Nipah virus (NiV): category 3 contact information

You have been given this information sheet because you have had very close or direct contact with someone with Nipah virus infection. You should stay at home and away from other people for 21 days after your last exposure to Nipah virus and regularly check yourself for symptoms of Nipah virus infection.

If you develop symptoms of Nipah virus infection within 21 days of your last exposure to Nipah virus, you should stay at home and call your designated contact immediately (see below for details).

About Nipah virus infection

Nipah virus infection is a rare but serious infection caused by Nipah virus. The virus was first detected in 1998 and is named after the village where it was first detected. Outbreaks and sporadic cases have been previously reported from various parts of Asia including Malaysia, India and Bangladesh.

How is Nipah virus spread?

Nipah virus can spread through close and direct contact with someone who is ill with the infection, or with their body fluids (such as saliva, blood or urine). It can also be spread through the air when someone coughs or sneezes or by touching contaminated objects and surfaces (fomites).

Nipah virus does not spread very easily between people and is not spread through normal social contact like shaking hands or sitting near someone who is well.

It can take between 4 and 21 days from contact with someone who has Nipah virus for symptoms to develop.

Symptoms of Nipah virus infection

Symptoms of Nipah virus infection typically start with sudden flu-like symptoms which include:

• fever (temperature of 37.5°C or higher)
• vomiting
• general exhaustion
• headache
• muscle aches
• coughing
• sneezing
• runny nose
• sore throats

Some individuals may experience neurological (nervous system) symptoms including:

• sensitivity to light or sound
• neck stiffness
• seizures
• reduced conscious levels (for example drowsiness)

Preventing and treating Nipah virus infection

There is currently no licensed vaccine for Nipah virus. To avoid Nipah virus spreading between people, those caring for individuals with possible or suspected Nipah virus infection should avoid contact with the patient’s body fluids and should wear personal protective equipment (PPE).

Treatment for Nipah virus infection is with supportive care, including balancing fluids and electrolytes, maintaining a person’s oxygen status and blood pressure, and treating any co-infections.

Your risk of developing Nipah virus infection

You reported that you either:

• are a household or overnight contact of a confirmed symptomatic case
• have had significant exposure to material from a confirmed case, for example a needlestick injury or body fluids from a case of Nipah virus infection splashed on your mucous membranes
• had direct or close contact with someone with Nipah virus infection, or their body fluids, outside of a designated high level isolation unit and you were not wearing appropriate PPE
• were in an environment contaminated with the body fluids of someone who had Nipah virus infection, but you were not wearing appropriate PPE
• have had contact with Nipah virus in a laboratory which did not meet containment level 4 requirements, and you were not wearing appropriate PPE

Because of your level of exposure, you are at risk of developing Nipah virus infection. We would therefore like to closely monitor you for a period of 21 days from when you were last exposed to Nipah virus. You should also carry out the actions listed below to minimise the risk to you and others close to you.

What you need to do

Because you are at risk of developing Nipah virus infection, you should take the following actions for the 21 days from when you were last exposed to Nipah virus:

• self-isolate in private accommodation (unless an alternative arrangement has been agreed with UKHSA). See the information below on how to self-isolate
• record your temperature and monitor yourself for other symptoms suggestive of Nipah virus infection twice per day at the same times each day (for example, once in the morning and once in the evening)
• report these temperatures to your designated contact (see below for details) by 12 noon each day. They will want to know whether your temperature is below, equal to, or above 37.5°C, and will arrange further evaluation as necessary. They will explain the local arrangements for accessing healthcare
• if you become ill with any of the symptoms listed above in between reporting to your designated contact, you should phone your designated contact immediately. See below for further information on what you should do if you become ill

How to self-isolate

You should self-isolate for 21 days from when you were last exposed to Nipah virus. This means you should stay at home and away from other people:

• do not go to work, school or public areas
• do not travel, either within the UK or internationally
• do not have visitors to your home

You should self-isolate in a separate room from other members of your household, and avoid all contact with them, including sexual contact. You should:

• sleep in a separate room to other people and use separate bathroom facilities for going to the toilet and for washing
• only leave your home if it is essential, for example in an emergency, for an urgent medical appointment, or for urgent health and wellbeing issues
• use separate items for eating and drinking, such as cutlery, cups, or plates, to other people in your household
• use your own personal items. Do not share items which you use, such as bedding, towels, wash cloths, toothbrushes, or razors.

If you need help with groceries or other essentials:

• ask friends or family to drop your shopping off, or order online
• ask your friends, family or delivery drivers to leave your shopping at your front door to avoid contact with them

Postpone any non-essential medical or dental treatment. You should discuss any essential treatment required with your designated contact before attending a healthcare facility.

Use of medicines such as aspirin, paracetamol or ibuprofen

Certain medicines, such as paracetamol, ibuprofen and aspirin, can reduce your body temperature during a fever (antipyretic) for up to 8 hours. Thermometer measurements may therefore show a lower temperature than would be expected for up to 8 hours after taking these medicines.

You must call your designated contact for further advice if you need to take an antipyretic medicine.

Take your temperature before you take paracetamol, ibuprofen or aspirin, and if your temperature is 37.5ºC or higher, you must call your contact immediately. A temperature of 37.5ºC or higher is always significant, whether you are taking one of these medicines or not, and must be reported urgently.

What to do if you feel unwell

If you are feeling unwell or develop any of the symptoms of Nipah virus infection (including a temperature of 37.5°C or higher) within the 21 days from when you were last exposed to Nipah virus, stay at home.

Take your temperature if you have not done this already. Phone your designated contact immediately, who will arrange for you to be assessed by an appropriate clinician.

If there is any delay in making contact, phone 111 reporting your recent contact with someone with Nipah virus infection.

In an emergency, you should call 999 and tell them about your symptoms and your recent contact with Nipah virus.

More Information

More information about Nipah can be found on the UK Health Security Agency website and the World Health Organization website.