Cluster of Nipah virus infection, Kushtia District, Bangladesh, 2007.
OBJECTIVE
In March 2007, we investigated a cluster of Nipah encephalitis to identify risk factors for Nipah infection in Bangladesh.


METHODS
We defined confirmed Nipah cases by the presence of IgM and IgG antibodies against Nipah virus in serum. Case-patients, who resided in the same village during the outbreak period but died before serum could be collected, were classified as probable cases.


RESULTS
We identified three confirmed and five probable Nipah cases. There was a single index case. Five of the secondary cases came in close physical contact to the index case when she was ill. Case-patients were more likely to have physical contact with the index case (71% cases versus 0% controls, p = <0.001). The index case, on her third day of illness, and all the subsequent cases attended the same religious gathering. For three probable cases including the index case, we could not identify any known risk factors for Nipah infection such as physical contact with Nipah case-patients, consumption of raw date palm juice, or contact with sick animals or fruit bats.


CONCLUSIONS
Though person-to-person transmission remains an important mode of transmission for Nipah infection, we could not confirm the source of infection for three of the probable Nipah case-patients. Continued surveillance and outbreak investigations will help better understand the transmission of Nipah virus and develop preventive strategies.
International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh. nhomaira@icddrb.org
Nusrat
N
Homaira
Mahmudur
M
Rahman
M Jahangir
MJ
Hossain
Nazmun
N
Nahar
Rasheda
R
Khan
Mostafizur
M
Rahman
Goutam
G
Podder
Kamrun
K
Nahar
Dawlat
D
Khan
Emily S
ES
Gurley
Pierre E
PE
Rollin
James A
JA
Comer
Thomas G
TG
Ksiazek
Stephen P
SP
Luby
D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D016022:Case-Control Studies; D045464:Henipavirus Infections / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D007075:Immunoglobulin M / Q000276:immunology; D008875:Middle Aged; D045405:Nipah Virus / Q000302:isolation & purification*
D007074:Immunoglobulin G; D007075:Immunoglobulin M