KOZHIKODE (Kerala), Sept 13: Nipah virus infection has broken out in Kerala
for a third time, claiming two lives and infecting three others. The two deaths
were reported from a private hospital in Kozhikode district in the past few
days.
The first death was of a 44-year-old reported on August 30. Nipah virus was
first suspected when his son (9) and another relative (24) also sought treatment
for symptoms similar to the viral infection. Antivirals and monoclonal antibodies
are currently being used to treat the two patients and another infected medical
worker.
The victim was a native of Maruthonkara village, where the first Nipah outbreak
took place in 2018 also. Fruit bats from the area had tested positive then.
Extensive deforestation has brought people and wildlife closer and hence the
viral diseases are on the rise.
The second death of a 40-year-old man of the same district took place in the
same hospital on Monday. He contracted it in the hospital from the person who
died earlier but both have no connection.
All the cases had confusing symptoms of a viral infection starting with high
fever.
"Nipah virus infection has been confirmed in Kozhikode district. Two people
died due to the infection. Of the four people whose saliva was sent for testing
(Pune Virology Lab), two were Nipah positive and two were Nipah negative," Chief
Minister Pinarayi Vijayan said in a Facebook post on Wednesday. He appealed
to the people to not panic but take precaution.
A list of contacts of those infected has been made. However, the Government
is yet to make an announcement of Nipah viral epidemic in the State. The health
department has started preventive steps.
Seven village panchayats - Atanchery, Maruthonkara, Tiruvallur, Kuttiyadi,
Kayakkodi, Villyapalli and Kavilumpara - in Kozhikode district have been declared
as containment zones.
Travel in and out is barred in the containment areas from Wednesday. Schools
and offices were closed, transport services stopped and public gatherings barred.
The Government said on Wednesday that a team from the National Institute of
Virology (NIV) in Pune is rushing to Kerala to set up a mobile lab at the Kozhikode
Medical College and also study the bat behaviour.
It has been stated that the new Nipah is a Bangladesh variant with high mortality
rate but slow in transmission unlike covid.
The Central Government on Tuesday sent a team of health experts
to Kerala.
There were two outbreaks in the State in the past and both were in the same
Kozhikode district. The first was reported at Changaroth near Perambra in May
2018 which claimed 17 lives (of 18 infected). Second time a 12-year-old boy
from Chathamangalam died in September 2021.
Meanwhile, neighbouring Tamil Nadu has announced that travellers coming from
Kerala would be subjected to medical tests.The Government has alerted the hospitals
in the State.
Mode of transmission, symptoms and patient management
Nipah viral infection is zoonotic and is spread mainly by fruit bats - through
fruits bitten by infected bats. It is potentially fatal to animals as well as
humans. Fruit bats transmit the virus to other animals like pigs, and also dogs,
cats, goats, horses and sheep. They, especially pigs, also transmit the infection
to human beings. Pigs can die en masse. Although, any animal or bird is a potential
host and may spread the disease.
The infection takes place through bodily fluids like saliva or fomites or even
by person to person or animal contact or through contaminated food. Transmission
through drinking of raw date palm sap (local toddy), or fruits contaminated
by bat urine or saliva (bite), has also been identified.
The symptoms start with fever, muscular pain, headache, fever, dizziness and
nausea like in other viral infections and could easily go misdiagnosed. It almost
looks similar to covid. Nipah leads to fatal encephalitis or what is called
brain fever, progressing to coma and death. A new symptom that kills the patient
is acute respiratory problem.
Since there is no cure or any vaccine, the focus has to be on prevention. The
management of the infection includes supportive care with treatment of symptoms.
However, antiviral Ribavirin has been found to an extent helpful in reducing
mortality. The fatality rate of Nipah is globally estimated at 40% to 75%. Nipah
has an R-value of less than one.
In order to help prevent infection, there are some basic and simple tips: Wash
your hands frequently, especially before taking food; heat food before
consumption; be wary of fomites; avoid fruits contaminated by bats; avoid
physical contact with other people.
In India, apart from Kerala, there have been cases reported from Bengal where
in 2001 and later over 50 people died.
Nipah virus was first identified in 1998-99 in an outbreak among pig farmers
in Malaysia (of 265 infected, 105 died). Singapore also had an outbreak. In
Bangladesh there have been several outbreaks.
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