Melena Passing in Langya Henipavirus and Severity of Infection: A Concern

Dear Editor, one of the most intriguing issues is usually the most recent viral infectious disease. There have been ongoing issues in recent years as a result of new viral infections. The Langya Henipavirus is a newly discovered viral infection that first appeared in 2022.¹,² Many patients are from various Chinese cities where this new virus was discovered. Although the exact mode of transmission is unknown, zoonosis is expected.

Data on the clinical manifestations of a new infection are scarce in clinical medicine. The platelet counts of some patients may be low, and hemorrhagic presentation is an intriguing problem.¹,² Melena passing is a common bleeding symptom seen in a wide range of medical conditions. The authors reevaluate the current information on how melena passing manifests in reported Langya Henipavirus cases. Using data from 26 currently available cases,¹,² the expected range (95% confidence interval [CI]) of melena passing rate in severe (hospitalized) and nonsevere cases is calculated and compared. (►Table 1). Melena passing is observed in 3.8% of cases (95%CI=0.2–19.0%). Melena passing is more likely in the severe group (proportional z-test, p=0.001).

Table 1
The expected range (95% confidence interval) of melena passing rate in the severe (hospitalized) and nonsevere cases

Severity	Gingival bleeeding (%)
	rate	expected range
Hospitalized cases (n = 14)	7.1	0.4–35.2
Non hospitalized cases (n = 12)	0	0

Melena passing can be caused by a variety of colonoproctological problems. Melena passing in viral infections can occur as a result of a variety of immune or nonimmune mechanisms. The new Langya Henipavirus infection is expected to cause melena passing, which is consistent with the thrombocytopenia caused by the disease. According to the most recent research, melena passing could indicate a serious illness. More research is needed to confirm this observation. Consider the possibility that the patient has been infected with the Langya Henipavirus. Melena passing may be the first sign of an infection.

• Consent
  The patient gave consent for the presentation of the case for academic purposes.
• Funding
  The present research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

References

• ¹
  Mallapaty S. New ‘Langya’ virus identified in China: what scientists know so far. Nature 2022;608(7924):656-657. Doi: 10.1038/d41586-022-02175-z
  » https://doi.org/10.1038/d41586-022-02175-z
• ²
  Zhang XA, Li H, Jiang FC, et al. A Zoonotic Henipavirus in Febrile Patients in China. N Engl J Med 2022;387(05):470-472

Publication Dates

• Publication in this collection
  07 Apr 2023
• Date of issue
  Oct-Dec 2022

History

• Received
  18 Aug 2022
• Accepted
  15 Sept 2022