Unani perspective regarding Nipah Virus (NiV) Infection

Unani perspective regarding Nipah Virus (NiV) Infection

Introduction

Nipah virus (NiV) is one of the newly emerging zoonosis (a disease that can spread from animals to humans). It is highly Infectious as there is no passive immunity for both human as well as animals. It is a fatal virus that causes severe disease in both animals and humans. The natural host of this virus are fruit bats of the Pteropodidae family, but there have been cases where pigs as well as some other domestic animals can be the host to this virus. It is a highly communicable virus which currently has no treatment.

Nipah virus is an RNA virus that is part of the Paramyxovidae family. It was first identified as a zoonotic pathogen after an outbreak involving severe respiratory illness in pigs and encephalitic disease in humans in Malaysia and Singapore in 1998 and 1999. NiV can cause a range of mild to severe disease in domestic animals such as pigs.

The case fatality rate is estimated about 40% to 75%. However, this rate can vary by outbreak depending on local capabilities for epidemiological surveillance and clinical management of the disease. Most people who survive acute encephalitis make a full recovery, but long term neurologic conditions have been reported in survivors. 

Signs and symptoms of Nipah Virus (NiV)

  • Sustained fever, headache and myalgia
  • Pain in stomach and vomiting
  • Mental confusion and disorientation 
  • Respiratory issues like sore throat, atypical pneumonia and severe respiratory problems including acute respiratory distress.
  • Dizziness, drowsiness and altered consciousness
  • Persistent convulsions and personality changes
  • Encephalitis and seizures occur in severe cases, progressing to coma within 24 to 48 hours. 

Transmission of Nipah Virus (NiV)

In Unani System of Medicine this type of fever comes under the heading of “Humma-e- Wabaiya” (epidemic fever)Transmission of Nipah virus (NiV) can happen on direct contact with infected fruit bats especially of the Pteropodidae family, infected pigs or from other Nipah virus infected people. In earlier outbreaks of the Nipah virus infection in India and Bangladesh, people to people transmission has been frequently reported. It has been commonly seen in the family and caregivers of Nipah virus infected patients. A potentially high occurrence reason identified from the Kerala outbreak is consumption of mango contaminated with infectious bat (Fruit bat) excretions.

Nipah Virus (NiV) Precautions & Prevention

  • Nipa Virus is a persistent virus, which sustains from 5 to 14 days.  Efforts to prevent transmission should first focus on decreasing bat access to date palm sap and to other fresh food products.
  • Keeping bats away from sap collection sites with protective coverings (e.g., bamboo sap skirts) may be helpful.
  • Freshly collected date palm juice should be boiled and fruits should be thoroughly washed and peeled before consumption.
  • Gloves and other protective clothing should be worn while handling sick animals or their tissues, and during slaughtering and culling procedures. As much as possible, people should avoid being in contact with infected pigs.
  • Close unprotected physical contact with Nipah virus infected people should be avoided.
  • Regular hand washing should be carried out after caring for or visiting sick people.
  • Health-care workers caring for patients with suspected or confirmed NiV infection, or handling specimens from them, should implement standard infection control precautions for all patients at all times
  • As human-to-human transmission in particular nosocomial transmission have been reported, contact and droplet precautions should be used in addition to standard precautions.
  • Samples taken from people and animals with suspected NiV infection should be handled by trained staff working in suitably equipped laboratories.

Dos and Don’ts

  • Avoid contact with pigs and pig handlers bats and horses.
  • Maintain personal hygiene and promote intensive hand washing practices
  • Avoid buying or eating vegetables and fruits at unhygienic places or fruits fallen on the ground.
  • Avoid consuming raw fruits. Before consuming fruits, they must be washed thoroughly and peeled or cooked properly.
  • Till the outbreak of the disease settles down, consume only well-cooked, clean homemade food.
  • Always drink pasteurized juices
  • Use N95 mask preferably, while travelling or working in public places to avoid person to person transmission of NiV infection.
  • Laboratory staff and healthcare workers should wear protective clothing, goggles, masks, impermeable gloves and boots to avoid contact with potentially infected animals
  • Try to avoid exposure to external environment.
  • NiV infected Patients should be isolated and barrier nursing should be used while caring them.

Fumigation with Unani medicine

  1. Fumigation with Sandal Safaid/ Sandal Zard (Santalum album Linn.), Kafoor (Cinnamomum camphora (Linn.) J. Presl), Barg-e- Bed (Leaves of Salix alba), Post-e- Anar (Peel of Punica granatum Linn.), Abnoos (Diospyros ebenum), Murad (Myrtus communis Linn.) and Darunaj (Dornoicum hookeri).
  2. Fumigation with Qust (Saussurea hypoleuca Spreng.), Meah saaila (Altingia excelsa Noronha), Kundur (Boswellia serrata), Sandal Safaid/ Sandal Zard (Santalum album Linn.), Ood Hindi/ Agar (Aquilaria malaccensis Lam.), Murr (Commiphora myrrha) and Kafoor (Cinnamomum camphora (Linn.) J. Presl).

Prophylactic Measures

Following measures may provide prophylaxis from the infection in outbreaks of the NiV infection:

  • Use of Immune modulatory drugs: Some Unani compound immno modulators are:
    • Mufarreh Baarid in 5-10gm dose
    • Khamira Marwareed in 3-5 gm dose
    • Dawa-ul- Misk Baarid in 7gm dose
    • Tiryaaq-e- Farooq in 875 mg dose
  • Use of concentrated extracts of apple, pomegranate and lemon in the diet
  • Use of vinegar is very effective in the diet
  • Oral administration of Barley water (Ma’al-Sha‘ir )
  • Oral administration of mixture of vinegar and water
  • Sprinkle of a mixture of vinegar and water in the house
  • Hijamah (Cupping) on calf muscle is also very effective
  • Oral administration of a specific powder prepared with Elwa (Aloe barbadensis Mill.) -2 parts, Z’afran (Crocus sativus Linn.) -1part, Murr makki (Commiphora myrrha) -1 part in the dose of 5gm along with Sharaab Raihani

Management of the symptoms: The following measures and drugs may prove useful in NiV disease

  • To curb infection
  • Inhalation with Ambar (Ambergris), Fad Zahar (Serpent stone), Araq-e- Gulab (Rose water), Kafoor (Cinnamomum camphora (Linn.) J. Presl) and Sandal Safaid/ Sandal Zard (Santalum album Linn.)
  • Inhalation with Sandal Safaid/ Sandal Zard (Santalum album Linn.), Kafoor (Cinnamomum camphora (Linn.) J. Presl), vinegar and Araq-e- Gulab (Rose water). The same formulation may be prepared as a paste and applied on chest.

Oral administration of decoction of Gul-i Surkh (Rosa damascena Mill.)-105gm, Gulqand-70gm, and Araq-i Gulab (Rose water)-175 gm along with Roghan-i Gul-35 gm.

  • To reduce fever
  • Qurs-e- Kafoor with Sharbat-e- Lemun (As advised)
  • Habb-e- Bukhaar (500 mg-1gm dose)
  • Habb-e- Zahar Mohra (250- 500 mg dose)
  • Qurs Tabashir (500 mg -1gm dose)
  • To ease expectoration
  • La’ooq Katan
  • La’ooq Khayar Shamber
  • Sharbat-e- Banafsha
  • Avoid meat in the diet
  • Take easily digestible diets

Note:

  • Along with medicine the patients have to follow strict regimen as per the concept of Unani system of medicine. The patients are therefore, strongly advised to avoid self-medication.
  • They are advised to visit the nearest authorized Unani treatment centre for advice and treatment.

 

  • PUBLISHED DATE : Jun 07, 2018
  • PUBLISHED BY : NHP Admin
  • CREATED / VALIDATED BY : Dr. Mahtab Alam Khan
  • LAST UPDATED ON : Jun 07, 2018

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