The coronavirus, or Nipah virus, has caused the death of a baby and two adults in Queensland. At least eight other people have been infected with the disease. One may also have contracted the virus but was not contagious at the time, bringing the total to 10 infected individuals. On the face of it, the link with the hospital in Australia’s first case suggests that exposure to a similar event — not vaccination or some other treatment — caused the infection. That leaves the Australian story as an example of how the disease can spread and what that means. There is also evidence of wider spread globally. For instance, the United Nations has said it plans to convene a summit in May to discuss how the spread of Nipah could be tackled.
Without a vaccine to turn to, or a cure, the risk of death looms large. So should you or your family consider traveling to Australia?
“I’d avoid going unless it’s an incredibly obvious time and an extremely unlikely place you wouldn’t go,” Dr. Robert Garry, a professor of infectious diseases at Johns Hopkins University, said. “It’s highly unlikely I’d go when I have a family there.” For most people, it’s extremely unlikely.
Killing the mosquito
The virus occurs primarily in the eastern and central part of the country, primarily on the Queensland and New South Wales coasts. Australia had almost no vector control before, even though the country had a decades-long history of mosquito-borne disease. Now, the country has plans to implement the Cairns City Mosquito Control, or Caprilley MMC, a program designed to eliminate mosquitoes throughout the city within one year. It already has established at least 10 sites where residents can dispose of nits, the larva of the mosquito Aedes albopictus, which transmits the virus. Mosquitoes in the three cities where it’s emerged — Cairns, Townsville and Mackay — were infected with a different strain from the one in Queensland, Cairns recorded 1,183 cases in 2018, many of which were fatal. Townsville had 26,787 reported cases, a number that’s been slowly on the rise since 2013, and those were not people traveling to the three places where it’s been identified.
The United States did not see Nipah for years. That means researchers have limited data about the virus’ general prevalence, just as they have with other mosquito-borne diseases, such as Zika, West Nile and dengue. So, experts don’t know how likely this infection is to spread around the world. They are able to predict that, in Australia, the spread was short-lived: The first cases in Cairns, Mackay and Townsville were diagnosed in April or May of last year, with nine deaths, according to the National Health and Medical Research Council. Australian health officials have said that they don’t anticipate the outbreak spreading to other areas, but they are concerned about the possibility of other infections. The best chance of that is for people in affected areas to avoid being bitten by mosquitoes.
The End of Stillbirths
It’s also unclear how prevalent the disease is, but the most likely outcome is fewer stillbirths. One case of Nipah infection has not been linked to a stillbirth, but about one in 12 fetuses in Queensland die in the first trimester after birth. Stillbirths were drastically reduced in the mid-20th century, but the Nipah virus is related to encephalitis. In its infancy, encephalitis was connected to subcutaneous cerebral hemorrhaging.
The virus has killed more babies than it has humans. Dr. Pauline Henry, who is the senior epidemiologist at the Australia Institute, a non-partisan think tank that focuses on public policy, said that exposure to the virus can kill babies as young as 4 months old. An infant is likely to die after being infected — a complication that no one expected when the first cases were diagnosed in Cairns. Many experts had assumed the virus would be more deadly to adults.
Still, nobody died when Cairns and Townsville developed an illness, and the chances of dying are much smaller now that Cairns and Mackay have control programs in place. The work done to control mosquitoes and reduce the chances of contract differ greatly across the country. The program implemented in Cairns is projected to cost $5.4 million a year, with some health and education assistance coming from the federal government. The Cairns program is estimated to cost $0.4 million to $1.5 million a year, Dr. Brendan West, an epidemiologist at Brisbane’s Royal