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Going Viral-Ebola vaccine is having ‘major impact’ but Congo outbreak may still explode; pg12

 
Feistylorax

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05/31/2018 09:20 PM

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Nigeria is back to eating bush meat.
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06/01/2018 02:53 PM
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Nipah virus with para influenza backbone...Ebola is the distraction...
NawtyBits  (OP)

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06/01/2018 09:21 PM

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Nipah virus with para influenza backbone...Ebola is the distraction...
 Quoting: Anonymous Coward 76638177


h/t ronan kelly

[link to www.thehindu.com]

Anatomy of an outbreak

WWJBD-What Would Jimmy Buffett Do

"If it's wet and not yours, don't touch it." Oregon H1N1 Summit speaker
NawtyBits  (OP)

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06/01/2018 09:36 PM

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h/t crofsblog

[link to crofsblogs.typepad.com]

EBOLA DRC - Evolution of the response of the Ebola outbreak to Friday 01 June 2018

The Ministry of Health has published EBOLA DRC - Evolution of the response of the Ebola outbreak to Friday 01 June 2018. Excerpt from the Google translation:

EPIDEMIOLOGICAL SITUATION

Friday 01 June 2018


The Epidemiological Situation of Ebola Virus Disease on May 31, 2018:

• A total of 55 cases of haemorrhagic fever were reported in the region, including 37 confirmed, 13 probable and 5 suspected.

• 5 new suspected cases, including 3 in Bikoro and 2 in Wangata

• No new deaths reported this day.

Epidemiological analyses have identified contacts living in nearby health areas in Bikoro and Iboko. These contacts are followed and advised to limit their movements during the entire follow-up period of 21 days.

Comment: Wangata is in Mbandaka.
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NawtyBits  (OP)

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06/01/2018 09:40 PM

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Confirmed MERS cluster in Saudi Arabia.
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NawtyBits  (OP)

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06/01/2018 09:48 PM

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The WHO said health workers were following up on 3 separate transmission chains for cases in Mbandaka's Wangata neighborhood -- one linked to a funeral, one to a church, and another to a rural health facility.

[link to www.promedmail.org]
 Quoting: NawtyBits


There were 3 xmission chains in Wangata. I can't find where the three "escaped" from...Wangata?
WWJBD-What Would Jimmy Buffett Do

"If it's wet and not yours, don't touch it." Oregon H1N1 Summit speaker
NawtyBits  (OP)

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Re: Going Viral-Ebola vaccine is having ‘major impact’ but Congo outbreak may still explode; pg12
The WHO said health workers were following up on 3 separate transmission chains for cases in Mbandaka's Wangata neighborhood -- one linked to a funeral, one to a church, and another to a rural health facility.

[link to www.promedmail.org]
 Quoting: NawtyBits


There were 3 xmission chains in Wangata. I can't find where the three "escaped" from...Wangata?
 Quoting: NawtyBits


Or where the quarantined priest is from...
WWJBD-What Would Jimmy Buffett Do

"If it's wet and not yours, don't touch it." Oregon H1N1 Summit speaker
Crazy Harriet

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06/02/2018 09:02 AM
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Re: Going Viral-Ebola vaccine is having ‘major impact’ but Congo outbreak may still explode; pg12
Three separate chains of transmission? These were all community-acquired cases. Looks like the odds of success to contain this before a larger outbreak have become astronomical.

Thanks for keeping the news up to date, Nawty Bits.
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a
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Re: Going Viral-Ebola vaccine is having ‘major impact’ but Congo outbreak may still explode; pg12
A new report published in the Journal of Pineal Research states that an over-the-counter supplement might be one of our best defenses against the Ebola virus. Widely known as a remedy that encourages normal sleep-wake cycles, melatonin is readily available for purchase online or at local drug stores. And yet, researchers have long recognized that melatonin is far more than just a simple aid for sleep — it’s also a potent antioxidant and treatment for sepsis, a condition associated with Ebola virus infections. The supplement also targets other Ebola symptoms such as endothelial disruption, disseminated intravascular coagulation and multiple organ hemorrhage.


[link to www.jbbardot.com (secure)]

The National Institute of Health has just announced a potential treatment for the Ebola virus, and you WILL NOT believe what it is! With those who are following these things closely quite amazed that such a simple and readily available product could be used to effectively treat such a deadly disease, there is NO reason at all that Americans and people across the world COULDN’T get this potential treatment
[link to fromthetrenchesworldreport.com]

clinical trials to start in africa
[link to www.bmj.com (secure)]



There is currently an urgent need for a viable, cheap, and readily available treatment for the Ebola virus outbreak in West Africa. Here, it is proposed that melatonin may have significant utility in helping the management of this outbreak. Optimizing natural killer (NK) cell responses seems crucial to surviving Ebola virus infection. Melatonin increases NK cell cytotoxicity significantly, suggesting efficacy in managing the Ebola virus. Under conditions of challenge, melatonin increases heme oxygenase‐1 (HO‐1), which inhibits Ebola virus replication. Melatonin also has protective effects in cases of septic shock, which, although bacterial, has similar end‐point presentations involving blood vessel leakage. Melatonin's effects on haemorrhage are mediated primarily by a decrease in pro‐inflammatory cytokines. By optimizing the appropriate immune response, melatonin is likely to afford protection to those at high risk of Ebola viral infection, as well as having direct impacts on the course of infection per se. Although no direct data pertain to the utility of melatonin in the management of the Ebola virus, convergent bodies of data suggest its utility, which is reviewed in this article. J. Med. Virol. 87:537–543, 2015. © 2015 Wiley Periodicals, Inc
[link to onlinelibrary.wiley.com (secure)]
NawtyBits  (OP)

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Re: Going Viral-Ebola vaccine is having ‘major impact’ but Congo outbreak may still explode; pg12
h/t ronan kelly

[link to gis.cdc.gov (secure)]

The CDC has tracked 14,853 Influenza fatalities from Weeks 40-19

Comparison of confirmed CDC fatalities Weeks 40-18 with corresponding period from previous years (note figures for 2017-18 are preliminary and are likely to increase)

2017-18: 14,853
2016-17: 6,538
2015-16: 3,176
2014-15: 8,234
2013-14: 4,308
2012-13: 4,580
WWJBD-What Would Jimmy Buffett Do

"If it's wet and not yours, don't touch it." Oregon H1N1 Summit speaker
NawtyBits  (OP)

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[link to www.ndtv.com (secure)]

Fresh Nipah Outbreak Scare, Schools, Colleges To Stay Shut In Kozhikode Till June 12: 10 Points




1 "We are getting ready to tackle the second phase as there are chances that the virus has spread as it is contagious. We have imported materials to keep our hospital staff safe and we are even training them," Ms Shailaja said, adding there is no need to panic.

2 The state announced that schools in Kozhikode, Wayanad, Kannur & Malappuram districts will re-open on June 12.

3 The Kerala Public Service Commission has postponed all its written and online exams, scheduled to be held, till June 16.

4 The Kerala government announced several precautionary measures including the postponing of meetings and schedules

5 ...asked people to keep away from crowds...

6

7 After the death of a superintendent of a Kozhikode district court complex due to Nipah virus, the district bar association asked the collector to temporarily put operations on hold.

8

9

10 Of the 203 samples tested for Nipah, there have been 18 positive cases, of whom 16 died. There is one unconfirmed death and 17 suspected Nipah cases are under observation.
WWJBD-What Would Jimmy Buffett Do

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Anonymous Coward
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Re: Going Viral-Ebola vaccine is having ‘major impact’ but Congo outbreak may still explode; pg12
Something seems different about this Nipah outbreak....the numbers I have seen seem to indicate the testing method may be missing many positives and releasing them back to population as they falsely indicate negative test results. I am not sure of the current protocol for quarantine is for those who test positive or not.

Either way this outbreak may very well be the true one to watch..the most recent article by Bill Gates was about a similar scenario.
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Definitely just deleted my last post for four recent nipah exercises
MissCleo

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Re: Going Viral-Ebola vaccine is having ‘major impact’ but Congo outbreak may still explode; pg12
The WHO said health workers were following up on 3 separate transmission chains for cases in Mbandaka's Wangata neighborhood -- one linked to a funeral, one to a church, and another to a rural health facility.

[link to www.promedmail.org]
 Quoting: NawtyBits


There were 3 xmission chains in Wangata. I can't find where the three "escaped" from...Wangata?
 Quoting: NawtyBits


Wakanda.
MissCleo

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06/02/2018 09:55 PM

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Re: Going Viral-Ebola vaccine is having ‘major impact’ but Congo outbreak may still explode; pg12
h/t ronan kelly

[link to gis.cdc.gov (secure)]

The CDC has tracked 14,853 Influenza fatalities from Weeks 40-19

Comparison of confirmed CDC fatalities Weeks 40-18 with corresponding period from previous years (note figures for 2017-18 are preliminary and are likely to increase)

2017-18: 14,853
2016-17: 6,538
2015-16: 3,176
2014-15: 8,234
2013-14: 4,308
2012-13: 4,580
 Quoting: NawtyBits


more than double over last year.
this is that pattern before the Spanish Flu pandemic... right?
Feistylorax

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06/02/2018 11:01 PM

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Re: Going Viral-Ebola vaccine is having ‘major impact’ but Congo outbreak may still explode; pg12
h/t ronan kelly

[link to gis.cdc.gov (secure)]

The CDC has tracked 14,853 Influenza fatalities from Weeks 40-19

Comparison of confirmed CDC fatalities Weeks 40-18 with corresponding period from previous years (note figures for 2017-18 are preliminary and are likely to increase)

2017-18: 14,853
2016-17: 6,538
2015-16: 3,176
2014-15: 8,234
2013-14: 4,308
2012-13: 4,580
 Quoting: NawtyBits


more than double over last year.
this is that pattern before the Spanish Flu pandemic... right?
 Quoting: MissCleo


No, the 1918 pandemic was much much worse the first year.

You watch for the healthy young (20-30)to die. From things like Cyonosis.
I had to read this book for a pathophysiology class I highly suggest it. Not only for the Flu info but for understanding how badly governments mismanage things

[link to www.amazon.com (secure)]
“Unless someone like you cares a whole awful lot, Nothing is going to get better. It's not.”
Dr. Seuss, The Lorax

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NawtyBits  (OP)

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06/03/2018 11:26 AM

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Re: Going Viral-Ebola vaccine is having ‘major impact’ but Congo outbreak may still explode; pg12
h/t ronan kelly

[link to www.deccanchronicle.com (secure)]

Nipah virus: No more harm, says Doctor

Kozhikode: Allaying fears of Nipah virus causing more deaths in its second wave, Dr G. Arunkumar, the head of Manipal Centre of Virus Research (MCVR), on Saturday said it was unlikely. "We are anticipating a couple of cases from Balussery and Mukkam. That would be known in a week as the incubation period ends," he said during a media interaction.

Dr Arunkumar, who was among the first to reach the spot in Perambra after the outbreak, said that a timely and effective intervention had helped rein in the virus. "All the 18 tested positive, of which 16 have died, got it from the index case, Sabith, who died on May 5," he said. They contracted the virus from the index case at two points, Perambra Taluk Hospital and Kozhikode Medical College Hospital (KMCH). Several bystanders of others got infected from the narrow corridor of the radiology section at KMCH where the index case underwent scanning on May 5.

[snip]

ll have developed symptoms in 11/12 days except one, which went to 16 days." NiV will spread only from a patient in an aggravated stage. Respiratory problems, including a high cough, are the symptoms.

[snip]

The MCVR recommended mask and gloves for medics who attend to the ill and not the public.
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"If it's wet and not yours, don't touch it." Oregon H1N1 Summit speaker
NawtyBits  (OP)

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06/03/2018 11:35 AM

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h/t crofsblog

[link to timesofindia.indiatimes.com (secure)]

Mystery over Nipah virus source deepens
TNN | Updated: Jun 3, 2018, 10:54 IST

KOZHIKODE: The original source of the Nipah virus infection that killed 16 people in Kozhikode and Malappuram districts continues to be elusive as the samples of the fruit-eating bats and rabbit collected from the surrounding areas of Soopikkada at Chengaroth panchayat in Perambra tested negative on Saturday.

The samples comprising three fruit-eating bats,10 samples of urine and samples of urine, blood and nasal swab of rabbit reared at the home of Mohammed Sabith, who died of suspected NiV infection, were sent to the National Institute of High Security Animal Diseases Laboratory in Bhopal on May 30. District animal husbandry officer A C Mohandas said that the sent samples were negative.

Comment: Sabith is considered P0.
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NawtyBits  (OP)

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[link to www.firstpost.com (secure)]

Nipah virus: Kerala districts wear deserted look as 2,000 kept under observation; businesses strained, NRIs stranded


Over 1,000 people have been kept under quarantine, public services severely affected, schools closed and examinations postponed due to the Nipah virus scare that has rocked Kerala and the rest of the country since May.
WWJBD-What Would Jimmy Buffett Do

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Re: Going Viral-Ebola vaccine is having ‘major impact’ but Congo outbreak may still explode; pg12
Remember Contagion, the pandemic movie? MEV-1 was the fictional virus based on the Nipah virus. This is a big one to watch out for because the symptoms of coughing and sneezing make it easier to spread than Ebola. I would keep a close eye on this one. Every person that gets infected allows the chance for mutation. RNA viruses like Nipah seem to mutate often, and as it is very new to the scene we know very little about it compared to other viruses.

Also, bats harbor numerous other undiscovered nasties that could spill out into the human population.
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Bump for Nipah info....Seems another death was reported recently.
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Seems the incubation period is decently long, sources are saying up to 14 to 21 days as the longer period. The recent reports and deaths have only been about a week or so. Could this have merely been the first wave of cases? Fruit bats have a huge migration distance and it is spread over vast amounts of land. This makes them a prime candidate to spread the virus, which at some point could mutate to be transmitted easily between humans.

This next week could be very telling. We have only known about this virus since the mid-late 90's during an outbreak in Malaysia which killed around 100 people. Some studies suggest that the Nipah virus has shown much variability in outbreaks of the past, and certainly this outbreak, since it has been since 1998-99 that the last outbreak in Malaysia occurred. We still do not known which strain is impacting India...Here's the abstract from nature.

[link to www.nature.com (secure)]

"Nipah virus (NiV) is a paramyxovirus that causes severe disease in humans and animals. There are two distinct strains of NiV, Malaysia (NiVM) and Bangladesh (NiVB). Differences in transmission patterns and mortality rates suggest that NiVB may be more pathogenic than NiVM. To investigate pathogenic differences between strains, 4 African green monkeys (AGM) were exposed to NiVM and 4 AGMs were exposed to NiVB. While NiVB was uniformly lethal, only 50% of NiVM-infected animals succumbed to infection. Histopathology of lungs and spleens from NiVB-infected AGMs was significantly more severe than NiVM-infected animals. Importantly, a second study utilizing 11 AGMs showed that the therapeutic window for human monoclonal antibody m102.4, previously shown to rescue AGMs from NiVM infection, was much shorter in NiVB-infected AGMs. Together, these data show that NiVB is more pathogenic in AGMs under identical experimental conditions and suggests that postexposure treatments may need to be NiV strain specific for optimal efficacy."



From Wiki for background

Nipah virus outbreaks have been reported in Malaysia, Singapore, Bangladesh and India. The highest mortality due to Nipah virus infection has occurred in Bangladesh. In Bangladesh, the outbreaks are typically seen in winter season.[18] Nipah virus first appeared in Malaysia in 1998 in peninsular Malaysia in pigs and pig farmers. By mid-1999, more than 265 human cases of encephalitis, including 105 deaths, had been reported in Malaysia, and 11 cases of either encephalitis or respiratory illness with one fatality were reported in Singapore.[19] In 2001, Nipah virus was reported from Meherpur District, Bangladesh [20][21] and Siliguri, India.[20] The outbreak again appeared in 2003, 2004 and 2005 in Naogaon District, Manikganj District, Rajbari District, Faridpur District and Tangail District.[21] In Bangladesh, there were also outbreaks in subsequent years.[22][8]

And info about the Fruit bats migration....Pretty interesting.

But where do the bats go once the glut is over? In the 1980s, DW Thomas of Aberdeen University used sightings to estimate that these mammals travelled some 1,500km during the course of a year. But when Heidi monitored their movements, she discovered this to be a major underestimation.

She fitted four individuals with satellite-tracking collars, then plotted their movements on a map. She found that after their departure in December, her study bats had covered a whopping 1,000km in just one month. “They disappeared off the radar somewhere over the Democratic Republic of Congo (DRC),” says Heidi. “The collars could have been lost or damaged, or the bats eaten.”

However, previous data showed that one particular bat, named Hercules, had travelled 1,900km in six months. The DRC may not even have been his final destination – with a return trip to Kasanka later in the year, Hercules would have made a round trip of at least 3,800km, a staggering distance. The full route will not be known until more tracking studies are carried out.

For now, I’m content to enjoy the memory of the drama. As I retrace my steps out of the forest and leave the colony to settle, I think about the 2,500 tonnes of bat in the branches above me, and wonder which part of the continent they’ll head for next.

But where do the bats go once the glut is over? In the 1980s, DW Thomas of Aberdeen University used sightings to estimate that these mammals travelled some 1,500km during the course of a year. But when Heidi monitored their movements, she discovered this to be a major underestimation.

She fitted four individuals with satellite-tracking collars, then plotted their movements on a map. She found that after their departure in December, her study bats had covered a whopping 1,000km in just one month. “They disappeared off the radar somewhere over the Democratic Republic of Congo (DRC),” says Heidi. “The collars could have been lost or damaged, or the bats eaten.”

However, previous data showed that one particular bat, named Hercules, had travelled 1,900km in six months. The DRC may not even have been his final destination – with a return trip to Kasanka later in the year, Hercules would have made a round trip of at least 3,800km, a staggering distance. The full route will not be known until more tracking studies are carried out.

For now, I’m content to enjoy the memory of the drama. As I retrace my steps out of the forest and leave the colony to settle, I think about the 2,500 tonnes of bat in the branches above me, and wonder which part of the continent they’ll head for next.

Below is a map labeling their migration and habitats as well as outbreaks of the disease by WHO

[link to www.who.int]

With such densely populated areas on the map...It really demonstrates that this virus has been completely overlooked.
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Another very interesting article...

[link to www.thehindu.com]

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Return to frontpage What is the connection between fruit bats and Nipah virus?
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SCI-TECH HEALTH
The Hindu Explains: From fruit bats-Nipah link to monsoon onset
What is the connection between fruit bats and Nipah virus?
Priyanka Pulla MAY 26, 2018 19:48 IST
UPDATED: MAY 26, 2018 21:16 IST
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A Rodrigues Fruit Bat.
A Rodrigues Fruit Bat. | Photo Credit: AFP

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The Hindu Explains
Nipah Virus
What is it?
As the name suggests, fruit bats, or Pteropodidae, are a bat family that eats fruit. Since the Nipah virus broke out in Kozhikode, Kerala, fruit bats have attracted attention as the wildlife reservoir for the virus. This means the virus survives in the bat’s body without causing disease, allowing it to jump to susceptible mammals like humans or pigs, when bats come in contact with them. Such contact is becoming increasingly frequent as agriculture and urbanisation destroy bat habitats, forcing them into human dwellings. In the world’s first Nipah outbreak, which occurred in 1998 in Malaysia, virologists isolated the virus from the urine of the Island Flying Fox, a fruit bat species. In Bangladeshi outbreaks, researchers found antibodies to Nipah in the Indian flying fox.

This is why, when a bat colony was spotted in a well at the home of Kozhikode’s first Nipah victim, virologists zeroed in on these mammals as a possible source of infection. However, things have not been as straightforward as expected. When animal husbandry officials collected bats from the well, they only found the insect-eating kind, which belong to a different family. There is some evidence that insectivorous bats can host Nipah, but they have not been connected with human infections so far, says Jonathan Epstein, an epidemiologist studying the virus at the U.S.-based EcoHealth Alliance. So, Kerala’s animal husbandry officials are scanning the region for other fruit bats in the hope of finding the wildlife reservoir.
Why does it matter?

Identifying the source of the Nipah infection will help prevent future spread. In the Kozhikode epidemic, the virus seems to have moved from bats to humans in one “spillover” event. After this, it moved from one human to another.
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Keep in mind, that some of the outbreaks infected large amount of pigs. Which as mammals they have more similar respiratory tracts to use and they develop the virus in a rather close manner to humans.
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Article for H2H transmission. About the Bangladeshi strain of the virus...

[link to www.ncbi.nlm.nih.gov (secure)]

Discussion
This investigation provides compelling evidence for person-to-person transmission of Nipah virus. Exposure histories of infected patients and the epidemiologic curve, which demonstrates multiple peaks of illness onset during this outbreak, suggest that Nipah virus was transmitted by person-to-person contact. Contact tracing documented Nipah virus illness after brief, yet close contact, with other persons infected with Nipah virus. Findings from the case-control study, which showed a 6-fold increased risk for infection for those who reported contact with patient F, a negative association with illness after handwashing, and specific exposures to ill persons linked to transmission, confirm that exposure to ill persons spread the outbreak.

Person-to-person transmission of Nipah virus is biologically plausible. Other paramyxoviruses that infect humans, including human parainfluenza viruses 1–4, measles virus, and mumps virus, are also transmitted from person to person. Nipah virus has been isolated from human respiratory secretions, including those of cases from this outbreak (2,23). Furthermore, we identified that direct exposure to respiratory secretions of patients with Nipah virus illness was associated with infection during this outbreak.
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And due to the relatively close proximity to Bangladesh. One could easily assume, although not yet prove that the strain found in Kerala is the Bangladeshi strain.
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Last post comes from NYT and is pretty interesting to say the least.

If the virus were to spread outside India, it would likely appear first in Dubai, where many Indians work, according to an analysis of flight patterns conducted by the EcoHealth Alliance, a nonprofit research group.

Among United States airports, an infected traveler would likely arrive first at John F. Kennedy Airport.

“The goal of mapping scenarios out is not to create panic. It’s to get countries ready,” said Dr. Peter Daszak, the president of the alliance. “This virus will get better and better at spreading — that’s what we’re up against. We need to be ahead of the curve.”
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21 Days ends on around the 9th or 10th of June...Be prepared for more of those "suspected" cases to go in the positive category. Latest chart showed roughly 30, nearly double the previous amount.
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Sorry just too interesting to stop from digging...

[link to www.ndtv.com (secure)]

KERALA: With a Nipah outbreak in Kerala since around two weeks, the carrier of the virus is yet to be identified.

The latest 13 samples of fruit bats sent to National Institute of High Security Animal Diseases have all tested negative. Samples of rabbits that were sent have also tested negative. This is the second set of samples that were sent for testing. The first set included samples of pigs, goats, cattle and insect bats, which were tested negative.
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Re: Going Viral-Ebola vaccine is having ‘major impact’ but Congo outbreak may still explode; pg12
Nawty, Feisty, I want to hear from you two on this...Please respond with comments when you get back...Article on common testing methods for the virus and potential for false positive results, even with genetic strains we are aware of yet alone variations from pre-existing strains....

[link to www.nature.com (secure)]

ELISA-based screening assays, although efficient, can yield high false positive and false negative rates compared with functional seroneutralization (SN) assays19. Thus, whenever possible, ELISA/Luminex-positive samples are confirmed by a SN assay. Although SN assays are considered a gold standard for seroprevalence studies19,20,21, follow-up confirmation with live virus SN assays is limited by the amount of sample available, and the requirement to work with live HNV in a high-containment facility (BSL-4). Consequently, in many prior studies only ELISA/Luminex-positive samples, and often only a small subset such as those with the highest binding activity, were confirmed with a biological or surrogate SN assay (reviewed in LF Wang et al.21; for example, AJ Peel et al.22). The latter is based on serum antibody competition of soluble receptor (sEphrinB2-Fc) binding to recombinant NiV-G or HeV-G conjugated to Luminex beads18. Although these procedures can guard against false positives, they do not address the loss of potential false negatives10,13,14.





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