MCQs on Nipah virus (with clinical case)

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                                        MCQs on Nipah virus with a clinical case

1. A 41 year old male fruit farmer residing in rural village Kerala, India comes to the local health clinic with a high fever, severe headache, and dizziness that he says started a week ago. He has been experiencing vomiting and muscle pain with difficulty in breathing.
Upon examination, the healthcare provider notices the patient has a high fever of 39.5°C (103.1°F), he exhibits signs of confusion and disorientation. His breathing is labored, and has a cough. He has been experiencing vomiting and diarrhea, complains of severe muscle pain and weakness. His wife informs the examiner that there has been an outbreak of an unknown illness in their village, and some of their neighbors have fallen ill as well. 
Blood sample is taken for bacterial culture, and to check virus antibodies and antigens. Serological testing reveals the presence of antibodies against virus, Nipah virus infection is suspected?
What could be the possible primary reservoir of the Nipah virus?
a) Dogs
b) Fruit bats 
c) Sandflies
d) Mosquitoes

2. How is Nipah virus primarily transmitted to humans?
a) Consuming contaminated water
b) Mosquito bites
c) Close contact with infected pigs   
d) Airborne transmission

3. Which of the following is a common symptom of Nipah virus infection?
a) Joint pain
b) Muscle pain 
c) Memory loss
d) Skin rash    

4. Which of the following is frequently used specimen for the diagnosis of Nipah virus antibodies and antigens?
a) Blood    
b) Skin tissue
c) Stool
d) Urine

5. What is the typical incubation period for Nipah virus after exposure?
a) 1-2 days
b) 5-7 days
c) 2-4 weeks    
d) 6-8 months

6. The first outbreak of Nipah virus in humans was recorded in which of the following country?
a) India
b) Japan
c) Bangladesh
d) Malaysia    

7. What is the fatality rate associated with severe Nipah virus infections in humans?
a) Less than 5%
b) Approximately 20%
c) Around 50%
d) Over 90%

8. Which of the following symptom develop in severe cases of Nipah virus infection?
a) Cirrhosis
b) Coronary heart disease (CHD)
c) Encephalitis
d) Kala-azar

9. Which of the following is NOT a common symptom of Nipah virus infection?
a) Cough
b) Loss of taste and smell
c) Seizures
d) Vomitting

10. What is the most possible mode of transmission of Nipah virus from bats to humans?
a) Direct physical contact
b) Consumption of bat meat
c) Inhalation of contaminated air
d) Mosquito bites

Answers:
1. b) Fruit bats
2. c) Close contact with infected pigs  
3. b) Muscle pain 
4. a) Blood
5. c) 2-4 weeks
6. d) Malaysia
7. c) Around 50%
8. c) Encephalitis
9. b) Loss of taste and smell
10. c) Inhalation of contaminated air

Key facts
  • Nipah virus infection in humans causes a range of clinical presentations, from asymptomatic infection (subclinical) to acute respiratory infection and fatal encephalitis.
  • The case fatality rate is estimated at 40% to 75%. This rate can vary by outbreak depending on local capabilities for epidemiological surveillance and clinical management.
  • Nipah virus can be transmitted to humans from animals (such as bats or pigs), or contaminated foods and can also be transmitted directly from human-to-human.
  • Fruit bats of the Pteropodidae family are the natural host of Nipah virus.
  • There is no treatment or vaccine available for either people or animals. The primary treatment for humans is supportive care.
  • The 2018 annual review of the WHO R&D Blueprint list of priority diseases indicates that there is an urgent need for accelerated research and development for the Nipah virus. 
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