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

Umesh D. Parashar, Lye Munn Sunn, Flora Ong, Anthony W. Mounts, Mohamad Taha Arif, Thomas G. Ksiazek, Muhammad A. Kamaluddin, Amal N. Mustafa, Hanjeet Kaur, Lay Ming Ding, Ghazali Othman, Hayati M. Radzi, Paul T. Kitsutani, Patrick C. Stockton, John Arokiasamy, Howard E. Gary, Larry J. Anderson

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Abstract

An outbreak of encephalitis affecting 265 patients (105 fatally) occurred during 1998-1999 in Malaysia and was linked to a new paramyxovirus, Nipah, that infected pigs, humans, dogs, and cats. Most patients were pig farmers. Clinically undetected Nipah infection was noted in 10 (6%) of 166 community-farm controls (persons from farms without reported encephalitis patients) and 20 (11%) of 178 case-farm controls (persons from farms with encephalitis patients). Case patients (persons with Nipah infection)were more likely than community-farm controls to report increased numbers of sick/dying pigs on the farm (59% vs. 24%, P = .001) and were more likely than case-farm controls to perform activities requiring direct contact with pigs (86% vs. 50%, P = .005). Only 8% of case patients reported no contact with pigs. The outbreak stopped after pigs in the affected areas were slaughtered and buried. Direct, close contact with pigs was the primary source of human Nipah infection, but other sources, such as infected dogs and cats, cannot be excluded.

Original languageEnglish (US)
Pages (from-to)1755-1759
Number of pages5
JournalJournal of Infectious Diseases
Volume181
Issue number5
DOIs
StatePublished - Jun 28 2000
Externally publishedYes

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ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

Cite this

Parashar, U. D., Sunn, L. M., Ong, F., Mounts, A. W., Arif, M. T., Ksiazek, T. G., Kamaluddin, M. A., Mustafa, A. N., Kaur, H., Ding, L. M., Othman, G., Radzi, H. M., Kitsutani, P. T., Stockton, P. C., Arokiasamy, J., Gary, H. E., & Anderson, L. J. (2000). 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. Journal of Infectious Diseases, 181(5), 1755-1759. https://doi.org/10.1086/315457