NİPAH VİRÜSÜ ENFEKSİYONU

Yıl 2018, Cilt: 2 Sayı: 2, 74 - 81, 29.09.2018

Semra Öz , Büşra Çınar Mustafa Altındiş

Öz

 

Özet

Nipah
virüsü (NiV), Paramyxoviridae ailesinden Henipavirus cinsinin bir üyesidir. İlk
defa 1999 yılında Malezya ve Singapur'da domuz çiftçileri ve domuzlarla yakın
temas halinde olan insanlar arasında ensefalit ve solunum yolu hastalığı
salgını sırasında izole edilmiştir. Pteropus cinsi meyve yarasaları rezervuar
rolü üstlenir. Enfekte yarasalar, enfekte domuzlar veya diğer NiV ile enfekte
kişilerle doğrudan temas sonrası insanlara bulaşı görülebilir. İnsan
enfeksiyonları asemptomatik enfeksiyondan akut solunum yolu enfeksiyonuna ve
ölümcül ensefalite kadar değişebilir. Enfekte insanlarda başlangıçta ateş, baş
ağrısı, kas ağrısı, kusma ve boğaz ağrısı gibi grip benzeri semptomlar
görülebilir. Sonrasında baş dönmesi, uyuşukluk, bilinç değişikliği ve akut ensefaliti
gösteren nörolojik bulgular eklenebilir. Bazı kişilerde akut solunum sıkıntısı
da dahil olmak üzere atipik pnömoni ve ciddi solunum problemleri görülebilir.
Ensefalit ve nöbetler ağır vakalarda ortaya çıkar. Nipah virüs enfeksiyonunun
başlangıç belirtileri ve semptomları nonspesifiktir ve tanıda genellikle
şüphelenilmez. Tanı daha çok klinikle konulur ama vücut sıvılarından gerçek
zamanlı polimeraz zincir reaksiyonu (RT-PCR) ve enzim bağlantılı immünosorbent
testi (ELISA) ile antikor tespitidir laboratuvar temelli kullanılan başlıca
testlerdir. Şu an için özgül bir tedavisi ve aşısı bulunmamaktadır ve destek
tedavisi önerilmektedir. Nipah virüsü enfeksiyonu, endemik bölgelerde hasta
domuz ve yarasa maruziyetinden kaçınarak ve ham hurma sularını içmeyerek
önlenebilir. Bu konuda yapılacak kapsamlı çalışmalarla hastalık tanısını ve
salgınların önelenmesiyle kalınmayıp bu ölümcül patojen için yeni tedavi ve
aşıların bulunmasını sağlanabilir. Günümüzde ulaşım koşulları ve virüsün
insanlar arası iletimi de göz önüne alındığında endemik bölgeler dışında da
dikkatli olunmalı, bu konuda farkındalık oluşturulmalı ve maruziyeti azaltmak
için alanabilecek önlemler hakkında insanlar eğitilmelidir.

Anahtar Kelimeler:
Nipah, Henipah, virüs.

Abstract

Nipah
virus (NiV) is a member of the genus Henipavirus from Paramyxoviridae family.
It was first isolated in 1999 in Malaysia and Singapore during an encephalitis
and respiratory disease outbreak among pig farmers and people in close contact
with pigs. Pteropus genus fruit bats play a reservoir role. Infection can be
seen in humans after direct contact with infected bats, infected pigs or other
NiV-infected persons. Human infections can range from asymptomatic infections
to acute respiratory tract infections and lethal encephalitis. Infected people
may initially have influenza-like symptoms such as fever, headache, muscle
aches, vomiting, and sore throat. Neurological findings with dizziness,
drowsiness, altered consciousness, and acute encephalitis can then be added.
Some people may have atypical pneumonia and severe respiratory problems
including acute respiratory distress. Encephalitis and seizures occur in severe
cases. The
initial signs and symptoms of nipah virus infection are nonspecific and are
usually not suspected. Diagnosis is mostly done clinically but it is
the principal laboratory-based test that detects antibodies from body fluids
using real-time polymerase chain reaction (RT-PCR) and enzyme-linked
immunosorbent assay (ELISA). Currently there is no specific treatment or
vaccination and supportive care is recommended. Nipah virus infection
can be prevented in patients with endemic areas avoiding pig and bat exposure
and not drinking raw palm sap. Comprehensive studies to be undertaken in this
area will not only help to prevent illnesses and epidemics, but also provide
new treatments and vaccines for this deadly pathogen. Nowadays, given the
transport conditions and the transmission of human interactions between
viruses, care must be taken outside of the endemic areas, awareness must be set
in this regard and people should be educated about precautions that may be
taken to reduce exposure.

Keywords:
Nipah, Henipah, virus.

Anahtar Kelimeler

Nipah, Henipah

Kaynakça

• Kaynaklar1 Islam MMZ, Rahman MM. Nipah virus Infection: A fatal Emerging disease. Northern International Medical College Journal. Vol. 7 No. 02 January 2016;146-148.2 MMWR. Outbreak of Hendra-like-virus-Malaysia and Singapore, 1998-1999, April 9, 1999; 48 (13): 265-9.3 WHO. NIPAH baseline situation analysis. January, 2018. pdf4 Wang L, Harcourt BH, Yu M, Tamin A, Rota PA, Bellini WJ, et al. Moleculer biology of Hendra and Nipah viruses. Microbes Infect. 2001 Apr; 3(4):279-87.5 Luby SP, Gurley ES, Hossain MJ. Transmission of human infection with Nipah Virus. Clin Infect Dis. 2009; 49 (11): 1743-1748. 6 Chua KB, Bellini WJ, Rota PA, Harcourt BH, Tamin A, Lam SK, et al. Nipah virus: a recently emergent deadly paramyxovirus. Science 2000; 288:1432–1435.7 Wang LF, Yu M, Hansson E, Pritchard LI, Shiell B, Michalski WP,et al. The exceptionally large genome of Hendra virus: support for creation of a new genus within the family Paramyxoviridae. J Virol 2000; 74:9972–9979.8 Lo MK, Rota PA. Molecular virology of the henipaviruses. Curr Top Microbiol Immunol. 2012;359:41-58.9 Angeletti S, Lo Presti A, Cella E, Ciccozzi M. Molecular epidemiology and phylogeny of Nipah virus infection: A mini review. Asian Pac J Trop Med. 2016 Jul;9(7):630-4.10 Wang LF, Mackenzie JS, Broder CC. Henipaviruses, In Knipe DM, Howley PM (ed), Fields virology, 6th ed. Lippincott Williams & Wilkins, Philadelphia, PA. 2013. p 286–313.11 Ong KC, Wong KT. Henipavirus Encephalitis: Recent Developments and Advances. Brain Pathol. 2015 Sep; 25(5):605-13.12 Contents lists available at ScienceDirectJournal of Proteomicsjournal homepage: www.elsevier.com/locate/jprotTechnical noteProteomic composition of Nipah virus-like particlesNatalia Mara Vera-Velasco1, Maria Jesús García-Murria1, Manuel M. Sánchez del Pino,Ismael Mingarro, Luis Martinez-Gi13 Mire CE, Satterfield BA, Geisbert JB, Agans KN, Borisevich V, Yan L, et al. Pathogenic differences between Nipah virus Bangladesh and Malaysia strains in primates: implications for antibody therapy. Sci Rep.2016;6:3091614 Clayton BA, Middleton D, Arkinstall R, Frazer L, Wang LF, Marsh GA. The nature of exposure drives transmission of Nipah viruses from Malaysia and Bangladesh in ferrets. PLoS Negl Trop Dis.2016;10:e000477515 Ang BSP, Lim TCC, Wang L. Nipah Virus Infection. J Clin Microbiol. 2018;56:e01875-17. 16 Parashar UD, Sunn LM, Ong F, Mounts AW, Arif MT, Ksiazek TG, et al. Case-control study of risk factors for human infection with a new zoonotic paramyxovirus, Nipah virus, during a 1998–1999 outbreak of severe encephalitis in Malaysia, J Infect Dis. 2000;181:1755-1759.17 Middleton DJ, Westbury HA, Morrissy CJ, van der Heide BM, Russell GM, Braun MA, et al. Experimental Nipah virus infection in pigs and cats. J Comp Pathol. 2002;126: 124-136.18 Hsu P, Hossain MJ, Parashar UD, Ali MM, Ksiazek TG, Kuzmin I, et al. Nipah virus encephalitis re-emergence, Bangladesh, Emerg Infect Dis, 2004;10:2082-2087.19 WHO. Nipah virus outbreak(s) in Bangladesh. January–April 2004. Wkly Epidemiol Rec, 2004;17:168-171.20 Chadha MS, Comer JA, Lowe L, Rota PA, Rollin PE, Bellini WJ, et al. Nipah virus-associated encephalitis outbreak, Siliguri, India, Emerg Infect Dis, 2006;12:235-24021 Arankalle VA, Bandyopadhyay BT, Ramdasi AY, Jadi R, Patil DR, Rahman M, et al. Genomic characterization of Nipah virus, West Bengal, India. Emerg. Infect. Dis. 2011;17:907–909.22 Simons RR, Gale P, Horigan V, et al. Potential for introduction of bat-borne zoonotic viruses into the EU: a review. Viruses. 2014 May 16;6(5):2084-121.23 Lo MK, Rota PA. The emergence of Nipah virus, a highly pathogenic paramyxovirus. J Clin Virol 2008; 43: 396–40024 Yob JM, Field H, Rashdi AM, Morrissy C, van der Heide B, Rota P, et al. Nipah virus infection in bats (order Chiroptera) in peninsular Malaysia. Emerg Infect Dis.2001;7:439–441. 25 Gurley ES, Montgomery JM, Hossain MJ, et al. Person-to-person transmission of Nipah Virus in an Bangladeshi Community. Emerging Infections Diseases. 2008; 46(7): 977-84.26 Luby SP, Gurley ES, Hossain MJ. 2009. Transmission of human infection with Nipah virus. Clin Infect Dis 49:1743–174827 https://medium.com/@dilipkumark/nipah-virus-niv-prevention-treatment-medicine-and-solutions-c088091b7861. Erişim Tarihi: 18/07/2018.28 Wong KT, Shieh WJ, Kumar S, Norain K, Abdullah W, Guarner J, et al. Nipah virus infection: pathology and pathogenesis of an emerging paramyxoviral zoonosis. Am J Pathol 2002;161: 2153–216.29 Goh KJ, Tan CT, Chew NK, et al. Clinical features of Nipah virus encephalitis among pig farmers in Malaysia. N Engl J Med. 2000 Apr 27;342(17):1229-35.30 Hossain MJ, Gurley ES, Montgomery JM, et al. Clinical presentation of Nipah Virus infection in Bangladesh. Clinical infectious diseases 2008; 46 (7): 977-84.31 Sherrini BA, Tan CT. Nipah encephalitis—an update. Med J Malaysia. 2014;69 (Suppl A):103–111.32 Daniels P, Ksiazek T, Eaton BT. Laboratory diagnosis of Nipah and Hendra virus infection. Microbes and infection 2001; 3 (4): 289-95.33 Chen JM, Yu M, Morrissy C, Zhao YG, Meehan G, Sun YX, et al. A comparative indirect ELISA for the detection of henipavirus antibodies based on a recombinant nucleocapsid protein expressed in Escherichia coli. J Virol Methods 2006;136:273–634 Zhu Z, Dimitrov AS, Bossart KN, Crameri G, Bishop KA, Choudhry V, et al. Potent neutralization of Hendra and Nipah viruses by human monoclonal antibodies. J Virol 2006;80:891–9.35 Chong HT, Kamarulzaman A, Tan CT, Goh KJ, Thayaparan T, Kunjapan SR, et al. Treatment of acute Nipah encephalitis with ribavirin. Ann Neurol 2001;49:810–81336 Bossart KN, Mungall BA, Crameri G, Wang LF, Eaton BT, Broder CC. Inhibition of Henipavirus fusion and infection by heptad-derived peptides of the Nipah virus fusion glycoprotein. J Virol. 2005;2:57.37 Porotto M, Doctor L, Carta P, Fornabaio M, Greengard O, Kellogg GE, et al. Inhibition of hendra virus fusion. J Virol. 2006;80:9837-984938 Breed A, Field H, Epstein JH, Dazsak P. Emerging henipaviruses and flying foxes – Conversation and management perspectives. Biol Conservation 2006;131:211-220.39 Nahar N, Paul RC, Sultana R, et al. A Controlled Trial to Reduce the Risk of Human Nipah Virus Exposure in Bangladesh. Ecohealth. 2017 Sep 13.40 Rahman SA. National Guideline for Management, Prevention and Control of Nipah Virus Infection Including Encephalitis. 1th edition. 2011.41 Broder CC. Henipavirus outbreaks to antivirals the current status of potential therapeutics, current opinion virology 2012; 2(2): 176-87.