Fresh Nipah case in India: What the symptoms look like, how it spreads, and what you should actually do

A Nipah virus infection case has been confirmed in Kozhikode district. The infection was confirmed in a 43-year-old man from Ramanattukara, Kozhikode District Collector M S Madhavikutty told PTI. According to the collector, 77 people have been identified in the contact list of the infected individual. They include 58 healthcare workers, 14 family members, and five friends and colleagues. None of the contacts has reported any symptoms so far, the statement said.

Nipah is a zoonotic virus, meaning it originates in animals and crosses over into humans. Fruit bats from the Pteropodidae family are considered the natural host of Nipah virus and are present in different parts of Asia and in Australia. The bats carry the virus without becoming ill. In most documented Nipah outbreaks, the virus first reaches people through contaminated food, most often fresh date-palm sap. To collect the sap, harvesters shave the bark of date-palm trees so the liquid can drip into a pot overnight. Fruit bats are attracted to the sweet sap and may lick it or drink from the collection pots. As they feed, bats can leave behind saliva or urine carrying the virus, which can infect people who later drink the raw sap. This route of transmission is particularly well-documented in Bangladesh and West Bengal.

This is important to understand clearly, because Nipah's early presentation is deceptively ordinary. For some people, Nipah virus infection may be asymptomatic. However, most people develop a fever, and symptoms involving the brain such as headache or confusion, and symptoms involving the lungs such as difficulty breathing or cough.

People with Nipah are typically sick for 3 to 14 days with fever, headache, cough, sore throat, and difficulty breathing. So far, that sounds like a bad flu. But what separates Nipah from a respiratory infection is how rapidly the neurological picture can emerge. The clinical spectrum ranges from asymptomatic infection to ARDS and fatal encephalitis, with rapid neurologic decline and coma possible within 24 to 48 hours in severe cases. Seizures, disorientation, altered consciousness, and personality changes can follow the initial fever within a matter of days. The transition from feeling unwell to requiring intensive care can be frighteningly fast.

The case fatality rate for Nipah is between 40 and 75 per cent. There is no antiviral drug approved for Nipah.

Avoiding raw date-palm sap is the single most important preventive measure for the general population in affected areas during the winter months. The virus is carried by fruit bats, which don't get sick but can spread Nipah through contaminated food or close contact.

Avoiding contact with wild fruit bats and with fruits that show signs of bat feeding, partial bites, tooth marks, or bat droppings nearby, is also relevant. Washing fruits thoroughly before eating them is genuinely useful.

For those in healthcare settings, strict adherence to infection prevention protocols when treating patients with unexplained fever and neurological symptoms is critical. Standard precautions apply, and where Nipah is suspected, droplet and contact precautions must be in place before confirmation arrives.