As Kerala health officials warn of second Nipah virus outbreak, here's all you need to know of the infection

As concern over the Nipah virus infection outbreak grows by the day, killing 17 people in Kerala so far, health officials in the southern state have warned of the possibility of a second outbreak.

Noting that all those in contact with the affected individuals are still in the incubating period of the virus, health minister KK Shailaja, in a statement on Friday, underlined that even though there is no need to fear or feel panic, as a matter of caution, all possible precautionary steps should be taken.

"We had indicated at the outset itself, there could be a possible second outbreak and the vulnerable are those who would have come in contact with the affected. All such people have to be closely watched... tests will reveal only at the appropriate time when the symptoms of the Nipah virus surface, so all those who have come in direct contact with the earlier affected have to see they get in touch with the special control room set up in Kozhikode," Shailaja said.

Even though there have been no positive cases on Friday, six persons were admitted to the Kozhikode medical college with symptoms of the virus, an official said. Of the 203 samples tested for the Nipah virus, there have been 18 positive cases.

Here is a detailed rundown of all that has happened since the Nipah virus infection broke out:

ICMR reaches out to Australia for antibody to 'neutralise' virus

Nipah virus (NiV) infection is a newly emerging zoonosis that causes severe disease in both animals and humans. The natural host of the virus are fruit bats of the Pteropodidae Family, Pteropus genus. Currently, there is no vaccine or drug for the treatment of the Nipah virus infection. The treatment for human cases is supportive and management treatment along with intensive supportive care.

The fruit eating bat that was caught by the expert group, for the study of the spread of Nipah Virus at Perambra in Kozhikode on Wednesday, May 30 2018. These bats were sent to Bhopal for the tests regarding the presence of the virus. PTI

The fruit eating bat that was caught by the expert group, for the study of the spread of Nipah Virus at Perambra in Kozhikode on Wednesday, 30 May. These bats were sent to Bhopal for the tests regarding the presence of the virus. PTI

The Indian Council for Medical Research (ICMR) had earlier reached out to the University of Queensland, Australia, which has developed an antibody to combat and 'neutralise' the virus. The antibody was expected to reach India on Thursday.

According to The News Minutethe Human Monoclonal Antibody (M 102.4) is a non-patented drug, developed by Dr Christopher C Broder from Australia. The antibody is still referred by a number, and not a name as its clinical trials are yet to be completed. It is important to note, that the antibody can only neutralise the effects of the virus, and is not a vaccine.

"We have asked them to give their monoclonal antibody for conducting a test in India to find out if it can neutralise the Nipah virus in humans. In Australia, it has only been tried in vitro (happening outside the body in artificial conditions, often in a test tube) and has been found to be effective. But it has not been tested on humans," Dr Balram Bhargava, ICMR Director General, said while clarifying that it will not lead to the creation of a vaccine.

Kerala government steps up vigil in Kozhikode, Malappuram

The Kerala government on Friday stepped up vigil against the Nipah virus that has claimed 17 lives in Kozhikode and Malappuram districts, even as staffers of a taluk hospital at Balussery have been asked to go on leave as a precautionary measure, after two Nipah-affected persons, who were treated at the hospital initially, succumbed to the virus.

Even though there have been no positive cases on Friday, six persons were admitted to the Kozhikode medical college with symptoms of the virus, an official said.

The Public Service Commission has postponed all its written and online exams, scheduled to be held, till 16 June. New dates will be announced later.

Reopening of schools in the two districts had earlier been postponed to 5 June.

Health authorities have drawn up a list of 1,949 people who had come in contact with the Nipah-affected persons to monitor their health condition. A control room has been opened at the Kozhikode medical college which will regularly contact them to know about their health conditions, the official said.

The central experts from the National Centre for Disease Control are continuing to evaluate the situation and taking necessary measures, said a press release quoting the minister. Moreover, a team of doctors from the Manipal and Thiruvananthapuram medical colleges is also evaluating the situation.

Soldier from Kerala dies of suspected Nipah virus infection

A soldier died in Kolkata of suspected Nipah virus infection, a defence spokesman said on Wednesday (30 May).

Seenu Prasad, who hails from Kerala and posted at the Eastern Command headquarters Fort William, was admitted to the Command Hospital in Kolkata on 20 May and passed away on 25 May, the spokesman said. Prasad had been on a month's leave to Kerala before rejoining duty on 13 May.

His body fluids have been sent to the National Institute of Virology in Pune which is the only agency in the country to certify whether it was a case of Nipah virus or not. "Till such time the report from the NIV in Pune is received it cannot be confirmed whether it was a case of Nipah virus or not," the spokesman said.

UAE bans fruits from Kerala after the outbreak

The United Arab Emirates (UAE) has banned imports of fresh vegetables and fruits from Kerala due to the outbreak of the rare brain-damaging Nipah virus, the Gulf state said on 29 May.

The UAE’s Ministry of Climate Change and Environment also notified other local authorities, including the Abu Dhabi Food Control Authority and the municipalities of its emirates, to prevent the entry of any fresh produce from Kerala, it said in a statement.

The ministry suspects that fruit bats are the source of the virus. It said it was banning fresh produce, including mangoes, dates, and bananas — the bats’ preferred fruits.

Doctors and relatives wearing protective gear carry the body of a victim, who lost his battle against the brain-damaging Nipah virus, during his funeral at a burial ground in Kozhikode, in the southern Indian state of Kerala on 24 May. Reuters

Doctors and relatives wearing protective gear carry the body of a victim, who lost his battle against the brain-damaging Nipah virus, during his funeral at a burial ground in Kozhikode, in Kerala on 24 May. Reuters

State governments issue health advisories

While the Nipah virus may not have spread beyond Kerala, concerns over it have spread across the country with several states investigating suspicious cases and issuing advisories on precautions and travel to Kerala.

Rajasthan: The Rajasthan government on 26 May issued an advisory, asking people not to travel to affected parts of Kerala and for officials to maintain caution. Although there has been not a single case of Nipah virus registered in the state till date, the state health department needs to remain extra cautious on the issue, said Chief Secretary DB Gupta.

Additional Chief Secretary, medical and health, Veenu Gupta said that all joint directors and chief medical officers have been directed to take special measures in this regard including setting up rapid response teams in the districts but requested people not to panic.

Madhya Pradesh: The state health ministry on 25 May issued an advisory against eating fruits that are fallen on the ground or appear to have animal teeth or claw marks. "People should avoid going to areas that might have bats. Stay away from suspected infected persons," said Health Services director BN Chouhan.

Bihar: The Bihar government issued a Nipah virus alert on 26 May, asking people to take precautions, an official said.

Chief Minister Nitish Kumar on 28 May said that there is a need to create awareness among people about the deadly virus. "There is a need to organise 'swasthya mela' at the panchayat level for creating awareness about various diseases. Recently, we have come to know about a disease (Nipah) in Kerala, for which we have to create awareness among people," Kumar said at a function organised by the health department.

Delhi: The Delhi government on Thursday, while issuing a health advisory for the Nipah virus, said that no incidence of the infection has been reported in the national capital as of now.

In the advisory, the Directorate General of Health Services said that the infection, spread from animals to humans, "can happen through infected bats by their bite or indirectly by consuming fruits contaminated by their saliva, close contact with infected pigs or patient of Nipah virus infection".

Himachal Pradesh: Panic gripped Himachal Pradesh when several bats were found dead at Government Senior Secondary School in Barmapapri in Sirmaur district this week. However, tests at the National Institute of Virology in Pune ruled out that the bats were carrying Nipah virus.

Himachal Pradesh Additional Chief Secretary BK Agarwal advised people not to panic about the Nipah virus and said that all medical colleges in the state are prepared to deal with the situation if it occurs.

Telangana: Similarly, in Telangana, two persons, including one who visited Kerala recently, were admitted to hospitals on 25 May with suspected Nipah virus infection. The state health authorities, without taking any chances, have sent their samples to Pune for investigation.

K Shankar, Director, Institute of Preventive Medicine (IPM), Hyderabad said that people should postpone their plans to visit Kerala in view of the situation. The authorities are conducting awareness campaigns and are also screening people at airport, railway and bus stations.

Telangana Director of Medical Education K Ramesh Reddy, however, said there was no need for panic as the state had not recorded any confirmed case of Nipah virus.

'No cases detected in North East'

No case of Nipah virus has been detected in the North East, an official said on 29 May, denying misleading social media reports about its presence in the region. Manipur's health services director, K Rajo said there were social media reports to the effect that some cases of Nipah had been detected in Meghalaya, but officials in the state denied any confirmed case.

The North East region, which is visited daily by people from other states including Kerala — where an outbreak of the disease claimed several lives, is vulnerable to such diseases, he said, but added the northeastern states have geared up on precautionary measures.

He also said that special isolation wards are being arranged in the two major hospitals, Regional Institute of Medical Sciences and JN Institute of Medical Sciences located in Imphal to cope with any eventuality.

The Nipah virus spreads through close contact with people's secretions and excretions. Eating food which may have the droplets of saliva and urine of infected bats can lead to the transmission of the virus.

Earlier, cases of Nipah virus were reported from Siliguri in 2001 and Nadia in 2007 in the eastern state of West Bengal and around 47 deaths were reported.

With inputs from agencies


Updated Date: Jun 02, 2018 16:24 PM

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