Nipah virus in Kerala – Artifex.News https://artifexnews.net Stay Connected. Stay Informed. Sat, 16 Sep 2023 15:30:00 +0000 en-US hourly 1 https://wordpress.org/?v=6.6.2 https://artifexnews.net/wp-content/uploads/2023/08/cropped-Artifex-Round-32x32.png Nipah virus in Kerala – Artifex.News https://artifexnews.net 32 32 Why Nipah virus outbreaks are occurring only in Kerala https://artifexnews.net/article67311946-ece/ Sat, 16 Sep 2023 15:30:00 +0000 https://artifexnews.net/article67311946-ece/ Read More “Why Nipah virus outbreaks are occurring only in Kerala” »

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Health workers wait to admit patients at a Nipah isolation ward at the Medical College, in Kozhikode on Friday.
| Photo Credit: PTI

Since May 2018 when Kerala reported the first Nipah outbreak in Kozhikode district, there have been three more outbreaks of Nipah virus including the latest one in late-August 2023. For reasons still not known, three of the four Nipah outbreaks in Kerala in 2018, 2021 and 2023 have been in Kozhikode district; the 2019 outbreak was in Ernakulam district.

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Even five years after the first outbreak in Kerala, and four outbreaks in all, it is still unclear why three of the four outbreaks have been in Kozhikode district in Kerala. Fruit bats that can cause Nipah virus outbreaks in humans are not restricted to Kozhikode district.

As per a 2021 study, Nipah virus was found to be in circulation in fruit bats (Pteropus species) in “many districts” in Kerala. An ongoing nationwide survey in 14 States by NIV Pune has found Nipah virus antibodies in fruit bats (Pteropus medius) in nine States, including Kerala, and the Union Territory of Pondicherry.

While date palm sap was linked to Nipah virus outbreaks in Bangladesh, and pigs acting as intermediate hosts were responsible for Nipah outbreaks in Malaysia, the route of virus transmission from bats to humans has not been clearly established in Kerala.

The four outbreaks in five years may be because the virus has either become endemic in bats in Kerala or is a reflection of Kerala’s superior healthcare system that thoroughly investigates undiagnosed fever cases for possible Nipah virus infection or both. However, with fruit bats positive for Nipah virus antibodies being found in other States, it is likely that Nipah virus infection and deaths may be going undetected in other States while they get picked up in Kerala, especially in Kozhikode district. 

“Whenever we have undiagnosed fever cases, a team involving virologists is formed and we undertake a detailed investigation which helps us diagnose Nipah virus and other new virus outbreaks early. In other States, Nipah cases might be going undetected,” says Dr. Anoop Kumar A.S., Director of Critical Care Medicine, North Kerala Cluster, Aster MIMS Calicut, Kerala. Dr. Kumar played a pivotal role in detecting the Nipah virus outbreak in Kerala in 2018 and 2023. “Early lab confirmation, healthcare system acting fast and immediate public health response in Kerala has helped contain the outbreak quickly each time.”

In the 2019 and 2021 outbreak, there was only a single case without any human-to-human transmission. “Nipah virus infection and deaths might have happened in different parts of India in people with undiagnosed fever, which might have gone undetected. Also, there is no Nipah testing facility anywhere in India except NIV Pune. Only Kerala screens for Nipah virus routinely in a molecular lab in Calicut Medical College,” he says. “While other States may not be routinely sending samples for Nipah virus testing, we test for Nipah whenever there are cases with unusual symptoms. That might be the reason why Kerala is detecting Nipah cases.”

Usually, people with Nipah virus infection present with encephalitic symptoms. But in the latest outbreak, patients presented with pure respiratory symptoms, not reported anywhere in the world before. “But we could still identify them as Nipah only because we have a high index of suspicion,” says Dr. Kumar.

In 2018 and in 2023, the index case had died with encephalitis in 2018 and severe pneumonia in 2023 that went unnoticed. In 2018, a cluster formed and Nipah virus was diagnosed among three contacts who were admitted with unusual symptoms about two weeks after the death of the index case. “There was a [possible] index case, clustering and unusual symptoms seen in the contacts. There was a high index of suspicion and that led us to diagnose Nipah virus in 2018,” recalls Dr. Kumar.

In the latest outbreak too, there was a death in another hospital in Kozhikode city on August 30 and four of the family members developed unusual symptoms on September 9 and were admitted two days later at Aster MIMS Calicut. Nipah virus was diagnosed the very next day after admission. “We noticed a clustering of cases after the death of the person. During a detailed history taking we came to know that the person who died had unusual symptoms. And the family was from a locality quite close (10-15 km) to the 2018 outbreak epicentre. There was a high index of suspicion of a new emerging virus or Nipah due to the combination of a [possible] index case, clustering of cases, unusual symptoms and proximity to the first outbreak epicentre. So we first tested for Nipah virus,” he says. 

At the time the deaths happened in the index case in 2018 and 2023, Nipah virus was not diagnosed. In 2019 and 2021, only a single case was detected (ending in death in 2021 unlike in 2019). This raises the possibility of several people getting infected with Nipah virus and even dying without a diagnosis in other parts of Kerala and other States, especially when only one or a few cases occur, he says.

The Nipah virus has low infectivity (R0 of 0.2-0.3 compared with R0 of over 1.5 in the case of SARS-CoV-2 virus). “The infectivity from first-degree to second-degree patients is low when infected with Nipah virus but high in the case of index cases,” Dr. Kumar explains. In 2019 and 2021, the infectivity of even the index case might have been less as they had only encephalitis symptoms, which reduces the chances of virus spread, he says while explaining why there were no secondary cases then. Also, every Nipah virus index case need not turn out to be a superspreader.



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Kerala To Test Samples Of All Persons In ‘High-Risk’ Nipah Contact List https://artifexnews.net/kerala-to-test-samples-of-all-persons-in-high-risk-nipah-contact-list-4391356rand29/ Fri, 15 Sep 2023 00:55:36 +0000 https://artifexnews.net/kerala-to-test-samples-of-all-persons-in-high-risk-nipah-contact-list-4391356rand29/ Read More “Kerala To Test Samples Of All Persons In ‘High-Risk’ Nipah Contact List” »

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Kerala Health Minister said the mobile lab has 2 machines each of which can test 96 samples at a time.

Thiruvananthapuram:

The Kerala government on Thursday decided to take body-fluid samples of all of those who are on the ‘high-risk’ contact list linked to the first Nipah victim, a 47-year-old man who died on August 30 in the latest outbreak of the infection in the state.

State Health Minister Veena George said they had a high-level meeting on Thursday and after that the Principal Secretary had a meeting with officials of the Union Government.

“We have decided to take samples of all the persons who are in the high-risk contact list of the first person, who died on August 30,” said Veena George.

The Minister also said that the hospitals, where Nipah patients are being treated, should constitute a medical board for their treatment, and every 12 hours they should provide a medical report of the patients to the Health Department.

Veena George said that there are 14 persons in isolation who don’t have any epidemiological link with the persons who died of the Nipah virus.

“We have some patients in isolation in private hospitals. Eleven have got mild symptoms, so their samples are also being taken and sent to the lab,” said Ms George.

The Minister also said that the vitals of the nine-year-old son of the first Nipah victim, who is being treated for the disease, are stable.

The minister flagged off the mobile virology lab of the Rajiv Gandhi Centre for Biotechnology. The mobile virology lab will be deployed in Nipah containment zone in the Kozhikode district.

The Minister said the mobile lab has two machines each of which can test 96 samples at a time.  

Chandrabhas Narayana, Director of Rajiv Gandhi Centre for Biotechnology, said that the mobile lab will function round the clock.  The results of the samples tested will be available after around six hours of the test, he added.

Meanwhile, after a health worker from a private hospital tested positive for Nipah on Wednesday, the number of cases in the current spell of Nipah in Kerala rose to five.

In Kozhikode district, where Nipah cases have been reported, District Collector declared closure of educational institutions on September 16, in addition to the two-day closure for September 14 and 15.

The schedule of university and PSC exam remains unchanged.

“All tuition centres and coaching centres in the district should not function on these days. Educational institutes can arrange online classes… Avoid unnecessary travel and gatherings. Caution is prevention,” said the Kozhikode DC A Geetha in a social media post.

(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)



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“All Arrangements In Place To Prevent Nipah Spread”: Kerala Health Minister https://artifexnews.net/all-arrangements-in-place-to-prevent-nipah-spread-kerala-health-minister-4386826rand29/ Wed, 13 Sep 2023 13:55:19 +0000 https://artifexnews.net/all-arrangements-in-place-to-prevent-nipah-spread-kerala-health-minister-4386826rand29/ Read More ““All Arrangements In Place To Prevent Nipah Spread”: Kerala Health Minister” »

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2 people have died of Nipah virus in Kerala. (Representational)

Thiruvananthapuram, Kerala:

Amid fears of the spread of Nipah virus in Kerala after the death of two patients in Kozhikode district, Health Minister Veena George on Wednesday said the state government had made all arrangements to contain the pathogen and ensure public safety.

In a reply to a query by CPI MLA P Balachandran in the Assembly, Veena George said on Wednesday, “It is now confirmed that the two patients, who died on Monday at a private hospital in Kozhikode, were infected with Nipah virus. There are two active cases in the district presently. Both the active cases – a 9-year-old child and a 24-year-old person – are relatives of one of the deceased.”

“After the unnatural death of two persons, the health director swung into action immediately. Om Tuesday, the central government sent a team of health experts to Kerala after the Union Health Minister (Mansukh Mandaviya) confirmed that the two unnatural deaths were caused by Nipah virus,” the minister added.

The first death was reported on August 30 and the second on September 11.

The minister informed further that the Health department, on Monday, held a high-level meeting and all senior health officials were asked to visit Kozhikode to assess the situation.

Certain protocols were issued and 16 committees were put together to keep track of the situation, the minister informed, adding that surveillance and contact tracing were being ensured in the district and isolation wards have also been opened at Kozhikode Medical College.

“The health department has taken every possible step to prevent the spread of Nipah infection. The priority for the Health department at this stage is to prevent more people from catching the Nipah virus and arrange timely treatment of suspected patients, including psychological support,” the Health minister said.

She added that while there are two laboratories in the state where samples could be tested for Nipah, only the National Institute of Virology (NIV), Pune, has been vested with the authority, under central norms, to determine if a person is infected with Nipah.

The Kerala Health Department has, meanwhile, issued an alert for Kannur, Wayanad and Malappuram districts after two confirmed Nipah deaths in Kozhikode.

Veena George said the Health department made contact with the Indian Council of Medical Research (ICMR), which assured of the availability of monoclonal antibodies for the treatment of the suspected Nipah patients admitted at a private hospital.

The Health minister, along Public Works Department Minister Mohammed Riyaz, reached Kozhikode earlier on Tuesday to coordinate the response to the suspected Nipah outbreak with the district administration.

An emergency meeting was held with MLAs of the district, people’s representatives of the affected areas, the district collector, senior health officials and othes officers concerned in the district.

(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)



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Nipah Alert Sounded In Kerala’s Kozhikode After Two ‘Unnatural’ Deaths https://artifexnews.net/nipah-alert-sounded-in-keralas-kozhikode-after-two-unnatural-deaths-4381348rand29/ Mon, 11 Sep 2023 19:34:37 +0000 https://artifexnews.net/nipah-alert-sounded-in-keralas-kozhikode-after-two-unnatural-deaths-4381348rand29/ Read More “Nipah Alert Sounded In Kerala’s Kozhikode After Two ‘Unnatural’ Deaths” »

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Deaths due to Nipah virus infection were reported in Kozhikode district in 2018 and 2021.

Thiruvananthapuram:

The Kerala Health Department sounded a health alert in Kozhikode district on Monday following two “unnatural” deaths suspected to be due to the Nipah virus infection.

State Health Minister Veena George held a high-level meeting and reviewed the situation, the health department said in a statement on Monday night.

It said two “unnatural” deaths following fever were reported from a private hospital, and it is suspected that these were due to the Nipah virus.

Relatives of one of the deceased are also admitted to the intensive care unit, it said.

Deaths due to Nipah virus infection were reported in Kozhikode district in 2018 and 2021.

The first Nipah virus (NiV) outbreak in south India was reported from Kozhikode on May 19, 2018.

According to the World Health Organization (WHO), Nipah virus infection is a zoonotic illness that is transmitted to people from animals and can also be transmitted through contaminated food or directly from person-to-person.

Among infected people, it causes a range of illnesses, from asymptomatic (subclinical) infection to acute respiratory illness and fatal encephalitis.

The virus can also cause severe disease in animals such as pigs, resulting in significant economic losses for farmers, WHO said.

(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)



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