Clinical presentation of Nipah virus infection in Bangladesh

M. Jahangir Hossain, Emily S. Gurley, Joel M. Montgomery, Michael Bell, Darin S. Carroll, Vincent P. Hsu, P. Formenty, A. Croisier, E. Bertherat, M. A. Faiz, Abul Kalam Azad, Rafiqul Islam, M. Abdur Rahim Molla, Thomas Ksiazek, Paul A. Rota, James A. Comer, Pierre E. Rollin, Stephen P. Luby, Robert F. Breiman

Research output: Contribution to journalArticle

138 Citations (Scopus)

Abstract

Background. In Bangladesh, 4 outbreaks of Nipah virus infection were identified during the period 2001-2004. Methods. We characterized the clinical features of Nipah virus-infected individuals affected by these outbreaks. We classified patients as having confirmed cases of Nipah virus infection if they had antibodies reactive with Nipah virus antigen. Patients were considered to have probable cases of Nipah virus infection if they had symptoms consistent with Nipah virus infection during the same time and in the same community as patients with confirmed cases. Results. We identified 92 patients with Nipah virus infection, 67 (73%) of whom died. Although all age groups were affected, 2 outbreaks principally affected young persons (median age, 12 years); 62% of the affected persons were male. Fever, altered mental status, headache, cough, respiratory difficulty, vomiting, and convulsions were the most common signs and symptoms; clinical and radiographic features of acute respiratory distress syndrome of Nipah illness were identified during the fourth outbreak. Among those who died, death occurred a median of 6 days (range, 2-36 days) after the onset of illness. Patients who died were more likely than survivors to have a temperature >37.8°C, altered mental status, difficulty breathing, and abnormal plantar reflexes. Among patients with Nipah virus infection who had well-defined exposure to another patient infected with Nipah virus, the median incubation period was 9 days (range, 6-11 days). Conclusions. Nipah virus infection produced rapidly progressive severe illness affecting the central nervous and respiratory systems. Clinical characteristics of Nipah virus infection in Bangladesh, including a severe respiratory component, appear distinct from clinical characteristics reported during earlier outbreaks in other countries.

Original languageEnglish (US)
Pages (from-to)977-984
Number of pages8
JournalClinical Infectious Diseases
Volume46
Issue number7
DOIs
StatePublished - Apr 1 2008
Externally publishedYes

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Nipah Virus
Bangladesh
Virus Diseases
Disease Outbreaks
Primary Headache Disorders
Abnormal Reflexes
Adult Respiratory Distress Syndrome
Respiratory System
Signs and Symptoms
Vomiting
Survivors

ASJC Scopus subject areas

  • Immunology

Cite this

Hossain, M. J., Gurley, E. S., Montgomery, J. M., Bell, M., Carroll, D. S., Hsu, V. P., ... Breiman, R. F. (2008). Clinical presentation of Nipah virus infection in Bangladesh. Clinical Infectious Diseases, 46(7), 977-984. https://doi.org/10.1086/529147

Clinical presentation of Nipah virus infection in Bangladesh. / Hossain, M. Jahangir; Gurley, Emily S.; Montgomery, Joel M.; Bell, Michael; Carroll, Darin S.; Hsu, Vincent P.; Formenty, P.; Croisier, A.; Bertherat, E.; Faiz, M. A.; Azad, Abul Kalam; Islam, Rafiqul; Molla, M. Abdur Rahim; Ksiazek, Thomas; Rota, Paul A.; Comer, James A.; Rollin, Pierre E.; Luby, Stephen P.; Breiman, Robert F.

In: Clinical Infectious Diseases, Vol. 46, No. 7, 01.04.2008, p. 977-984.

Research output: Contribution to journalArticle

Hossain, MJ, Gurley, ES, Montgomery, JM, Bell, M, Carroll, DS, Hsu, VP, Formenty, P, Croisier, A, Bertherat, E, Faiz, MA, Azad, AK, Islam, R, Molla, MAR, Ksiazek, T, Rota, PA, Comer, JA, Rollin, PE, Luby, SP & Breiman, RF 2008, 'Clinical presentation of Nipah virus infection in Bangladesh', Clinical Infectious Diseases, vol. 46, no. 7, pp. 977-984. https://doi.org/10.1086/529147
Hossain MJ, Gurley ES, Montgomery JM, Bell M, Carroll DS, Hsu VP et al. Clinical presentation of Nipah virus infection in Bangladesh. Clinical Infectious Diseases. 2008 Apr 1;46(7):977-984. https://doi.org/10.1086/529147
Hossain, M. Jahangir ; Gurley, Emily S. ; Montgomery, Joel M. ; Bell, Michael ; Carroll, Darin S. ; Hsu, Vincent P. ; Formenty, P. ; Croisier, A. ; Bertherat, E. ; Faiz, M. A. ; Azad, Abul Kalam ; Islam, Rafiqul ; Molla, M. Abdur Rahim ; Ksiazek, Thomas ; Rota, Paul A. ; Comer, James A. ; Rollin, Pierre E. ; Luby, Stephen P. ; Breiman, Robert F. / Clinical presentation of Nipah virus infection in Bangladesh. In: Clinical Infectious Diseases. 2008 ; Vol. 46, No. 7. pp. 977-984.
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abstract = "Background. In Bangladesh, 4 outbreaks of Nipah virus infection were identified during the period 2001-2004. Methods. We characterized the clinical features of Nipah virus-infected individuals affected by these outbreaks. We classified patients as having confirmed cases of Nipah virus infection if they had antibodies reactive with Nipah virus antigen. Patients were considered to have probable cases of Nipah virus infection if they had symptoms consistent with Nipah virus infection during the same time and in the same community as patients with confirmed cases. Results. We identified 92 patients with Nipah virus infection, 67 (73{\%}) of whom died. Although all age groups were affected, 2 outbreaks principally affected young persons (median age, 12 years); 62{\%} of the affected persons were male. Fever, altered mental status, headache, cough, respiratory difficulty, vomiting, and convulsions were the most common signs and symptoms; clinical and radiographic features of acute respiratory distress syndrome of Nipah illness were identified during the fourth outbreak. Among those who died, death occurred a median of 6 days (range, 2-36 days) after the onset of illness. Patients who died were more likely than survivors to have a temperature >37.8°C, altered mental status, difficulty breathing, and abnormal plantar reflexes. Among patients with Nipah virus infection who had well-defined exposure to another patient infected with Nipah virus, the median incubation period was 9 days (range, 6-11 days). Conclusions. Nipah virus infection produced rapidly progressive severe illness affecting the central nervous and respiratory systems. Clinical characteristics of Nipah virus infection in Bangladesh, including a severe respiratory component, appear distinct from clinical characteristics reported during earlier outbreaks in other countries.",
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AU - Montgomery, Joel M.

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AU - Carroll, Darin S.

AU - Hsu, Vincent P.

AU - Formenty, P.

AU - Croisier, A.

AU - Bertherat, E.

AU - Faiz, M. A.

AU - Azad, Abul Kalam

AU - Islam, Rafiqul

AU - Molla, M. Abdur Rahim

AU - Ksiazek, Thomas

AU - Rota, Paul A.

AU - Comer, James A.

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AU - Luby, Stephen P.

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N2 - Background. In Bangladesh, 4 outbreaks of Nipah virus infection were identified during the period 2001-2004. Methods. We characterized the clinical features of Nipah virus-infected individuals affected by these outbreaks. We classified patients as having confirmed cases of Nipah virus infection if they had antibodies reactive with Nipah virus antigen. Patients were considered to have probable cases of Nipah virus infection if they had symptoms consistent with Nipah virus infection during the same time and in the same community as patients with confirmed cases. Results. We identified 92 patients with Nipah virus infection, 67 (73%) of whom died. Although all age groups were affected, 2 outbreaks principally affected young persons (median age, 12 years); 62% of the affected persons were male. Fever, altered mental status, headache, cough, respiratory difficulty, vomiting, and convulsions were the most common signs and symptoms; clinical and radiographic features of acute respiratory distress syndrome of Nipah illness were identified during the fourth outbreak. Among those who died, death occurred a median of 6 days (range, 2-36 days) after the onset of illness. Patients who died were more likely than survivors to have a temperature >37.8°C, altered mental status, difficulty breathing, and abnormal plantar reflexes. Among patients with Nipah virus infection who had well-defined exposure to another patient infected with Nipah virus, the median incubation period was 9 days (range, 6-11 days). Conclusions. Nipah virus infection produced rapidly progressive severe illness affecting the central nervous and respiratory systems. Clinical characteristics of Nipah virus infection in Bangladesh, including a severe respiratory component, appear distinct from clinical characteristics reported during earlier outbreaks in other countries.

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