Volume 80, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


Continued Nipah encephalitis outbreaks in Bangladesh highlight the need for preventative and control measures to reduce transmission from bats to humans and human-to-human spread. Qualitative research was conducted at the end of an encephalitis outbreak in Faridpur, Bangladesh in May 2004 and continued through December 2004. Methods included in-depth interviews with caretakers of cases, case survivors, neighbors of cases, and health providers. Results show contrasts between local and biomedical views on causal explanations and appropriate care. Social norms demanded that family members maintain physical contact with sick patients, potentially increasing the risk of human-to-human transmission. Initial treatment strategies by community members involved home remedies, and public health officials encouraged patient hospitalization. Over time, communities linked the outbreak to supernatural powers and sought care with spiritual healers. Differing popular and medical views of illness caused conflict and rejection of biomedical recommendations. Future investigators should consider local perceptions of disease and treatment when developing outbreak strategies.


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  1. Hsu VP, Hossain MJ, Parashar UD, Ali MM, Ksiazek TG, Kuzmin I, Niezgoda M, Rupprecht C, Bresee J, Breiman RF, 2004. Nipah virus encephalitis reemergence, Bangladesh. Emerg Infect Dis 10 : 2082–2087. [Google Scholar]
  2. International Centre for Diarrheal Disease Research, Bangladesh, 2004. Nipah encephalitis outbreak over wide area of western Bangladesh. Health Sci Bull 2 : 7–11. [Google Scholar]
  3. International Centre for Diarrheal Disease Research, Bangladesh, 2004. Person-to-person transmission of Nipah virus during outbreak in Faridpur District. Health Sci Bull 2 : 5–9. [Google Scholar]
  4. Luby SP, Rahman M, Hossain MJ, Blum LS, Husain MM, Gurley E, Khan R, Ahmed BN, Rahman S, Nahar N, Kenah E, Corner JA, Ksiazek TG, 2006. Evidence for foodborne transmission of Nipah virus, Bangladesh. Emerg Infect Dis 12 : 1888–1894. [Google Scholar]
  5. Gurley ES, Montgomery JM, Hossain MJ, Bell M, Azad AK, Islam MR, Molla MAR, Carroll DS, Ksiazek TG, Rota PA, Lowe L, Corner JA, Rollin P, Czub M, Grolla A, Feldmann H, Luby SP, Woodward JL, Breiman RF, 2007. Person-to-person transmission of Nipah virus in a Bangladeshi community. Emerg Infect Dis 13 : 1031–1037. [Google Scholar]
  6. International Centre for Diarrheal Disease Research, Bangladesh, 2007. Person-to-person transmission of Nipah infection in Bangladesh, 2007. Health Sci Bull 5 : 1–6. [Google Scholar]
  7. Hossain MJ, Gurley ES, Montgomery JM, Bell M, Carroll DS, Hsu VP, Formenty P, Croisier A, Bertherat E, Faiz MA, Azad AK, Islam R, Molla MA, Ksiazek TG, Rota PA, Comer JA, Rollin PE, Luby SP, Breiman RF, 2008. Clinical presentation of Nipah virus infection in Bangladesh. Clin Infect Dis 46 : 977–984. [Google Scholar]
  8. International Centre for Diarrheal Disease Research, Bangladesh, 2008. Outbreaks of Nipah virus in Rajbari and Manikgonj, February 2008. Health Sci Bull 6 : 12–13. [Google Scholar]
  9. Chadha MS, Comer JA, Lowe L, Rota P, Rollin PE, Bellini WJ, Ksiazek TG, Mishra AC, 2006. Nipah virus-associated encephalitis outbreak, Siliguri, India. Emerg Infect Dis 12 : 235–240. [Google Scholar]
  10. Harcourt BH, Lowe L, Tamin A, Liu X, Bankamp B, Bowden N, Rollin PE, Comer JA, Ksiazek TG, Hossain MJ, Gurley ES, Breiman RF, Bellini WJ, Rota PA, 2005. Genetic characterization of Nipah virus, Bangladesh, 2004. Emerg Infect Dis 11 : 1594–1597. [Google Scholar]
  11. Ross JL, Leston SL, Pelto PJ, Muna L, 2004. Exploring explanatory models of women’s reproductive health in rural Bangladesh. Cult Health Sex 4 : 173–190. [Google Scholar]
  12. Blum LS, Nahar N, 2004. Cultural and social context of dysentery: implications for the introduction of a new vaccine. J Health Popul Nutr 22 : 159–169. [Google Scholar]
  13. Larson CP, Saha UR, Islam R, Roy N, 2006. Childhood diarrhoea management practices in Bangladesh: private sector dominance and continued inequities in care. Int J Epidemiol 35 : 1430–1439. [Google Scholar]
  14. Kleinman A, 1980. Patients and Healers in the Context of Culture: An Exploration of the Borderland between Anthropology, Medicine and Psychiatry. Berkeley: University of California Press.
  15. Zaman S, 2004. Poverty and violence, frustration and inventiveness: hospital ward life in Bangladesh. Soc Sci Med 59 : 2025–2036. [Google Scholar]
  16. Hadley MB, Blum LS, Mujaddid S, Parveen S, Nuremowla S, Haque ME, Ullah M, 2007. Why Bangladeshi nurses avoid ‘nursing’: social and structural factors on hospital wards in Bangladesh. Soc Sci Med 64 : 1166–1177. [Google Scholar]
  17. Arnold D, 1993. Colonizing the Body: State Medicine and Epidemic Disease in Nineteenth-Century India. Berkeley: University of California Press.
  18. Hewlett BS, Amola RP, 2003. Cultural contexts of Ebola in northern Uganda. Emerg Infect Dis 9 : 1242–1248. [Google Scholar]
  19. Alland A, 1970. Adaptation in Cultural Evolution: An Approach to Medical Anthropology. New York: Columbia University Press.
  20. Blum LS, Pelto GH, Pelto PJ, 2004. Coping with a nutrient deficiency: cultural models of vitamin A deficiency in northern Niger. Med Anthropol 23 : 195–227. [Google Scholar]

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  • Received : 09 Jul 2008
  • Accepted : 17 Sep 2008

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