Transmission of Nipah Virus - 14 Years of Investigations in Bangladesh
In: ISSN: 0028-4793, 2019
Online
academicJournal
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International audience ; BackgroundNipah virus is a highly virulent zoonotic pathogen that can be transmitted between humans. Understanding the dynamics of person-to-person transmission is key to designing effective interventions.MethodsWe used data from all Nipah virus cases identified during outbreak investigations in Bangladesh from April 2001 through April 2014 to investigate case-patient characteristics associated with onward transmission and factors associated with the risk of infection among patient contacts.ResultsOf 248 Nipah virus cases identified, 82 were caused by person-to-person transmission, corresponding to a reproduction number (i.e., the average number of secondary cases per case patient) of 0.33 (95% confidence interval [CI], 0.19 to 0.59). The predicted reproduction number increased with the case patient’s age and was highest among patients 45 years of age or older who had difficulty breathing (1.1; 95% CI, 0.4 to 3.2). Case patients who did not have difficulty breathing infected 0.05 times as many contacts (95% CI, 0.01 to 0.3) as other case patients did. Serologic testing of 1863 asymptomatic contacts revealed no infections. Spouses of case patients were more often infected (8 of 56 [14%]) than other close family members (7 of 547 [1.3%]) or other contacts (18 of 1996 [0.9%]). The risk of infection increased with increased duration of exposure of the contacts (adjusted odds ratio for exposure of >48 hours vs. ≤1 hour, 13; 95% CI, 2.6 to 62) and with exposure to body fluids (adjusted odds ratio, 4.3; 95% CI, 1.6 to 11).ConclusionsIncreasing age and respiratory symptoms were indicators of infectivity of Nipah virus. Interventions to control person-to-person transmission should aim to reduce exposure to body fluids. (Funded by the National Institutes of Health and others.)
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Transmission of Nipah Virus - 14 Years of Investigations in Bangladesh
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Autor/in / Beteiligte Person: | Nikolay, Birgit ; Salje, Henrik ; Hossain, M. Jahangir ; Khan, A.K.M. Dawlat ; Sazzad, Hossain, M. S. ; Rahman, Mahmudur ; Daszak, Peter ; Ströher, Ute ; Pulliam, Juliet, R. C. ; Kilpatrick, A. Marm ; Nichol, Stuart, T. ; Klena, John, D. ; Sultana, Sharmin ; Afroj, Sayma ; Luby, Stephen, P. ; Cauchemez, Simon ; Gurley, Emily, S. ; Modélisation mathématique des maladies infectieuses - Mathematical modelling of Infectious Diseases ; Institut Pasteur Paris (IP)-Centre National de la Recherche Scientifique (CNRS) ; Medical Research Council Unit The Gambia (MRC) ; International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) ; University of New South Wales Sydney (UNSW) ; Institute of Epidemiology Disease Control and Research Dhaka, Bangladesh (IEDCR) ; EcoHealth Alliance New York ; Centers for Disease Control and Prevention Atlanta (CDC) ; Centers for Disease Control and Prevention ; University, Stellenbosch ; University of California Santa Cruz (UC Santa Cruz) ; University of California (UC) ; Auburn University (AU) ; University, Stanford ; Johns Hopkins Bloomberg School of Public Health Baltimore ; Johns Hopkins University (JHU) ; Supported by a grant (2R01-TW005869) from the National Institutes of Health ; by the CDC ; by support from the Laboratory of Excellence Integrative Biology of Emerging Infectious Diseases (to Drs. Nikolay and Cauchemez) ; by support from the National Institute of General Medical Sciences Models of Infectious Disease Agent Study Initiative (to Drs. Nikolay and Cauchemez) ; by support from the INCEPTION project (PIA/ANR-16-CONV-0005) (to Drs. Nikolay, Salje, and Cauchemez) ; by support from the AXA Research Fund (to Drs. Nikolay and Cauchemez) ; and by core or unrestricted support from the governments of Bangladesh, Canada, Sweden, and the United Kingdom. ; ANR-10-LABX-0062,IBEID,Integrative Biology of Emerging Infectious Diseases(2010) ; ANR-16-CONV-0005,INCEPTION,Institut Convergences pour l'étude de l'Emergence des Pathologies au Travers des Individus et des populatiONs(2016) |
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Zeitschrift: | ISSN: 0028-4793, 2019 |
Veröffentlichung: | HAL CCSD ; Massachusetts Medical Society, 2019 |
Medientyp: | academicJournal |
DOI: | 10.1056/NEJMoa1805376 |
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