unknown disease in Bangladesh- report it's Nipah

Re: 19 died, others fall sick of unknown disease in Bangladesh- report it's Nipah

From WHO Factsheet - Excerpts

Nipah virus
Fact sheet N°262
Revised July 2009


--------------------------------------------------------------------------------

KEY FACTS
Nipah virus causes severe illness characterized by inflammation of the brain (encephalitis) or respiratory diseases.
Nipah virus can be transmitted to humans from animals, and can also be transmitted directly from human-to-human; in Bangladesh, half of reported cases between 2001 and 2008 were due to human-to-human transmission.
Nipah virus can cause severe disease in domestic animals such as pigs.
There is no treatment or vaccine available for either people or animals.
Fruit bats of the Pteropodidae family are the natural host of Nipah virus.

--------------------------------------------------------------------------------

Signs and symptomsHuman infections range from asymptomatic infection to fatal encephalitis. Infected people initially develop influenza-like symptoms of fever, headaches, myalgia (muscle pain), vomiting and sore throat. This can be followed by dizziness, drowsiness, altered consciousness, and neurological signs that indicate acute encephalitis. Some people can also experience atypical pneumonia and severe respiratory problems, including acute respiratory distress. Encephalitis and seizures occur in severe cases, progressing to coma within 24 to 48 hours.

The incubation period (interval from infection to onset of symptoms) varies from four to 45 days.

Most people who survive acute encephalitis make a full recovery, but around 20% are left with residual neurological consequences such as persistent convulsions and personality changes. A small number of people who recover subsequently relapse or develop delayed onset encephalitis. In the long term, persistent neurological dysfunctions are observed in more than 15% of people.

The case fatality rate is estimated at 40% to 75%; however, this rate can vary by outbreak depending on local capabilities for surveillance investigations.

Controlling infection in health-care settingsHealth-care workers caring for patients with suspected or confirmed Nipah virus infection, or handling specimens from them, should implement standard infection control precautions.

Samples taken from people and animals with suspected Nipah virus infection should be handled by trained staff working in suitably equipped laboratories.

Full Factsheet at
http://www.who.int/mediacentre/factsheets/fs262/en/

There is not much indication of the degree of transmissibility between humans before patients become symptomatic, but Nipah is highly contagious between pigs, and pigs are infectious during the incubation period - so I suspect the same may be true for humans.
 
Re: 19 died, others fall sick of unknown disease in Bangladesh- report it's Nipah

Re: 19 died, others fall sick of unknown disease in Bangladesh- report it's Nipah

The lab in Bangladesh is among the best in the world for detecting Nipah, according to a previous post in this thread; if they say it's Nipah, it's Nipah.

The timing is a bit odd here. These cases are too close together in time to represent significant H2H transmission; perhaps the entire village had a mass exposure a couple weeks ago to infected bats, fruit, or juice (or the one previous confirmed case mentioned in a previous post, although the fact that the dead are predominantly children makes that less likely).

There is a table at the link below with Nipah cases by region since 2001, including the current outbreak (and also the belatedly reported outbreak in Faridpur here http://www.flutrackers.com/forum/showthread.php?p=391160&posted=1#post391160):

http://www.bdnews24.com/details.php?id=186461&cid=2
 
Re: 19 died, others fall sick of unknown disease in Bangladesh- report it's Nipah

Re: 19 died, others fall sick of unknown disease in Bangladesh- report it's Nipah

The case fatality rate is estimated at 40% to 75%; however, this rate can vary by outbreak depending on local capabilities for surveillance investigations.
Based on the table in the link posted by alert above, the overall CFR is .71 for the 174 reported cases in Bangladesh. It is certainly is a dangerous disease.
 
Re: 19 died, others fall sick of unknown disease in Bangladesh- report it's Nipah

Re: 19 died, others fall sick of unknown disease in Bangladesh- report it's Nipah

Based on the table in the link posted by alert above, the overall CFR is .71 for the 174 reported cases in Bangladesh. It is certainly is a dangerous disease.

And there are certainly some peculiarities about this outbreak. 50 probable cases in four days is very unusual, if there have only been about 174 in the past 11 years in the whole country. Perhaps the investigation will reveal an unusual exposure, or perhaps the pathogen has gained enhanced transmission. Definitely one to keep a close eye on, even though it is not flu...
 
Re: 19 died, others fall sick of unknown disease in Bangladesh- report it's Nipah

Re: 19 died, others fall sick of unknown disease in Bangladesh- report it's Nipah

Alert - I am trying to follow your logic (but hope you are right about the H2H transmission).

The initial report posted by RoRo states
"Five people, including three minors, died and six others fell seriously sick after being attacked by an unknown disease at different villages in Bangladesh's Hatibandha sub-district of Lalmonirhat district, 343 km northwest of capital Dhaka, on Tuesday and Wednesday."

That argues against a single transmission event - as the cases are in differing locations. Cases are spread across the age range.

There are only a couple of possiblities that spring to my mind:-
a) widespread infection in an intermediate vector such as pigs in the area, leading to multiple point sources of human infections
b) human index cases that went undetected (when set against the high levels of background deaths in the region e.g. H1N1 and other respiratory viral diseases, including JE etc) leading to multiple human infections i.e what is being reported now could be 2nd or 3rd generation infections

Other options anyone?
 
Re: 19 died, others fall sick of unknown disease in Bangladesh- report it's Nipah

Re: 19 died, others fall sick of unknown disease in Bangladesh- report it's Nipah

By mass exposure, I didn't mean a single event; perhaps "common, ongoing exposure" would have been more accurate. Nipah is widespread in bats, which would likely be the intermediate vector. The obvious explanation is that all these people may have had contact with infected bats, or with fruit or juice contaminated by such bats. Several of the articles suggest that if that was the case, contaminated fruit or juice could be widespread. I think that's essentially option (a) above.

I don't think it's possible that too many Nipah cases could be missed; this illness is so severe and unusual that the reports started coming immediately after the fatalities started Tuesday. The WHO bulletin on Nipah above indicates that the incubation period is 4-45 days. Just because not much H2H has occurred does not mean that it might not, however. I have seen a couple articles that suggest an R0 for Nipah of about 0.5 (see below).

I agree that this is odd; it's why personally I had thought something insect-borne might have been more likely. It will take some investigation on the ground to determine exactly how this happened.
 
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Re: 19 died, others fall sick of unknown disease in Bangladesh- report it's Nipah

Re: 19 died, others fall sick of unknown disease in Bangladesh- report it's Nipah

http://www.bdnews24.com/details.php?id=186448&cid=13

In Bangladesh, half of the reported cases between 2001 and 2008 were due to human-to-human transmission, the WHO website says.

------------

OK. Using the above information, I calculate an R0 of 0.5 for Nipah as follows:

Suppose a disease has an R0 of 0.5. Imagine that one person is infected by an animal. Then he infects 0.5 people. That 0.5 people then infects 0.25 (0.5 x 0.5) people. Repeating this, one gets a total of:

1 + 0.5 + 0.25 + 0.125 + ...

as a geometric series, whose sum is 2. So you have 2.0 infections, of which 1.0 is the result of H2H, and 1.0 was the result of the animal infection. Thus half of the cases would be the result of H2H.

That's why I estimate an R0 of 0.5 for Nipah in Bangladesh.
 
Re: 19 died, others fall sick of unknown disease in Bangladesh- report it's Nipah

Re: 19 died, others fall sick of unknown disease in Bangladesh- report it's Nipah

On this basis, so long as the R0 of this outbreak remains at the level you have calculated, it should naturally die out with quarantine of infected individuals.
 
Re: 19 died, others fall sick of unknown disease in Bangladesh- report it's Nipah

Re: 19 died, others fall sick of unknown disease in Bangladesh- report it's Nipah

General maps for reference. Hantibandha Upazila

Bangladesh map 20110203.jpg

Hatibandha 20110203.jpg
 
Re: 19 died, others fall sick of unknown disease in Bangladesh- report it's Nipah

Re: 19 died, others fall sick of unknown disease in Bangladesh- report it's Nipah

http://www.thedailystar.net/newDesign/news-details.php?nid=172896

Encephalitis claims 4 more
Lab test confirms Nipah virus causing the disease; bats are natural hosts of the virus; can spread disease thru' date juice
Star Report The government has confirmed the disease that claimed at least 20 people in Lalmonirhat and Rangpur districts in the last four days as Nipah encephalitis, caused by Nipah virus.

"The laboratory test has identified the virus as Nipah," said Prof Mahmudur Rahman, director of Institute of Epidemiology, Disease Control and Research (IEDCR), yesterday.

Meanwhile, two more virologists from Dhaka went to Lalmonirhat. They will go door-to-door conducting medical inquiry until the situation improves.

A common symptom of the disease is high fever accompanied by headache and vomiting. The disease causes inflammation of brain, and bats are natural hosts of the virus, said the doctors of IEDCR.

They also advised caution while drinking raw date juice as bats usually drink date juice at night.

The virus can transmit among humans through the saliva, urine and stools of infected bats, Prof Mahmudur said adding, boiled date juice can be taken.

The disease can pass from human to human, though the rate of such infection is low, said the doctors, suggesting taking precautions such as washing hands after coming into contact with an infected person.

They also advised not to use patient's bed, and to wash patient's clothes separately. Patient's spit, cough and excreta will have to be dumped into the ground, they added.

Meantime, four more people died of the disease in Lalmonirhat and Rangpur yesterday and Thursday night, raising the death toll to 20, reports our Lalmonirhat and Rangpur correspondents.

Two more people-- Israt Jahan, 15, and Lamia, 2, of South Kolkond village in Gangachara upazila of Rangpur--have been found infected with the disease. They were admitted to Rangpur Medical College Hospital yesterday.


The dead were identified as Bachchu Miah, 56, of Baraipara village; Joynal, 42, of South Goddimari; and Asadul Islam, 18, of Gendukuri village in Hatibandha upazila of Lalmonirhat and Lubna, 14, of South Kolkan village in Gangachara upazila of Rangpur.

Of them, Bachchu and Joynal died at Hatibandha Upazila Health Complex at about 11:30pm on Thursday and Asadul died at Rangpur Medical College Hospital early hours yesterday and Lubna at her residence around 12:00noon.

A three-member medical team led by Civil Surgeon of Rangpur Rejaul Karim visited the house of Lubna yesterday morning.

Nipah was first reported in the country in 2001. A total of 152 people have been infected by the disease from 2001 to January 31, 2011. Of the infected, 113 people died. In Bangladesh, two types of encephalitis--Japanese and Nipah--are common, IEDCR sources said.

The case fatality (the percentage of people who got the disease and did not survive) rate of the Nipah virus in Bangladesh is 75 percent. No vaccine against the disease has yet been developed, but the fatality can be reduced through symptom control or general management, they said
 
Re: 20 died, others fall sick of disease in Bangladesh- report it's Nipah

Re: 20 died, others fall sick of disease in Bangladesh- report it's Nipah

Nipah virus identified as culprit for deaths

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Saturday, 05 February 2011 <!--edited by HASAN-->
Author / Source : STAFF REPORTER & AGENCIES http://www.flutrackers.com/componen...udGlmaWVkLWFzLWN1bHByaXQtZm9yLWRlYXRocy5odG1s http://www.flutrackers.com/paper-ed...l?tmpl=component&print=1&layout=default&page= http://www.flutrackers.com/paper-ed...ah-virus-identified-as-culprit-for-deaths.pdf


DHAKA, Feb 4: The deadly Nipah virus has been identified as the culprit behind the mysterious disease that claimed more than a dozen lives in Lalmonirhat, over the last few days. Mahmudur Rahman, the director of the Institute of Epidemiology, Disease Control and Research (IEDCR), confirmed the finding.
According to Rahman, the disease is referred to as encephalitis, in medical terminology and leads to inflammations in an affected person's brain. The virus spreads through consumption of date palm juices or fruits half-eaten by infected fruit bats. The official death toll has been pegged at 14, while 22 others have been identified as infected, till Friday evening. Rahman waved aside media reports that claimed a higher death toll, terming them as speculative.
However, area residents claimed that at least 19 people have died, as of Friday. Bimal Kumar Roy, a physician at Hatibandha Upazila Health Complex, put the number of those infected at 50.
Meanwhile, the civil surgeon of Lalmonirhat said that a team of experts, from Dhaka, was working to contain the outbreak, along with area health workers.
The disease, experts said, is quite common in regions like south-west Faridpur, Madaripur and Rajbari. The government already has monitoring mechanisms in place, in these areas.
According to experts, the virus spreads mostly during the period between December and April, when jars are fixed to date palm trees, to collect juice. The virus spreads when infected bats perch on the jars and leave saliva and droppings, containing the deadly virus, into the juice.

The virus enters the human body when someone drinks contaminated date palm juice and is then freely transmitted among human beings. Scientists at the IEDCR have already advised against drinking unprocessed date extracts, to prevent the spread of the disease, which has a 75% mortality rate.
According to the World Health Organisation (WHO), there is no treatment or vaccine available for the disease. In Bangladesh, half of the cases reported between 2001 and 2008, were caused by human-to-human transmission of the Nipah virus, a WHO document noted.
According to Rahman, the virus claimed 113 lives between 2001 and January 2011. The most severe outbreak was in 2004, he added.:tiphat:http://www.theindependentbd.com/pap...h-virus-identified-as-culprit-for-deaths.html
 
Re: 20 died, others fall sick of disease in Bangladesh- report it's Nipah

Re: 20 died, others fall sick of disease in Bangladesh- report it's Nipah

20 die in 4 days in Lalmonirhat

Font size:
IEDCR says encephalitis caused by nipah virus

Sajia Afrin
The Institute of Epidemiology, Disease Control and Research on Friday identified the disease that killed three more people in Lalmonirhat on the day as encephalitis, acute brain inflammation, caused by nipah virus. So far 20 people died of the disease in the place in four days, according to an unofficial figure.
The IEDCR director, Mahmudur Rahman, said, ?After a laboratory test, we have confirmed that the people were suffering from encephalitis caused by nipah virus.?
The IEDCR, however, said 22 people were infected with the virus and 14 of them died till Friday.
Death rate of nipah virus is very high, said Mahmudur Rahman adding that three in four such patients died from the infection.
Reports from Hatibandha in the district said that more than 50 others, mostly children, contracted the disease, panicking people in the locality.
The people who died on Friday were Bacchu Mia, 57, of Baraipara, Asadul Islam, 18, of Gendukuri and Joynal, 42, of Dakkhin Goddimari in the upazila.
An eight-member IEDCR team was visiting the area. The team leader Subodh Kumar Kunda, principal scientific officer at the IEDCR, said that it is a contagious disease and has no specific treatment.
The local people on Friday morning, meanwhile, organised a human chain in front of the upazila health complex demanding immediate identification of the disease and take steps against the disease.
ASM Alamgir, senior scientific officer at the IEDCR, said there is no effective medicine or vaccine available to treat the patient infected by nipah virus. Creating awareness of the disease is main step which can prevent the disease.
Symptoms appear with fever followed by altered mental status, seizure and death, IEDCR experts said. They suggested that people in affected areas with such symptoms should see doctors.
The virus is highly infectious and has the potential to pass from person to person, they added.
The IEDCR experts advised people in the areas where nipah infection was prevalent areas not to eat fruit bitten or half-bitten by fruit bats, or drink raw juices of palm and date trees. They also suggested that date juice should not be collected in open pitchers.
According to experts, most of the nipah infection cases were reported between January and May. This is the breeding period of fruit bats and pregnant bats harbour the virus and possibly transmit it to humans.
When children collect fruits and eat them without washing, the virus discharged from bat?s saliva is transmitted to them.
Experts also urged the parents of the nipah-prone areas not to allow their children to play under fruit trees.
Five people were infected with the virus in January and four of them died according to the IEDCR.
One hundred and fifty-two cases of nipah infection were reported in the country after 2001 and 113 of them died, IEDCR officials said.:tiphat:http://newagebd.com/newspaper1/frontpage/7681.html
 
Re: 20 died, others fall sick of disease in Bangladesh- report it's Nipah

Re: 20 died, others fall sick of disease in Bangladesh- report it's Nipah

Saturday, February 5, 2011
<FIELDSET><!--

-->Encephalitis claims another life



</FIELDSET>
Star Online Report
Nipah encephalitis claimed life of another child at Rangpur Medical College Hospital Friday night, raising the death toll from the disease to 21.

Swarna, 4, daughter of Jahangir of Dakshin Goddimari village in Hatibandha upazila of Lalmonirhat died at about 9:00pm, reports our Rangpur correspondent.

She was admitted to RMCH on Tuesday with high fever.

Meanwhile, local administration has declared all the schools of Hatibandha upazila closed for six days from Saturday to control the spread of the disease.

Hospital sources said 24 encephalitis-infected people are now undergoing treatment at RMCH, Gangachara Upazila Health Complex of Rangpur and Hatibandha Upazila Health Complex of Lalmonirhat at present.

The government has confirmed the disease as Nipah encephalitis after a laboratory test, which mainly spread to Hatibandha upazila and its bordering Gangachara area.

The Institute of Epidemiology, Disease Control and Research (IEDCR), advised caution while drinking raw date juice as bats, which are natural hosts of the disease, usually drink date juice at night:tiphat:http://www.thedailystar.net/newDesign/latest_news.php?nid=28304
 
Re: 20 died, others fall sick of disease in Bangladesh- report it's Nipah

Re: 20 died, others fall sick of disease in Bangladesh- report it's Nipah

Saturday, February 5, 2011

The government has confirmed the disease as Nipah encephalitis after a laboratory test, which mainly spread to Hatibandha upazila and its bordering Gangachara area.

Regional location map

Bangaldesh Nipah 20110204.jpg
 
Re: 20 died, others fall sick of disease in Bangladesh- report it's Nipah

Re: 20 died, others fall sick of disease in Bangladesh- report it's Nipah

http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,86951

Archive Number 20110204.0408
Published Date 04-FEB-2011
Subject PRO/AH/EDR> Undiagnosed encephalitis - Bangladesh (02): (RP), Nipah virus conf.

UNDIAGNOSED ENCEPHALITIS - BANGLADESH (02): (RANGPUR) NIPAH VIRUS CONFIRMED
***************************************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Fri 4 Feb 2011
Source: The Daily Star [edited]
<http://www.thedailystar.net/newDesign/latest_news.php?nid=28294>


The government on Friday [4 Feb 2011] confirmed the disease as Nipah
virus encephalitis that claimed at least 21 people over the last few
days in Lalmonirhat and Rangpur. It means inflammation of brain and
infected rats [sic; bats] are the carrier of the disease, said
doctors at the Institute of Epidemiology Disease Control and Research
(IEDCR). They cautioned about drinking raw date juice and about bats,
saying rats [sic; bats] usually drink date juice at night. "The
laboratory test has confirmed the virus as Nipah," said Prof Mahmudur
Rahman, director of the IEDCR.

Meanwhile, 4 more people, including a 14-year-old girl, died in an
outbreak of encephalitis in northern parts of the country Lalmonirhat
and Rangpur Thursday night and Friday [3 and 4 Feb 2011], taking the
death toll to 21, report our correspondents in Lalmonirhat and Rangpur.

2 more people -- ages 15 and 2, residents of South Kolkond village in
Gangachara upazila, Rangpur -- contracted the disease on Friday [4 Feb 2011].

The IEDCR director said the virus spreads through the saliva, urine
and stools of the infected rats [sic; bats].

The latest deceased were identified as a person aged 56, of Baraipara
village; a person age 42, of South Goddimari; and a 3rd person age
18, of Gendukuri, village in Hatibandha upazila of Lalmonirhat and a
4th person age 14, of South Kolkan village under in Gangachara
upazila of Rangpur.

A 3-member medical team led by civil surgeon of Rangpur Rejaul Karim
visited the house of one victim in the morning.

The residents of Hatibandha and Gangachara upazilas have been
terrified with the outbreak of the virus and many of them left their houses.

--
Communicated by:
Health Map Alerts via ProMED-mail
<promed@promedmail.org>

[This is the annual Nipah virus transmission season. Unsurprisingly,
the "unknown disease" has now been confirmed as due to Nipah virus
infections. Now there are cases of Nipah virus infection with deaths
going on in 2 localities in Bangladesh. Clearly, a public education
campaign is needed in villages to keep fruit bats away from palm
juice and discourage people (especially children) from eating fruit
on which bats have been feeding
.

Mod.CP provided a good summary of Nipah virus transmission and
epidemiology in ProMED-mail archive number 20100122.0250. Unlike the
initial Nipah outbreak in Malaysia, human cases in Bangladesh do not
involve pigs, transmission being from _Pteropus_ fruit bats to humans
via contaminated fruit or palm juice.
 
Re: 20 died, others fall sick of disease in Bangladesh- report it's Nipah

Re: 20 died, others fall sick of disease in Bangladesh- report it's Nipah

Historically;

2001 April ? May, Meherpur district, Bangladesh: 13 cases with nine fatalities (69% mortality).[22]

2003 January, Naogaon district, Bangladesh: 12 cases with eight fatalities (67% mortality).[22]

2004 January ? February, Manikganj and Rajbari provinces, Bangladesh: 42 cases with 14 fatalities (33% mortality).

2004 19 February ? 16 April, Faridpur district, Bangladesh: 36 cases with 27 fatalities (75% mortality). Epidemiological evidence strongly suggests that this outbreak involved person-to-person transmission of Nipah virus, which had not previously been confirmed.[23] 92% of cases involved close contact with at least one other person infected with Nipah virus. Two cases involved a single short exposure to an ill patient, including a rickshaw driver who transported a patient to hospital. In addition, at least six cases involved acute respiratory distress syndrome which has not been reported previously for Nipah virus illness in humans. This symptom is likely to have assisted human-to-human transmission through large droplet dispersal.

2005 January, Tangail district, Bangladesh: 12 cases with 11 fatalities (92% mortality). The virus was probably contracted from drinking date palm juice contaminated by fruit bat droppings or saliva.[24]

2011 February- till: The outbreak of Nipah Virus is occurred at Hatibanda, Lalmonirhat, Bangladesh on the onset of 2011. There have a record of 21 school childrens death due to infection of Nipah virus on 4th February, 2011. IEDCR has confirmed the infection is due to this virus [27]. Local schools are declared for one week leave to prevent the spread. However, people are also requested to avoid consumption of fruits or fruit products (e.g. raw date palm juice) contaminated with urine or saliva from infected fruit bats was the most likely source of infection.[28]

Eleven isolated cases of Nipah virus encephalitis have also been documented in Bangladesh since 2001.

http://en.wikipedia.org/wiki/Henipavirus#Nipah_virus

Wiki references:
22.^ a b Hsu VP, Hossain MJ, Parashar UD, et al. (2004). "Nipah virus encephalitis reemergence, Bangladesh". Emerging Infect. Dis. 10 (12): 2082?7. PMID 15663842. http://www.cdc.gov/ncidod/EID/vol10no12/04-0701.htm.
23.^ ICDDR,B (2004). "Nipah encephalitis outbreak over wide area of Western Bangladesh". Health and Science Bulletin 2 (1): 7?11. http://www.icddrb.org/pub/publication.jsp?pubID=5144&classificationID=0&typeClassificationID=0.
24.^ ICDDR,B (2005). "Nipah virus outbreak from date palm juice". Health and Science Bulletin 3 (4): 1?5. http://www.icddrb.org/pub/publication.jsp?classificationID=56&pubID=6590.
27.^ http://www.thedailystar.net/newDesign/latest_news.php?nid=28294
28.^ http://www.prothom-alo.com/detail/date/2011-02-04/news/128856
 
Re: 21 died, others fall sick of disease in Bangladesh- report it's Nipah

Re: 21 died, others fall sick of disease in Bangladesh- report it's Nipah

The post above states

"There have a record of 21 school childrens death due to infection of Nipah virus on 4th February, 2011. "

New reports indicate deaths in older adults - so are we given to understand that these are additional to the school children referred to above?
 
Re: 21 died, others fall sick of disease in Bangladesh- report it's Nipah

Re: 21 died, others fall sick of disease in Bangladesh- report it's Nipah

I believe that that is a misinterpretation of the reports by the wikipedia editor. As a current event, that entry may be altered as updates are made.
 
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