title: Person-to-person transmission of Nipah virus in a Bangladeshi community.
abstract: An encephalitis outbreak was investigated in Faridpur District, Bangladesh, in April-May 2004 to determine the cause of the outbreak and risk factors for disease. Biologic specimens were tested for Nipah virus. Surfaces were evaluated for Nipah virus contamination by using reverse transcription-PCR (RT-PCR). Thirty-six cases of Nipah virus illness were identified; 75% of case-patients died. Multiple peaks of illness occurred, and 33 case-patients had close contact with another Nipah virus patient before their illness. Results from a case-control study showed that contact with 1 patient carried the highest risk for infection (odds ratio 6.7, 95% confidence interval 2.9-16.8, p < 0.001). RT-PCR testing of environmental samples confirmed Nipah virus contamination of hospital surfaces. This investigation provides evidence for person-to-person transmission of Nipah virus. Capacity for person-to-person transmission increases the potential for wider spread of this highly lethal pathogen and highlights the need for infection control strategies for resource-poor settings.
authors.affiliation: Program on Infectious Diseases and Vaccine Sciences, ICDDR,B, Dhaka, Bangladesh. egurley@icddrb.org
authors.forename: Emily S
authors.initials: ES
authors.lastname: Gurley
authors.forename: Joel M
authors.initials: JM
authors.lastname: Montgomery
authors.forename: M Jahangir
authors.initials: MJ
authors.lastname: Hossain
authors.forename: Michael
authors.initials: M
authors.lastname: Bell
authors.forename: Abul Kalam
authors.initials: AK
authors.lastname: Azad
authors.forename: Mohammed Rafiqul
authors.initials: MR
authors.lastname: Islam
authors.forename: Mohammed Abdur Rahim
authors.initials: MA
authors.lastname: Molla
authors.forename: Darin S
authors.initials: DS
authors.lastname: Carroll
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Ksiazek
authors.forename: Paul A
authors.initials: PA
authors.lastname: Rota
authors.forename: Luis
authors.initials: L
authors.lastname: Lowe
authors.forename: James A
authors.initials: JA
authors.lastname: Comer
authors.forename: Pierre
authors.initials: P
authors.lastname: Rollin
authors.forename: Markus
authors.initials: M
authors.lastname: Czub
authors.forename: Allen
authors.initials: A
authors.lastname: Grolla
authors.forename: Heinz
authors.initials: H
authors.lastname: Feldmann
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Luby
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Woodward
authors.forename: Robert F
authors.initials: RF
authors.lastname: Breiman
mesh_terms: D000293:Adolescent; D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D021821:Communicable Diseases, Emerging / Q000453:epidemiology / Q000401:mortality / Q000635:transmission*; D016001:Confidence Intervals; D016358:Contact Tracing; D003428:Cross Infection / Q000453:epidemiology / Q000401:mortality / Q000635:transmission*; D004196:Disease Outbreaks; D018562:Disease Transmission, Infectious; D018792:Encephalitis, Viral / Q000453:epidemiology / Q000401:mortality / Q000635:transmission*; D004783:Environmental Microbiology; D005260:Female; D045464:Henipavirus Infections / Q000453:epidemiology / Q000401:mortality / Q000635:transmission*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D045405:Nipah Virus / Q000302:isolation & purification*; D016017:Odds Ratio; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors