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The Main Risk Factors of Nipah Disease and Its Risk Analysis in China

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The Main Risk Factors of Nipah Disease and Its Risk Analysis in China viruses Review The Main Risk Factors of Nipah Disease and Its Risk Analysis in China Jiarong Yu 1, Xinbo Lv 1, Zijun Yang 1, Shengbin Gao 1, Changming Li 1, Yumei Cai 1,* and Jinming Li 2,* 1 Shandong Provincial Key Laboratory of Animal Biotechnology and Disease Control and Prevention, Shandong Agricultural University, 61 Daizong Street, Taian 271018, China; [email protected] (J.Y.); [email protected] (X.L.); [email protected] (Z.Y.); [email protected] (S.G.); [email protected] (C.L.) 2 China Center for Animal Health and Epidemiology, Qingdao 266000, China * Correspondence: [email protected] (Y.C.); [email protected] (J.L.); Tel.: +86-13053827753 (Y.C.) Received: 31 August 2018; Accepted: 12 October 2018; Published: 19 October 2018 Abstract: Nipah disease is a highly fatal zoonosis which is caused by the Nipah virus. The Nipah virus is a BSL-4 virus with fruit bats being its natural host. It is mainly prevalent in Southeast Asia. The virus was first discovered in 1997 in Negeri Sembilan, Malaysia. Currently, it is mainly harmful to pigs and humans with a high mortality rate. This study describes the route of transmission of the Nipah virus in different countries and analyzes the possibility of the primary disease being in China and the method of its transmission to China. The risk factors are analyzed for different susceptible populations to Nipah disease. The aim is to improve people’s risk awareness and prevention and control of the disease and reduce its risk of occurring and spreading in China. Keywords: Nipah virus; fruit bat; transmission route; risk analysis 1. Introduction 1.1. Virus Characteristics The Nipah virus (NiV) belongs to the paramyxovirus family and the Henipavirus genus. In addition to thia, the Henipavirus genus also has four virus members: the Cedar virus (CedV), Kumasi virus (KV), Mòjiang¯ virus (MojV) and Hendra virus (HeV) [1,2]. Due to its ease of transmission and high lethality, the World Organisation for Animal Health (OIE) lists Nipah as a Biosafety Protection Level 4 (BSL-4), and the US Center for Disease Control and Prevention (CDC), and the National Institute of Allergy and Infectious Diseases (NIAID) list it as a Class C priority pathogen [3]. Henipaviruses are lipid-encapsulated viruses that form spherical to polymorphic, sometimes filamentous, particles. Wrapped in the virus particles is the filamentous nucleocapsid, which is made of viral RNA and nucleoproteins, and is associated with the RNA-dependent RNA polymerase and phosphoprotein [4] The diameter of an entangled filamentous nucleocapsids is about 1.9 µm, and the length of the envelope membrane about 17 nm [5]. The NiV genome has six structural genes. From the 3 ‘end, N proteins (nuclear proteins), P proteins (phospho-proteins), M proteins (matrix proteins), F proteins (fusion proteins), G proteins (glycoproteins) and L proteins (large proteins) are coded sequentially, and between each two genes, there is a non-coding region [6]. Among them, phospho-proteins are the largest proteins and are encoded by the P gene of HeV and NiV. In addition to phospho-proteins, the P gene also encodes the V and C proteins. The P gene of HeV also has a small ORF (the open reading frame) located between the coding regions of the C and V proteins which is used to encode basic proteins such as the SB protein (a short basic protein). However, this ORF is not Viruses 2018, 10, 572; doi:10.3390/v10100572 www.mdpi.com/journal/viruses Viruses 2018, 10, x FOR PEER REVIEW 2 of 12 usedViruses to2018 encode, 10, 572 basic proteins such as the SB protein (a short basic protein). However, this ORF is2 not of 12 found in NiV [7,8]. The main cellular targets of NiV are microvascular endothelial cells, epithelial cells,found and in NiVneurons, [7,8]. and The fusion main cellularproteins targets (F) and of glycoproteins NiV are microvascular (G) can mediate endothelial syncytia cells, formation epithelial [9,10cells,]. andSince neurons, N proteins and fusionare highly proteins immunogenic, (F) and glycoproteins they can stimulate (G) can mediate the body syncytia to produce formation antibodies [9,10]. atSince an early N proteins stage, and are highlytheir antibody immunogenic, titer is theyhigh canand stimulate has a long the duration, body to so produce they can antibodies be used atas ana detectionearly stage, antigen and their for NiV antibody [11]. titerNiV isand high HeV and are has rapidly a long inactivat duration,ed so in they dry can environments be used as a and detection both virusesantigen survive for NiV for [11 less]. NiVthan and15 min HeV at are37 °C rapidly [12]. T inactivatedhe Nipah virus in dry is an environments enveloped virus; and both the virus viruses is easilysurvive destroyed for less thanby soaps 15 min and at detergents 37 ◦C[12]. [13] The. Nipah virus is an enveloped virus; the virus is easily destroyed by soaps and detergents [13]. 1.2. Epidemic Situation 1.2. Epidemic Situation NiV was first discovered in the state of Negeri Sembilan in Malaysia in 1997 [14] and was subsequentlyNiV was identified first discovered as a new in virus the that state seriously of Negeri harms Sembilan the health in Malaysia of domestic in 1997pigs and [14] humans. and was Fromsubsequently September identified 1998 to April as a new 1999, virus large that-scale seriously outbreak harmss of acute the health respiratory of domestic syndrome pigs andin pig humans. herds occurredFrom September in Malaysia 1998, causing to April 265 1999, pig large-scale workers to outbreaks become infected of acute, 105 respiratory deaths, syndromea fatality rate in pigof about herds 40%,occurred and in1.16 Malaysia, million causingpigs being 265 culled pig workers [15]. Due to become to pig trading infected, between 105 deaths, Malaysia a fatality and rate Singapore, of about there40%, was and also 1.16 a million report pigsof an being NiV outbreak culled [15 in]. Singapore Due to pig in trading March between1999, which Malaysia resulted and in Singapore,11 people beingthere infected was also and a report one death of an NiV[16]. outbreakSince then, in SingaporeIndia, Siliguri, in March Kampuchea, 1999, which Thailand, resulted and in other 11 people nine countriesbeing infected have reported and one deaththe disease [16]. Since [17,18 then,]. In India,Australia, Siliguri, although Kampuchea, there has Thailand, been no andreports other of ninethe Nipcountriesah virus, have the reportedHendra virus the disease which [is17 similar,18]. In to Australia, the Nipah although virus was there first has reported been no in reportsQueensland, of the AustraliaNipah virus, in 1994 the Hendra[19]. That virus incident which caused is similar 20 tohorses the Nipahto become virus infected was first and reported one human in Queensland, fatality. BetweenAustralia 1994 in 1994and 2014, [19]. there That incidentwere nearly caused 50 reports 20 horses of outbreaks to become of infectedthis virus and in Australia. one human All fatality. of the infBetweenected animals 1994 and were 2014, horses. there were nearly 50 reports of outbreaks of this virus in Australia. All of the infectedFrom animals 2001 to were 2015 horses., there were reports of outbreaks of NiV in Bangladesh in almost every year (FigureFrom 1). 2001There to were 2015, a therenumber were of reports cases of of outbreaksNipah virus of NiVinfection in Bangladesh in Bangladesh in almost (mainly every in yearthe Western(Figure1 ).and There Northwestern were a number parts), of caseswith of249 Nipah reported virus infection infection cases in Bangladesh and 176 deaths (mainly—a in death the Western rate of aboutand Northwestern 71%. In 2005, parts), of 12 withcases, 249 11 reporteddied, and infection the mortality cases and rate 176 was deaths—a 91.8%. In death 2011 rateand of 2012, about all 71%. 30 casesIn 2005, resulted of 12 cases,in death 11— died,a mortality and the mortalityrate of 100% rate [20] was. 91.8%. In 2011 and 2012, all 30 cases resulted in death—a mortality rate of 100% [20]. Figure 1. Death rate from Nipah virus (NiV) outbreaks per year in Bangladesh. Figure 1. Death rate from Nipah virus (NiV) outbreaks per year in Bangladesh. 1.3. Nipah Disease-Bearing Animals and Major Incidence Populations 1.3. Nipah Disease-Bearing Animals and Major Incidence Populations Current research indicates that fruit bats of the Pteropus genus are the natural hosts of NiV [21]. TheyCurrent are mainly research distributed indicates in that South fruit Asia, bats Southeast of the Pteropus Asia, and genus Australia are the (Figure natural2 )[hosts17]. of They NiV perch[21]. Theyon trees are [mainly22] and distributed feed on fruits, in South flowers, Asia, and Southeast pollen. In Asia, Australia, and Australia researchers (Figure conducted 2) [17]. radiographic They perch ontracking trees [22] studies and feed showing on fruits, that flowers, fruit bats, and or pollen. flying In foxes, Australia, have researchers a flying range conducted of up to radiographic 600 km [23]. trackingEphrin-B2 studies and -B3showing were identifiedthat fruit asbats, the or host flying cellular foxes, receptors have a flying for henipaviruses range of up [ 24to, 25600]. Thiskm [23] also. Ephrincauses-B2 NiV and to - infectB3 were more identified animals, as including the host cellular pigs, humans, receptors dogs, for henipaviruses horses, goats, cats,[24,25 and]. This rodents. also causesIt has beenNiV to reported infect more that animals even cows, including are infected pigs, [humans,26]. Among dogs, these horses, susceptible goats, cats, animals, and rodents. pigs and It humans are the most susceptible animals. Viruses 2018, 10, x FOR PEER REVIEW 3 of 12 hasViruses been2018 reported, 10, 572 that even cows are infected [26]. Among these susceptible animals, pigs and3 of 12 humans are the most susceptible animals.
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