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Nipah virus and other emerging infections

A brief guide to some important emerging infections and their impact in Bangladesh.

Nipah virus was first discovered in 1998 in Malaysia and was first seen in Bangladesh in 2001.
Nipah virus infection causes potentially lethal inflammation of the brain (encephalitis); in Bangladesh, about three-quarters of those infected with Nipah virus have died.
Since 2001,outbreaks of Nipah virus encephalitis have occurred nearly annually in Bangladesh and India.¹
During 2001–14, 248 Nipah virus infections were reported in Bangladesh
Nipah virus is usually transmitted by bats, but it can also be spread from one infected person to another.
In Bangladesh, Nipah virus is usually acquired through consumption of date palm sap contaminated with bat saliva or urine.

Highly pathogenic H5N1 avian influenza was first detected in Bangladesh in poultry in 2007.
As of 2019, eight human infections with H5N1 avian influenza have been confirmed in Bangladesh, with one death.^2,3
H5N1 is endemic within poultry in Bangladesh.
Three cases of H9N2 avian influenza, which causes a mild disease, have been detected in Bangladesh.⁴

Dengue virus is spread by mosquitoes and can cause high fever, severe headache, and pain behind the eyes, in muscle and in joints.
Dengue occurred sporadically in Bangladesh from the 1960s to 2000, when a large epidemic established it within the country.
The largest dengue epidemic occurred in 2002, when 6,132 cases and around 60 deaths were reported.⁵
The number of recorded cases is now much lower, but many infections are likely to be unrecorded; the Global Burden of Disease 2019 study estimated there were 1.48 million symptomatic dengue infections in Bangladesh during 2019.
Globally, there were around 57 million symptomatic episodes and approximately 36,055 died of the disease in 2019; however, most cases are mild.^6,7

Chikungunya virus is transmitted by mosquitoes and causes fever and joint pain.
Chikungunya virus was first identified in Tanzania in 1952; the first recorded outbreak in Bangladesh occurred in 2008.
A further small outbreak occurred in 2011, and evidence of Chikungunya infection was found in analysis of blood samples from people living in Dhaka in 2014.
A large outbreak occurred in 2017, with more 13,000 confirmed cases in Dhaka alone.⁸

Anthrax (‘Torka’) is an infection caused by the bacterium Bacillus anthracis; most infections are skin lesions, although the bacterium can infect the lungs, intestine and bloodstream.
Anthrax is spread through exposure to Bacillus anthracis spores; it is usually caught following exposure to infected animals – it does not normally spread from person to person.
Since 2009, 2400 cases of human anthrax had been reported⁹, but many more cases probably go unreported.
Anthrax is probably endemic in Bangladesh livestock; the disease is most prevalent in Sirajganj(site of an anthrax outbreak in 2016) and nearby districts

MERS-CoV is a novel virus causing severe respiratory disease, first identified in Saudi Arabia in 2012.
As of 2022, 2,591 cases laboratory-confirmed cases have been reported globally, causing 894 deaths have been reported.¹⁰
MERS-CoV has not been detected in Bangladesh; a possible infection reported in 2014 was later found to be a false alarm.