'Mystery' fever alarms experts

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The death of seven people from ‘mystery’ fever in a northern border district has the experts scrambling to find out whether it was caused by a fresh outbreak of highly fatal ‘nipah virus’.

The virus is highly infectious as it has killed 113 people out of 152 who had the fever since its first outbreak in 2001 when it was unknown to all.

The disease has become a cause of anxiety among Bangladesh’s health authorities as it unfailingly strikes every year and there is little the doctors can do except circulating awareness message ‘not to drink raw palm juice’. The juice, scientists say, is thought to be responsible for causing the infection.

“The government has taken the fatalities in Hatiabandha upazila of Lalmonirhat district seriously,” said Prof Mahmurdur Rahman, director of the Institute of Epidemiology Disease Control and Research (IEDCR).

He told bdnews24.com that a 10-member team, comprising IEDCR and ICDDR,B scientists, left Dhaka for Hatiabandha on Wednesday to investigate into the mystery fever that left a few people critically ill in the last 36 hours.

Doctors at the Rangpur Medical College Hospital where some victims were transferred have not been able to pin-point the origin of the disease or how it spreads. It reportedly begins with high fever followed by seizure and death.

“We suspect it is encephalitis, a serious brain infection, usually triggered by a virus either nipah or Japanese Encephalitis,” Prof Rahman said, adding that only lab test can confirm the virus.

They (the team) will collect blood samples for lab test in the IEDCR, the lone nipah virus identification laboratory in the South-East Asia

A ICDDR,B scientist requesting anonymity, however, said they were suspecting nipah to be the cause of the latest outbreak as the symptoms of the patients who died were similar to those infected with nipah virus. Last month, they also got a nipah case from that region.

According to experts nipah virus spread during December to April when fruit bats perch on the jars used for collecting palm juice. They usually leave saliva and droppings into it while sipping the juice.

When people drink raw juice, the virus gets into them and passes from person to person.

It is so infectious that in 2004 four members of a family in Faridpur died after one of them got infected. A rickshaw-puller who carried a patient to the hospital also got infected and died.

“Pteropus bats carry the virus in Bangladesh,” said Dr Salahuddin Khan, an ICDDR,B scientist, adding that their research showed using bamboo or stick shade or covering the pitcher with polythene can prevent the juice contamination.

“But people should avoid drinking raw juice,” Prof Rahman said, adding they have been circulating such messages and carrying out their surveillance at six health facilities including medical colleges.

Besides, IEDCR also collects information from local health authorities elsewhere.

He suggested ‘one health’ approach that means concerted effort of physicians, animal scientists and anthropologists to contain the spread of the virus.

Prof Rahman said once people believed that it was ‘evil spirit’ that kill people, but now they have started to understand the fact. “When people can understand the fact, they can prevent it.”

Nipah was first detected in Malaysia in 1998, but at present Bangladesh, a hotspot for emerging diseases, is the only country in the world that reports nipah. No one can say why.

Meherpur, Naogoan, Rajbari, Faridpur, Tangail, Thakurgoan, Kushtia, Manikganj, and Rangpur are the districts where the disease was detected.

“We should heighten our surveillance but we cannot do due to budget constraints,” Prof Rahman said.

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