Date palm sap linked to Nipah virus outbreak in Bangladesh, 2008

Rahman, Muhammad Aziz, Hossain, Mohammad Jahangir, Sultana, Sharmin, Homaira, Nusrat, Khan, Salah Uddin, Rahman, Mahmudur, Gurley, Emily S., Rollin, Pierre E., Lo, Michael K., Comer, James A., Lowe, Luis, Rota, Paul A., Ksiazek, Thomas G., Kenah, Eben, Sharker, Yushuf and Luby, Stephen P. 2012, Date palm sap linked to Nipah virus outbreak in Bangladesh, 2008, Vector borne and zoonotic diseases, vol. 12, no. 1, pp. 65-72, doi: 10.1089/vbz.2011.0656.

Attached Files
Name Description MIMEType Size Downloads

Title Date palm sap linked to Nipah virus outbreak in Bangladesh, 2008
Author(s) Rahman, Muhammad AzizORCID iD for Rahman, Muhammad Aziz
Hossain, Mohammad Jahangir
Sultana, Sharmin
Homaira, Nusrat
Khan, Salah Uddin
Rahman, Mahmudur
Gurley, Emily S.
Rollin, Pierre E.
Lo, Michael K.
Comer, James A.
Lowe, Luis
Rota, Paul A.
Ksiazek, Thomas G.
Kenah, Eben
Sharker, Yushuf
Luby, Stephen P.
Journal name Vector borne and zoonotic diseases
Volume number 12
Issue number 1
Start page 65
End page 72
Total pages 8
Publisher Mary Ann Liebert Publishers
Place of publication New Rochelle, N.Y.
Publication date 2012-01-04
ISSN 1530-3667
Keyword(s) Adolescent
Case-Control Studies
Encephalitis, Viral
Food Microbiology
Henipavirus Infections
Middle Aged
Nipah Virus
Risk Factors
Time Factors
Young Adult
Summary INTRODUCTION: We investigated a cluster of patients with encephalitis in the Manikgonj and Rajbari Districts of Bangladesh in February 2008 to determine the etiology and risk factors for disease.
METHODS: We classified persons as confirmed Nipah cases by the presence of immunoglobulin M antibodies against Nipah virus (NiV), or by the presence of NiV RNA or by isolation of NiV from cerebrospinal fluid or throat swabs who had onset of symptoms between February 6 and March 10, 2008. We classified persons as probable cases if they reported fever with convulsions or altered mental status, who resided in the outbreak areas during that period, and who died before serum samples were collected. For the case-control study, we compared both confirmed and probable Nipah case-patients to controls, who were free from illness during the reference period. We used motion-sensor-infrared cameras to observe bat's contact of date palm sap.
RESULTS: We identified four confirmed and six probable case-patients, nine (90%) of whom died. The median age of the cases was 10 years; eight were males. The outbreak occurred simultaneously in two communities that were 44 km apart and separated by a river. Drinking raw date palm sap 2-12 days before illness onset was the only risk factor most strongly associated with the illness (adjusted odds ratio 25, 95% confidence intervals 3.3-∞, p<0.001). Case-patients reported no history of physical contact with bats, though community members often reported seeing bats. Infrared camera photographs showed that Pteropus bats frequently visited date palm trees in those communities where sap was collected for human consumption.
CONCLUSION: This is the second Nipah outbreak in Bangladesh where date palm sap has been implicated as the vehicle of transmission. Fresh date palm sap should not be drunk, unless effective steps have been taken to prevent bat access to the sap during collection.
Language eng
DOI 10.1089/vbz.2011.0656
Field of Research 111708 Health and Community Services
1117 Public Health And Health Services
Socio Economic Objective 920599 Specific Population Health (excl. Indigenous Health) not elsewhere classified
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2012, Mary Ann Liebert, Inc.
Persistent URL

Document type: Journal Article
Collections: Faculty of Health
School of Medicine
Connect to link resolver
Unless expressly stated otherwise, the copyright for items in DRO is owned by the author, with all rights reserved.

Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 84 times in TR Web of Science
Scopus Citation Count Cited 104 times in Scopus
Google Scholar Search Google Scholar
Access Statistics: 133 Abstract Views, 1 File Downloads  -  Detailed Statistics
Created: Fri, 20 May 2016, 14:17:22 EST

Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact