Nipah virus infection

                          Nipah virus infection:

  Nipah virus (NiV) infection is a newly emerging zoonosis that causes severe disease in both animals and humans. The natural host of the virus is fruit bats of the pteropodids family, Pteropus genus. Nipah virus infection was first identified during an outbreak of disease that took place in Kampung Sungai Nipah, Malaysia in 1998. On this occasion, pigs were the intermediate hosts. However, in subsequent NiV outbreaks, there were no intermediate hosts. In Bangladesh in 2004, humans became infected with NiV as a result of consuming date palm sap that had been contaminated by infected fruit bats. Human-to-human transmission has also been documented, including in a hospital setting in India. 

 NiV infection in humans has a range of clinical presentations, from asymptomatic infection to the acute respiratory syndrome and fatal encephalitis. NiV is also capable of causing disease in pigs and animals. The primary treatment for human cases is intensive supportive care.  

STUDY REPORT SUBMITTED BY THE EXPERT COMMITTEE APPOINTED BY IHMA KERALA TO IDENTIFY A PROBABLE HOMOEOPATHIC GENUS EPIDEMIC FOR THE CURRENT VIRAL EPIDEMIC – 2018 - IN KERALA. ( THE REPORT WAS FORWARDED TO DMO, DEPARTMENT OF HOMOEOPATHY, KOZHIKODE. )

Expert committee members : 

Dr.Saji K, MD(Hom) Repertory. ( Senate Member KUHS.)

Dr.Dinesh.R.S, MD(Hom) Materia Medica; MBBS, MD(Psychiatry); Psychiatrist, Mental Hospital Trivandrum.

Dr.Siju Joseph Seena, BHMS; MSC Epidemiology, Consultant Epidemiologist.

Dr.Amar Bodhi, MD(Hom) Organon; Lecturer, B.R.Sur Homoeopathic Medical College, New Delhi.

INTRODUCTION :

In the last few years, pre-monsoon viral fevers took the life of a considerable number of patients in our state 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. Homeopathy 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 was obtained from patients caregivers, 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. A 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 encephalitis (JE) 4. Bell is found effective against viral encephalitis (JE) in some in 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 a 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 homeopathic GE for administration to contain the epidemic. GE is a time-tested Homoeopathic method of prevention of epidemic and has yielded a positive outcome in many previous epidemics.