By Rachel V. Thomas

New Delhi, May 26 (IANS): Simple good hygiene practices such as frequent hand washing and cooking food properly before consuming can help you avoid contracting the brain-damaging Nipah virus which has claimed 12 lives in Kerala till now and led to quarantining of at least 40 others, health experts suggest.

The Nipah virus is a zoonotic disease that is naturally transmitted from vertebrate animals to humans, while human-to-human transmission has also been documented.

First identified among pig farmers in Malaysia, the disease also surfaced in Siliguri, West Bengal, in 2001 and again in 2007.

Historically, the virus had largely remained in a cluster, meaning it was mostly confined to an area, and affected those that came in close contact to the patients, the experts said.

The latest outbreak in India has so far affected mainly four districts of Kerala -- Kozhikode, and its neigbouring districts of Malappuram, Kannur and Wayanad. People in other states do not have much to worry, unless they need to travel to the affected areas, or come in contact with someone who has contracted the virus.

"All the previous such epidemics were reported to be in clusters and historical evidence shows no simultaneous outbreaks," Vidya Menon, Clinical Professor at the Department of Medicine, Amrita Institute of Medical Sciences, Kochi, told IANS.

"So people who come in close contact of the patients are usually the ones who acquire the disease. If that contact group increases or travel to other places, the disease is likely to spread," Menon said.

Nipah virus can be transmitted by infected pigs, or by fruit bats, through their secretions of saliva, urine or faeces.
The other mode of transmission is human to human, through body secretions and respiratory secretions.

Contracting Nipah causes an upper respiratory infection, leading to fever, body ache, breathlessness and cough.

"There is no need to panic, but if you have symptoms similar to this or if you have visited the state recently, visit a doctor at the earliest," Suranjit Chatterjee, Senior Consultant - Internal Medicine at the Indraprastha Apollo Hospitals, New Delhi, told IANS.

Depending upon the exposure to the virus, it can also proceed to further complication like Encephalitis -- inflammation of the brain. This can result in mental confusions and deteriorate to coma.

"The progression is very severe. While the incubation period is long for some, on an average in 90 per cent of cases, the disease manifests itself within two weeks of exposure to the virus," Menon said.

"Those infected should be isolated for at least 10-15 days, till the virulence of the virus settles and our immune system also starts fighting," Vikas Maurya, Head of Department - Pulmonolgy, Fortis Hospital - Shalimar Bagh, New Delhi, told IANS.

There is no real treatment but supportive care is given to the affected patients, which means treating the symptoms differently.

"For example, people suffering from fever are treated for it, for those with breathlessness support is provided to them with artificial ventilators, and for those with seizures or convulsions anti-epileptic drugs are given as a support to the brain," Menon said.

The Kerala government has now recommended using Ribavarin -- an anti-viral -- as a life-saving measure. It is not a proven treatment, but it is approved because of a few studies that have proved the anti-viral's benefits.

"Beginning Thursday, the Kerala government has recommended using Ribavarin -- an anti-viral -- but only in proven cases," Menon said.

Lauding the efforts by the government officials, Menon said, "The situation seems to be under control, the state public health department has done a remarkable job in containing the disease so far. There is no need to panic."

Besides maintaining hygiene, the experts suggested to avoid eating fruits that has any paw marks on it or is contaminated. Food should be properly cooked before consuming.

Restricting mobility to and fro to the affected areas can curtail the virus up to some extent, Chatterjee suggested.

"If you are travelling to the infected area, use a general mask. While coughing close your mouth with a handkerchief or cough on your sleeve, wash hands properly, and maintain hygiene," Menon said.