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Fatal encephalitis due to Nipah virus among pig-farmers in Malaysia

K B Chua1, K J Goh, K T Wong

  • 1Department of Medical Microbiology, University of Malaya, Kuala Lumpur, Malaysia.

Lancet (London, England)
|October 16, 1999
PubMed
Abstract

Insights

A novel paramyxovirus, related to Hendra virus, caused a fatal encephalitis outbreak in Malaysian pig farmers. This Hendra-like virus transmission likely occurred through close contact with infected pigs.

Area of Science:

  • Virology
  • Neurology
  • Epidemiology

Background:

  • An outbreak of viral encephalitis occurred among pig farmers in Malaysia between February and April 1999.
  • This report details the findings for the first three fatal cases.

Observation:

  • Patients presented with fever, headache, altered consciousness, myoclonus, and signs of brainstem dysfunction.
  • Clinical deterioration was rapid, leading to hypotension and death.
  • Necropsy revealed widespread central nervous system microinfarction due to vasculitis-induced thrombosis.

Findings:

  • A syncytial-forming virus was isolated from cerebrospinal fluid (CSF) and identified as related to Hendra virus via immunofluorescence.
  • All three patients had CSF IgM antibodies against Hendra viral antigens.
  • Inclusion bodies suggestive of viral origin were observed in neurons near affected blood vessels.

Implications:

  • The causative agent was a novel paramyxovirus, distinct from Hendra virus, likely transmitted from pigs.
  • This outbreak highlights a new zoonotic viral encephalitis with significant mortality.
  • Understanding this Hendra-like virus is crucial for preventing future outbreaks.

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