Tag: nipah virus kerala

‘All Four Cases of Nipah Infections Are Each Other’s Contacts’: Kerala Epidemiologist

Kerala is in the midst of the fourth outbreak of Nipah virus. Four had tested positive in the Kozhikode district out of which two have died.

New Delhi: As Kerala undergoes the fourth outbreak of Nipah virus since 2018 which has already killed two and infected two more, the state government has kicked in protocols to make containment zones in Kozhikode district. The Union government has also sent an Indian Council of Medical Research (ICMR) team to the state. The village panchayats, where these four lived, have also stepped up surveillance. 

Talking to The Wire, state epidemiologist Dr. Hari Shankar said all the four people who have tested positive are related to, or are contacts of the index(first) case. This explains how the virus can spread between humans, once it enters the human chain. Besides the four known cases, there are two more suspected ones, he said. He added that contact tracing is still going on. 

“Since out of the four, two are still undergoing treatment [and two have died], we are speaking to their relatives to trace the history of their whereabouts for at least the last two weeks so that further spread of the virus can be stopped,” he added.

Kerala experienced its first-ever and the worst outbreak of the Nipah virus in Kozhikode in 2018, when of the 23 infected, only two people survived. In that outbreak too, the majority of them were related to the index case. The second and the third outbreaks were far less deadly than the first one. In 2019, one boy from Ernakulam district reported positive for the virus but no death took place. In 2021, one died in the outbreak in Kozhikode. 

Also read: How Kerala Passed the Tough Nipah Test

In a paper published in 2021, the researchers of National Institute of Virology (NIV) wrote that they had found that Pteropus medius bats, or what are also known as the Indian fruit bats, were harbouring the Nipah virus. And, the spillover to the lone Nipah case of the 21-year-old boy in 2019 happened from the animal only. 

To know what led to the spillover this time, ICMR and National Institute of Virology researchers are expected to arrive in Kerala soon, the state epidemiologist said. 

In the paper, the researchers said that the Nipah virus was going to stay in the state. “NiV [Nipah virus] Positivity in Pteropus species of bats revealed that NiV is circulating in many districts of Kerala state, and active surveillance of NiV should be immediately set up to know the hotspot area for NiV infection.”

The Kerala government was nonetheless able to limit the spread of the virus to a great extent in 2019 and 2021 taking lessons from the 2018 outbreak after the spillover events from animals to humans. 

According to the World Health Organisation, the virus is mostly found in bats or pigs. 

“If the NIV/ICMR scientists are able to pinpoint the details of the spillover event this time, it would help us take precautionary measures,” Dr. Shankar said. Although it is not an easy task to do. 

According to the Indian Express, the areas under surveillance in the current outbreak are two villages in the eastern region of the Kozhikode district. Both the villages are situated 15 km away from Changaroth, where the deadly outbreak of 2018 happened. The region has dense forests where these bats are mostly found.

Dr. Shankar said, on the evening of September 12, that it was not clear at the moment as to which of the two strains of the virus – Malaysian or Bangladeshi – was currently in circulation. “The results of the genome sequencing, done to know this, are still awaited,” he said. Incidentally, all three previous outbreaks were related to Bangladeshi strain.

According to the WHO, there are mostly two strains of the virus – Bangladeshi and Malaysian. 

“During the first recognized outbreak in Malaysia [in 1999], which also affected Singapore, most human infections resulted from direct contact with sick pigs or their contaminated tissues. Transmission is thought to have occurred via unprotected exposure to secretions from the pigs, or unprotected contact with the tissue of a sick animal,” the WHO says.

In Bangladesh, the consumption of certain fruits or fruit products, which have been contaminated with saliva or secretions of fruit bats, that harboured the virus, led to the outbreaks. In all the previous three outbreaks of the virus in Kerala, fruit bats have been identified as the source which breed between July and October, and thus the chances of them infecting raw fruits become higher in this season.

As for the symptoms, they are mostly respiratory. And, therefore, the spread from one person to another is quite noticeable unless the containment measures are not quickly put in place. Some patients also develop neurological complications which may lead to death. Those who died in the current outbreak had both neurological and respiratory symptoms, the state epidemiologist said. While one died on August 30, the other passed away on September 11. 

Just like the vaccine, there is currently no proven treatment for the disease per se, according to the WHO. The symptomatic treatment is, however, available although the state epidemiologist said they are using antivirals and monoclonal antibodies to treat those infected. 

One More Dead Due to Nipah Virus in Kerala. Should We Be Worried?

About 160 samples have been sent for testing at the virology institute and 13 cases have been found to be positive, of which 11 people have died.

New Delhi: The death toll due to the Nipah virus has risen 11 in Kerala, with one more person succumbing to the deadly virus this morning.

The deceased, V. Moosa (61), had been battling for his life for the past few days in a private hospital here and was on ventilator support, Kozhikode district medical officer Dr Jayasree E. told reporters.

About 160 samples have been sent for testing at the virology institute and 13 cases have been found to be positive, she said. Of the 13 confirmed cases, 11 people have died so far. The official further said confirmation is awaited with regard to one more death in Kozhikode.

This is the fourth death in Moosa’s family. Moosa’s sons Mohammed Saliah (28), Mohammed Sadiq (26) and a relative Mariumma had died earlier.

While two of the deaths have been confirmed due to Nipah, the blood samples of one of his sons had not been tested for the virus, sources said.

Nurse Lini Puthussery, who had initially treated the affected members of Moosa’s family in the Perambra Taluk hospital in the district, also died after being infected by the virus.

The state government has also issued an advisory, asking travellers to avoid visiting the four districts of Kozhikode, Malappuram, Wayanad and Kannur.

“Travelling to any part of Kerala is safe. However, if travellers wish to be extra cautious, they may avoid the four districts,” health secretary Rajeev Sadanandan said.

The government has also called for an all-party meeting at Kozhikode on May 25 to discuss the issue.

Most of the deaths reported are from Kozhikode and Malappuram districts from where 11 deaths have now been reported and 18 are undergoing treatment in various hospitals, including one in Wayanad.

Isolation wards have also been set up in Thalassery government hospital in Kannur, according to media reports.

In Kozhikode, from where seven deaths have been reported, district collector U.V. Jose has ordered temporary halt to all training programmes and summer camps in affected areas such as Changaroth, Koorachund, Kottur, Cheruvannur, Chekyad, Chakkittapara and Olavanna. The anganwadis in these regions too have been asked to close down to avoid spread of the virus among children.

However, no decision has been taken yet on reopening of schools after the summer vacation. The administration is hoping that the situation will be under control by the time schools reopen in a week.

In neighbouring Malappuram, where three persons have died due to the virus, orders have been issued in four panchayats to stop anganwadi classes for the time being.

A crisis management group has been constituted to coordinate the response of government agencies following the deaths in Kozhikode and Malappuram districts. An expert team from the National Centre for Disease Control, including its director Dr Sujeet Kumar Singh and head of epidemiology Dr S.K. Jain, and a high-level team from the All India Institute of Medical Sciences are camping in Kerala to take stock of the situation.

Surveillance has been increased in all districts.

According to NDTV, there is a fear that two people in Karnataka may also be infected with the virus. Symptoms of the virus were seen in a 20-year-old woman and a 75-year-old man in Mangalore after they travelled to neighbouring Kerala and came into contact with infected patients, Rajesh BV, a health official in Karnataka told the channel.

“They are not confirmed Nipah cases yet, so there is no need to panic,” he said by telephone. “The situation is under control.”

The outbreak of the virus infection, which is a newly emerging zoonosis that causes severe disease in both animals and humans, is suspected to be from an unused well which was infested with bats.

The natural host of the virus is believed to be fruit bats of the Pteropodidae family, Pteropus genus. The virus also transmits from humans to humans.

Treatment options are limited mostly to supportive care.

(With PTI inputs)

Watch: What Is Nipah Virus and Should We Worry?

The World Health Organisation has been informed about the outbreak of the virus in Kerala.

Explainer: Nipah Virus in Kerala and What the Government Is Doing About It

Ten people have died of the virus so far.

New Delhi: A virus without a vaccine has hit Kozhikode in Kerala. Ten people have died after being infected with the virus, including one nurse who was treating the patients. Previous outbreaks of this Nipah virus were reported in India in 2001, from Siliguri.

“Situation under control, no cause for panic,” said Union health minister J.P. Nadda today. In a press release, the ministry said people should not believe in rumours posted on social media and should not spread panic.

They have also said that those who have come in contact with the virus have been placed under observation and further steps are being taken to prevent exposure through animal vectors. “This appears to be a localised occurrence,” said the Central government.

Here’s what you need to know about the deadly virus and the situation in Kozhikode, Kerala.

What is the Nipah virus?

Fruit-eating bats and domestic animals like pigs are hosts for the virus. In Kerala, bats were found inside a well from which victims were drawing water. The virus is also transmitted from contaminated half-eaten fruits, consumed by these animals, or from items like palm wine or toddy. The virus also transmits from humans to humans.

According to the Centers for Disease Prevention and Control (CDC), the virus manifests as an inflammation of the brain. The incubation period is between five and 14 days, and the illness presents itself as fevers, headaches, drowsiness and disorientation. This can become a coma in 24 to 48 hours.

What are the treatment and prevention options?

Treatment options are limited mostly to supportive care.

Prevention measures involve avoiding exposure to risks like infected pigs or bats in endemic areas, and avoiding drinking date palm sap or eating fruits that may have been half-eaten by these bats. Besides this, focused surveillance, effective diagnostics and awareness measures can mitigate outbreaks.

What happened in Kerala?

The first set of deaths was reported in the press Sunday, when three members of the same family died from the Nipah virus. They had died between May 5 and May 19. Another two members of the same family are also being treated for the virus.

What is the government of Kerala doing?

The chief minister of Kerala tweeted that his office is “closely monitoring the spread of the Nipah virus”.

A state-wide alert has been issued, although the virus has been reported in the district of Kozhikode. The state government has also set up a 24-hour control room. Private hospitals have been told not to deny treatment to anyone suffering from fever. Isolation wards have also been set up.

What is the Centre doing?

Two teams from New Delhi have been sent by the Central government to investigate the outbreak.

The government’s investigation team visited the house where the first set of victims were reported. They found many bats in the well which the family was drawing water from. Some of these bats have been caught and sent to labs for examination. Sixty samples of other materials have also been sent for examination.

The government’s press release today describes the protocol being followed:

“The field team has advised hospitals to follow intracranial pressure (ICP) guidelines, use personal protective equipment (PPE) for healthcare workers and sample collection; assist in enhancing active fever surveillance in the community; strengthen contact tracing in close contacts of cases, relatives, health care workers; ensure isolation facilities, ventilator support and hospital infection control practices; and coordinate with animal sector and enhance surveillance for unusual illness and deaths in animals.”

The Central government is also working to ensure that diagnostic kits, protective equipment and risk communication material is available in both private and public hospitals.

The Centre and state governments are working with resources of the National Institute of Virology, National Centre for Disease Control, Ministry of Health and Family Welfare and Department of Animal Husbandry, Dairying and Fisheries. The Manipal Centre for Virus Research is also involved in the investigation into this outbreak.

Occurrence of the Nipah virus?

The virus was first isolated and identified in 1999 among pig farmers in Malaysia and Singapore. Nearly 300 cases were reported during this outbreak, with over a 100 deaths.

The World Health Organisation (WHO) calls this a “newly-emerging zoonosis”.

In South Asia, a different strain of the virus was detected in Bangladesh in 2001.

Siliguri in India saw an outbreak in 2001. Sixty-six cases were detected, 45 of these patients died. A smaller outbreak was reported in 2007, when all five people who were detected with the virus died.

“Unlike the Malaysian NiV outbreak, outbreaks occur almost annually in Bangladesh and have been reported several times in India,” says the CDC. The CDC also says “Conversely, person-to-person transmission of Nipah virus in Bangladesh and India is regularly reported. This is most commonly seen in the family and caregivers of Nipah virus-infected patients.”

Nipah Virus Claims Ten Lives in Kerala, Including Nurse

The World Health Organisation has been informed about the outbreak of the virus in Kerala.

New Delhi: The Nipah virus has so far claimed ten lives in Kozhikode and Malappuram districts in north Kerala, while the condition of two persons undergoing treatment for the viral disease is said to be critical, health minister K.K. Shylaja said today (May 22).

The World Health Organisation has been informed about the outbreak of the virus in Kerala, she told reporters.

Two persons – Rajan and Ashokan, who were undergoing treatment at Kozhikode and died this morning, have been confirmed to have contracted the virus, she said. A nursing assistant, Lini Puthussery, who died yesterday, had also contracted the virus, she added.

A note Puthussery left for her husband has been widely read, with many pointing out how her death highlights the risks involved in being a healthcare worker. “Saji Chetta, I am almost on my way. I don’t think I will be able to see you. Sorry. Take care of our children properly. Our innocent child, take him to the gulf. They shouldn’t be alone like our father. Lots of love,” her note says.

Kerala chief minister Pinarayi Vijayan said nurse Puthussery’s “selfless service will be remembered”.

Twelve out of the 18 samples sent for testing have tested positive for the virus, of which ten people have died.

Two deaths reported on May 20 from Malappuram – Sindhu and Sijitha – also tested positive for the Nipah virus.

The two had come to Kozhikode Medical College Hospital for treatment and had been in touch with one of the infected persons who had died of the virus, the minister said.

No fresh case has been reported so far, she said.

Shyalaja said Union health minister J.P. Nadda, who is in Geneva, had called her and enquired about the situation in the state, and promised all possible help from the Central government.

An expert team from the National Centre for Disease-Control, including its director Dr Sujeet Kumar Singh and head of epidemiology Dr S.K. Jain, are already in Kerala.

A high level team from AIIMS has also reached the state, she said.

(With PTI inputs)