Thread by @AbraarKaran

1/ Phenomenal lecture today from Dr. Stephen Luby on his team's work discovering the mechanisms of #NipahVirus transmission in Bangladesh over nearly the past two decades

The story starts with an outbreak of fatal encephalitis among 11 patients (Dec 2004)
pubmed.ncbi.nlm.nih.gov/17326940/

2/ They asked the families of deceased cases about many exposures; & similarly asked the same to neighborhood controls

The evidence here pointed to consumption of raw date palm sap (odds ratio of 7.9)

Bats were suspected to drink from/near the clay pots of sap in the trees

3/ They used infrared cameras to help add to the evidence base, showing Pteropus bat behaviors at night related to consumption of the date palm sap where they presumably shed live virus. pubmed.ncbi.nlm.nih.gov/21207105/

4/ They investigated further outbreaks in Bangladesh in subsequent years where the only significant risk factor for infection was consumption of raw date palm sap consumption; they further utilized infrared cameras to document bat contact with the sap. pubmed.ncbi.nlm.nih.gov/21923274/

5/ They designed an intervention-- a skirt that could cover the date palm collection pots-- and tested it in a randomized controlled trial which showed that these could effectively prevent bat-sap contact. pubmed.ncbi.nlm.nih.gov/22905160/

6/ And worked together with the government of Bangladesh to help create commercials and other forms of public health communications to help effect behavior change around safe-sap consumption.

bmcpublichealth.biomedcentral.com/articles/10.11…

7/ They tested their behavior-change intervention in a controlled trial and found that messaging around only consuming safe sap likely significantly reduced consumption (self reported) of raw sap.
pubmed.ncbi.nlm.nih.gov/28905152/

8/ Dr. Luby discusses further the pandemic potential of Nipah Virus, which can be transmitted person-person and has a very high infection fatality rate; with zoonotic spillover happening in multiple countries in South/SE Asia.
sciencedirect.com/science/articl…

9/ In other studies, they explored Nipah virus RNA detection at bat roosts. One of the challenges is identifying where/when outbreaks may occur.

pubmed.ncbi.nlm.nih.gov/35731130/

10/ In other studies, they have found Nipah virus antibodies in cattle, dogs, and cats suggesting further spillover into other species, although unclear to what extent these will serve as important reservoirs for future outbreaks.

pubmed.ncbi.nlm.nih.gov/36692447/

11/ Inspiring to hear about some of the work of a true giant in global health and infectious disease epi. The Luby Lab was also part of the Bangladesh masks RCT for #Covid19.

Lucky to be working in the Luby lab for my post-doc @stanford @StanfordCIGH @stanfordwoods
@Stanford_ID

Cc @SethAHoffmanMD @JulieParsonnet @JasonAndrewsMD @IngridKatzMD @lmadoff @megan_b_murray @kj_seung @RanuDhillon @sri_srikrishna @DrWilfredoM @drlouiseivers