Five patients, who lived far apart with no prior contact, exhibited clinical signs like fever, confusion, altered mental state, abnormal walking, and trouble breathing. One pediatric patient even experienced convulsions linked to the fever.
After being discharged from the hospital—two or three weeks post-admission—two patients made a full recovery. However, two others reported ongoing fatigue, confusion, and continued difficulties in breathing and walking. Sadly, one patient passed away in August 2024 after a decline in health accompanied by unexplained neurological issues.
“Our findings indicate that the risks associated with consuming raw date palm sap go beyond just NiV,” noted Nischay Mishra, PhD, from the Center for Infection and Immunity at Columbia University’s Mailman School of Public Health, in a press release.
Signs of Virus Reassortment
The complete coding sequences for all ten Bangladesh PRV segments showed a genetic similarity ranging from 91.1% to 100%. Some segments of the virus’s double-stranded RNA genomes were closely related to different PRVs found in fruit bats, and less frequently, in humans from Indonesia and Malaysia.
The possibility of reassortment in segmented viruses like PRV could lead to changes in how they transmit and their severity.
“This finding points to unique evolutionary paths for each segment due to reassortment among circulating strains in Southeast Asia, along with the extensive flight ranges of fruit bats,” the authors commented. “Reassortment is a common aspect of how segmented RNA viruses evolve and increases the zoonotic risk.”
As PRV and NiV share similar symptoms and are linked to the consumption of raw date palm sap contaminated with bat droppings, the researchers advised healthcare providers to include PRV in their differential diagnoses.
“The potential for reassortment in segmented viruses like PRV can lead to changes in transmissibility and virulence,” they concluded. “Therefore, in areas where raw date palm sap is consumed, thorough molecular and serologic surveillance, along with differential diagnoses for respiratory illnesses, encephalitis, and other unexplained febrile diseases, should encompass PRV, NiV, and other batborne viruses.”
