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Date palm sap linked to Nipah virus outbreak in Bangladesh, 2008.
- Source :
-
Vector borne and zoonotic diseases (Larchmont, N.Y.) [Vector Borne Zoonotic Dis] 2012 Jan; Vol. 12 (1), pp. 65-72. Date of Electronic Publication: 2011 Sep 16. - Publication Year :
- 2012
-
Abstract
- Introduction: We investigated a cluster of patients with encephalitis in the Manikgonj and Rajbari Districts of Bangladesh in February 2008 to determine the etiology and risk factors for disease.<br />Methods: We classified persons as confirmed Nipah cases by the presence of immunoglobulin M antibodies against Nipah virus (NiV), or by the presence of NiV RNA or by isolation of NiV from cerebrospinal fluid or throat swabs who had onset of symptoms between February 6 and March 10, 2008. We classified persons as probable cases if they reported fever with convulsions or altered mental status, who resided in the outbreak areas during that period, and who died before serum samples were collected. For the case-control study, we compared both confirmed and probable Nipah case-patients to controls, who were free from illness during the reference period. We used motion-sensor-infrared cameras to observe bat's contact of date palm sap.<br />Results: We identified four confirmed and six probable case-patients, nine (90%) of whom died. The median age of the cases was 10 years; eight were males. The outbreak occurred simultaneously in two communities that were 44 km apart and separated by a river. Drinking raw date palm sap 2-12 days before illness onset was the only risk factor most strongly associated with the illness (adjusted odds ratio 25, 95% confidence intervals 3.3-∞, p<0.001). Case-patients reported no history of physical contact with bats, though community members often reported seeing bats. Infrared camera photographs showed that Pteropus bats frequently visited date palm trees in those communities where sap was collected for human consumption.<br />Conclusion: This is the second Nipah outbreak in Bangladesh where date palm sap has been implicated as the vehicle of transmission. Fresh date palm sap should not be drunk, unless effective steps have been taken to prevent bat access to the sap during collection.
- Subjects :
- Adolescent
Adult
Bangladesh epidemiology
Case-Control Studies
Child
Encephalitis, Viral epidemiology
Female
Henipavirus Infections virology
Humans
Male
Middle Aged
Risk Factors
Time Factors
Young Adult
Arecaceae
Encephalitis, Viral virology
Food Microbiology
Henipavirus Infections epidemiology
Nipah Virus
Subjects
Details
- Language :
- English
- ISSN :
- 1557-7759
- Volume :
- 12
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Vector borne and zoonotic diseases (Larchmont, N.Y.)
- Publication Type :
- Academic Journal
- Accession number :
- 21923274
- Full Text :
- https://doi.org/10.1089/vbz.2011.0656