Nipah Virus

Nipah virus infection (NiV) is a viral infection caused by the Nipah virus. Symptoms from infection vary from none to fever, cough, headache, shortness of breath, and confusion. This may worsen into a coma over a day or two. Complications can include inflammation of the brain and seizures following recovery.

The Nipah virus is a type of RNA virus in the genus Henipavirus. It can both spread between people and from other animals to people.Spread typically requires direct contact with an infected source. The virus normally circulates among specific types of fruit bats. Diagnosis is based on symptoms and confirmed by laboratory testing.

Management involves supportive care. As of 2018 there is no vaccine or specific treatment. Prevention is by avoiding exposure to bats and sick pigs and not drinking raw date palm sap. As of 2013 a total of 582 human cases of Nipah virus are estimated and 54 percent of those who were infected died. In 2018, an outbreak of the disease resulted in at least 14 deaths in the Indian state of Kerala.

The disease was first identified in 1998 during an outbreak of the disease in Kampung Sungai Nipah district of Malaysia

Genus Epidemicus(GE)
In the last few years, pre monsoon viral fevers took the life of a considerable number of patients in Indian states and in spite of adequate preventive measures from the part of the government health authorities, newly emerging epidemics lead to a threatening situation each year. Homoeopathy always played its part in such circumstances and the role of both government and private doctors in those situations was really commendable.
As Homoeopathic system has a unique method of finding out the preventive medicine by selection of genus epidemicus (GE) on the basis of collective symptomatology ( including pathology ) of the patients,  there is always a hope even in newly emerging epidemics. This is an attempt to find out a GE for the current viral epidemic encephalitis.
IDENTIFICATION OF GE, STEP 1 – COLLECTION OF SYMPTOMS FROM PATIENTS.
As direct interaction with the patient was not allowed, information about the patient’s symptoms were obtained from patients care givers, treating physician and literature on Nipah epidemic in past.
SYMPTOMS COLLECTED FROM PATIENTS :
1. High fever 2. Violent headache. 3. Fear of death. ( Due to knowledge about the mortality of the disease ? ) 4. Body pain. ( Muscle pain ? ) 5. Vomiting. ( H/o Gastritis ? ) 6. Weakness. 7. Scanty urine ( Retention ? Suppression ? ) 8. Confusion, disorientation. ( Time?, Place ? ) 9. Delirium, fever during 10. Heat, alternating with chill
11. Convulsions 12. Coma.
PATHOLOGICAL – FROM REPORTS :
1. Encephalitis 2. Myocarditis 3. Vasculitis
IDENTIFICATION OF GE, STEP 2 – FINDING OUT A PROBABLE SIMILIMUM FOR THE SYMPTOMS.
REPERTORISATION :
RUBRICS :
1. Fever, Zymotic fevers 2. Fever, Heat, Intense heat. 3. Headache, violent, fever during. 4. Mind, coma, fever during 5. Mind, Delirium, fever during 6. Fever, Heat, alternating with chill 7. Urine, scanty, fever during. 8. Convulsions, fever during 9. Weakness, fever during
REPERTORIAL RESULT :
Ars   : 24/9 
Bell   : 20/9   
Lyc   : 17/9
Rhus tox  : 20/8,   Hyos   : 18/8,  Bapt  : 17/8, , Bry  : 17/8,
Nat-mur : 17/8,   Puls  : 17/8,  Nux vom : 16/8,   Arn  : 15/8
Phos  : 15/8
PATHOLOGICAL CONSIDERATION :
1. Encephalitis  :  Ars1 Bell3 2. Carditis  :  Ars2, Bell2, Lyc2 3. Vasculitis :  Ars3, Bell2
Ars and Bell are the Final medicines.


DIFFERENTIATION OF THE FINAL MEDICINES
Plus points for Bell.
1. First grade medicine in Inflammation of brain. Ars only 1 mark. 2. Bell is the only medicine ( 1 mark )under the rubric ‘ retention of urine, with congestion of brain’ 3. Previous successful h/o prophylactic use against Japanese encephalitis (JE) 4. Bell is found effective against viral encephalitis (JE) in some  vitro studies too.
Plus points for Ars
1. Main medicine for fever with weakness out of proportion to the disease.
FINALLY SELECTED MEDICINE : BELLADONNA.
PROPOSED DOSAGE :
Day 1 to 5  :  Bell 200/bd
From Day 6 onwards 1 dose of bell 200 every 3rd day until the epidemic subsides.
1 dose = 2 Number 40 medicated pills

SPECIAL ADVISES :
Any person who is taking the medicine should stop the medication if any adverse symptoms appear.
Since the GE is only a proposed medication, any person who is on GE should follow the protocol on fever proposed by the health authorities. The GE offers no guarantee but there is chance for prevention            ( provided that the individual is not already infected ) as observed in earlier preventive medicine study examples.
Informed consent should be obtained before giving the GE.

CONCLUSION :
Since the current infection has almost 100 percent case fatality rate and as there is no available treatment except supportive care, we propose this homoeopathic GE for administration to contain the epidemic. GE is a time tested Homoeopathic method of prevention of epidemic and has yielded positive outcome in many previous epidemics.

REFERENCES :
1. National guideline for management, prevention and control of Nipah virus infection, including encephalitis. Directorate general of health services, Ministry of Health and Family welfare, Govt. of the People ’s Republic of Bangladesh.
2. JE, Homeoprophylaxis in India. Dr Srinivasulu Gadugu & Prof. Shailendra K Saxena.
3. Complete dynamics in Homoeopathy – Eduard Van Grinsven
4. Organon of Medicine – Samuel Hahnemann.
5. Decreased intensity of Japanese encephalitis virus infection in chick chorioallantoic membrane under influence of ultradiluted Belladonna extract. – Bandyopadhyay B, Das S, Sengupta M, Saha C, Das KC, Sarkar D, et al.
6. Suckling mice of “Belladonna 200” fed mothers evade virulent Nakayama strain Japanese encephalitis virus infection. Int J Microbiol Res 2011;2;252-7.
7. Evolution of homeopathic medicines as add-on to institutional management protocol in Acute encephalitis syndrome. – Raj.K.Manchanda , Praveen Oberai.

Nipah virus infection
Structure of a Henipavirus
Specialty	Infectious disease
Symptoms	None, fever, cough, headache, confusion
Complications	Inflammation of the brain, seizures
Usual onset	5 to 14 days after exposure
Causes	Nipah virus (spread by direct contact)
Diagnostic method	Based on symptoms, confirmed by laboratory testing
Prevention	Avoiding exposure to bats and sick pigs, not drinking raw date palm sap
Treatment	Supportive care
Frequency	582 human cases (2001 until 2012)
Deaths	~75% risk of death