A large outbreak of hysteria occurred in the media over the past week regarding a small Nipah virus outbreak in eastern India. ‘Hysteria’ is the correct word in terms of proportionality. It is not, unfortunately, the right word in terms of intent. Ten years ago this episode of Nipah virus disease would barely have rated a mention internationally, and certainly not stimulated airport screening and travel warnings – there have been many larger outbreaks of Nipah virus than this one which did not.

The change over recent years is not that people have lost their minds. It relates to the adoption of the fear-panic-profit model that has entrenched itself in international public health. Tens of billions in annual funding are on the table, and they depend – with the thousands of salaries and exorbitant Pharma profits tied to the pandemic industry – on the maintenance of a constant sense of imminent threat.

The World Health Organisation reports two cases from this Nipah outbreak, which is fewer than usual. As is common, they involve health service personnel, a group that is often infected by the virus before the diagnosis is clear in the patients they care for. Nipah virus infection historically has a high mortality rate among those infected, and each death is a tragedy, especially in those who are infected through caring for others. The deliberate hysteria and fearmongering these cases are being used to promote will kill lots more, because they divert resources from programmes aimed at far worse health problems. But using small recurrent outbreaks to promote fear is a business case that is too attractive to too many. This Nipah outbreak is simply its latest iteration.

What is Nipah virus disease?

An outbreak of encephalitis (brain inflammation) occurred in a semi-rural area of Malaysia in 1998. It was quite severe, with almost half of the early cases dying. Initially assumed to be an outbreak of Japanese encephalitis (a more common mosquito-borne disease), it was noted that early cases were associated with illness in nearby pigs. The initial outbreak was on a farm where pigs and an orchard were in close proximity.

Unusual characteristics noted in this 1998 outbreak raised questions as to whether this was a new disease. There is an unofficial back story regarding what happened next, including a vial of blood from an infected case carried through customs and ending up at CDC in the United States. With the help of (what were then) new techniques for distinguishing genetic sequences, it was established that a previously undetected virus was involved. This outbreak became the first recorded outbreak of Nipah virus, named after Sungai Nipah (the Nipah river) in peninsular Malaysia. The virus is now known to be endemic in various bat species that range across much of Asia and Africa. In the case of the Malaysian outbreak, it spread from fruit bats attracted to an orchard, to the pigs that were kept alongside the fruit trees they fed on, to the humans who looked after the pigs. This remains one of the worst recorded outbreaks of this virus in history, with 105 deaths from 265 recorded cases by May 1999. Malaysia took various steps after this, initially killing a lot of pigs, but also changing farming practices. There has not been an outbreak recorded there since.

Why new viruses are not necessarily new

Since the Malaysian episode, recurrent outbreaks have been recorded, particularly in the northeast and southwest of the Indian subcontinent. These have been small outbreaks, less than 110 deaths in the worst, with well under 1,000 people recorded ever dying from Nipah virus globally. However, it is important to realise that this number will not reflect true Nipah virus mortality. The difference between now and the years before 1998 is almost certainly not that a new virus has emerged, but that we have simply developed the means to detect it. We simply could not distinguish Nipah virus outbreaks from other causes of encephalitis. New testing technologies emerged, rather than new viruses. Back in 1900 we knew of no human viruses, identifying the first – Yellow fever virus – in 1901. But it was the invention of PCR in the 1980s and gene sequencing since then that really allowed the ‘new virus’ idea to take off.

Nipah virus outbreaks on the Indian subcontinent, distant from the first Malaysian outbreak, presumably recur due to local characteristics regarding human-bat interactions or interactions with an intermediate animal host. Evidence of the virus in fruit bats across Asia and Africa means it has almost certainly been around for a very long time, perhaps many thousands of years. We would still be ignorant of Nipah virus disease if someone had not been clever enough to figure out how to detect and sequence the genetic material that characterises it.

Read More: Nipah Virus Triggers Another Bout of Hysteria in the Media