Occupational exposure, age, diabetes mellitus and outcome of acute Nipah Occupational exposure, age, diabetes mellitus and outcome of acute Nipah Occupational exposure, age, diabetes mellitus and outcome of acute Nipah Occupational exposure, age, diabetes mellitus and outcome of acute Nipah Occupational exposure, age, diabetes mellitus and outcome of acute Nipah encephalitis

The outbreak of acute Nipah encephalitis in Malaysia in 1998 and 1999 affected 256 patients with 105 mortalities, as well as decimated the local pig farm industry. The outbreak from the novel Nipah virus was attributed to close contact with infected pigs. In the pathogenesis of the disease, the level of exposure to sick animals and host factors were not known. We undertook a retrospective study of 194 patients from the University Malaya Medical Centre and Seremban Hospital to examine these. The level of exposure to sick animals had no effect on the outcome of human disease. The diabetic patients had similar clinical presentations and laboratory findings as non-diabetic patients, apart from higher serum and cerebrospinal fluid sugar levels, with more patients having renal impairment, and more severe autonomic dysfunction with higher blood pressure and temperature. On Cox regression analysis, the diabetic patients had increased mortality by 123% (p<0.001). We concluded that outcome of acute Nipah encephalitis was not related to the level of exposure to the sick animals, but was related to concomitant diabetes mellitus, probably due to immunoparesis.