In 2017, Nipah virus (NiV) was declared as one of the World Health Organization’s top eight emerging pathogens. The NiV infection is a newly emerging zoonosis first identified during an outbreak of disease that occurred in Kampung Sungai Nipah, Malaysia in 1998. Since then, outbreaks have regularly occurred with human infections being reported in Malaysia, Singapore, India and Bangladesh.
In 2018 and 2019, in WHO’s South East Asia (SEA) Region, a geographically distinct NiV strain was seen emerging in India and Bangladesh causing human NiV infection cases. These outbreaks and their public health and social impacts were a cause of concern, necessitating a systematic and comprehensive regional strategy for combatting NiV infections. The strategy was to ensure availability of evidence-based guidance to Member Countries for effective implementation of preparedness, surveillance, early warning and alert, rapid response, containment of and recovery from NiV outbreaks.
To fulfil this need, an expert consultation was organized by the Infectious Hazards Management (IHM) Unit of the WHO Health Emergencies programme (WHE) at the WHO’s Regional Office for SEA on 15–16 October 2019, in New Delhi. The objective of the expert consultation was to advise the Regional Director, WHO SEARO on regional needs, priorities, and gaps in combatting NiV infections in Member States in the SEA Region.
The expert consultation provided recommendations on ten thematic areas to develop a roadmap and regional strategy for combatting Nipah in WHO’s SEA Region. Based on recommendations of the technical expert group in the thematic area of laboratory diagnosis, it was decided to develop a draft regional laboratory manual with standard operating procedures (SoP) for establishing, strengthening, and improving essential laboratory techniques (including molecular testing, point of care diagnostics, immunodiagnostics, and viral culture) and biosafety/biosecurity and biorisk management practices.
This manual intends to guide future laboratory diagnostic activities while ensuring quality and safety aspects of the diagnosis of NiV infections. This regional laboratory diagnostic manual for NiV infections will be useful for countries that are currently considering establishing diagnostic capacity for NiV and for those with existing capacity to further strengthen their capacities.
The manual is an outcome of the laboratory diagnosis related recommendations of the expert consultation. It provides guidance on how to implement standardized procedures to support laboratories conducting diagnosis of NiV in the SEA region and augments NiV surveillance activities. Details on the regional reference/expert laboratories and data sharing/reporting mechanisms have also been included in the manual.
Guided by recommendations of the multi-disciplinary expert committee on NiV, WHO SEA Regional Office collaborated with the WHO Collaborating Centre for Strengthening Capacity for Emerging Infectious Diseases at ICMR-NIV, Pune in India to develop the manual. As next steps the draft manual will be further reviewed by regional and global experts and by the Member States before being ready for approval and dissemination in 2022.