2 deaths due to Nipah virus and 5 confirmed cases, Kerala sees 2018 all over again

In 2018, a total of 17 people died from Nipah virus infection in Kerala, and the case fatality rate was very high, at 83 per cent. In 2023, the state of Kerala is once again grappling with Nipah virus cases.

Given that there is no specific treatment for the infection, Kerala is responding swiftly to this rare and deadly outbreak, which has already claimed two lives in the state in the past few days.

Kerala's Health Minister, Veena George, confirmed a new case of the Nipah virus in Kozhikode district on Wednesday, September 13, bringing the total number of affected individuals to five.

George disclosed that over 700 people, including 153 healthcare workers and 77 individuals in high-risk categories, have come into contact with the health worker associated with the latest case.

Control measures in place

In response to the escalating threat, Kerala has temporarily closed some schools, offices, and public transportation services. The Nipah virus is known to spread through contact with the bodily fluids of infected bats, pigs, or humans.

Kerala's Chief Minister, Pinarayi Vijayan, has urged the public to avoid gatherings in the Kozhikode district for the next 10 days.

"More people could be tested... Isolation facilities will be provided," Pinarayi Vijayan, Chief Minister of Kerala, said in a statement. He asked people to avoid public gatherings in the Kozhikode district for the next 10 days.

Strict isolation protocols have been implemented, and medical staff are placed in quarantine after any contact with infected individuals.

VIDEO | "So far, three samples have tested positive for Nipah virus. Since yesterday, we have started contact tracing and 706 people are in the contact list. Out of 706, 77 people are at high risk," says Kerala Health minister Veena George on #NipahVirus outbreak in the state. pic.twitter.com/geImlzDSPf

— Press Trust of India (@PTI_News) September 13, 2023

Outbreak origin and risk

The first victim of this outbreak was a small-scale farmer residing in the Kozhikode village of Maruthonkara.

The Nipah virus was initially identified in 1999 during an outbreak in Malaysia and Singapore, affecting pig farmers and individuals in close contact with animals.

Outbreaks are sporadic, with previous infections in South Asia linked to the consumption of date-palm sap contaminated with bat excreta.

Kerala's proximity to a forest inhabited by several bat species has raised concerns, as fruit bats from the same area tested positive for the virus during the 2018 Nipah outbreak.

Containment zones in Kerala

• The Kerala government has declared seven villages in Kozhikode as containment zones due to the Nipah outbreak.
• Entry and exit in these areas are restricted, with only essential stores permitted to operate from 7 am to 5 pm.
• Social distancing, mask-wearing, and sanitizer use are mandatory in these zones, where vehicular traffic is prohibited.
• Neighboring districts of Kannur, Wayanad, and Malappuram have been put on alert after several people tested positive for Nipah.
• Education Minister V Sivankutty has directed the Public Education Director to organize online classes for students of all schools in the containment zone.
• Entry and exit in 43 wards in the seven gram panchayats (containment zones) have been restricted.

VIDEO | Central team visits Nipah-affected areas in Kozhikode, Kerala. pic.twitter.com/80n5zLbVfQ

— Press Trust of India (@PTI_News) September 14, 2023

Karnataka, Tamil Nadu issue safety guidelines

Karnataka has issued guidelines to prevent the spread of the Nipah virus in response to the outbreak in Kerala. These include taking voluntary and vigilant measures near the Kerala border, taking necessary action to convene a meeting of the District Rapid Response Team regarding Nipah virus management, and alerting all government and private health institutions in Dakshina Kannada to report Nipah virus cases and immediately inform the district unit.

Tamil Nadu has also taken precautionary measures, announcing medical tests for travelers arriving from Kerala. Those displaying flu symptoms will be isolated.

VIDEO | The Kozhikode administration has declared seven village panchayats as containment zones to prevent the spread of Nipah virus. Two people have died and two others have been infected by the virus in Kerala so far.#NipahVirus pic.twitter.com/FwDG00DsGu

— Press Trust of India (@PTI_News) September 13, 2023

What is Nipah virus? Symptoms, diagnosis, and treatment

Nipah virus (NiV) is a zoonotic virus, meaning that it can spread between animals and people. Fruit bats, also called flying foxes, are the natural reservoir for NiV. NiV can also infect pigs and people.

ALSO READ: Nipah virus alert issued in Kerala after two 'unnatural' deaths

Symptoms of NiV infection can range from mild to severe, and can include:

• Fever
• Headache
• Cough
• Sore throat
• Difficulty breathing
• Vomiting
• Dizziness
• Drowsiness
• Altered consciousness
• Seizures
• Coma
• Encephalitis, or swelling of the brain, is a common complication of NiV infection and can be fatal.

Diagnosis of NiV infection can be made through laboratory testing of blood, saliva, or cerebrospinal fluid (CSF). RT-PCR testing is the most sensitive and specific test for NiV infection.

Treatment for NiV infection is supportive and includes treatment for symptoms such as fever, respiratory problems, and seizures. There are no specific antiviral drugs approved for the treatment of NiV infection.

Prevention of NiV infection includes:

• Avoiding contact with sick pigs and bats
• Not drinking raw date palm sap
• Practicing good hygiene, including washing hands frequently
• Cooking meat thoroughly

Person-to-person transmission of NiV is rare but can occur through close contact with respiratory secretions or bodily fluids of an infected person. Healthcare workers who care for NiV patients should take precautions to prevent infection, such as wearing personal protective equipment (PPE).

If you have any concerns that you may have been exposed to NiV, please contact your healthcare provider.