Kerala gears up to contain Nipah; 50 who came in contact with youth under observation; no need to panic, says health minister

The Kerala government is gearing up for another battle against the deadly Nipah virus that claimed 17 lives, including five members of a family, in Kozhikode and Malappuram districts in May last year. The state health department has summoned resources after a 23-year-old youth admitted in a private hospital in Ernakulam with severe fever showed signs of the virus in his samples tested at the National Institute of Virology at Alappuzha. The results of the samples sent to the institute at Pune are awaited for confirmation. [caption id=“attachment_6749621” align=“alignleft” width=“380”] People queue up at Ernakulam General Hospital after reports emerged of a 23-year-old man contracting the Nipah virus. PTI[/caption] The youth, who studies at a college in Thodupuzha town of Idukki district, developed fever after he came to Thrissur for an internship in a private company. While the youth has been moved to an isolation ward, 22 students who travelled with him to Thrissur and another 28 persons who came in contact with him have been put under observation. Thrissur district medical officer Dr KJ Reena said none of the people under observation in the district have shown any sign of fever or other diseases. However, the authorities have stepped up facilities at Thrissur Medical College for meeting any eventuality. Precautionary measures have also been taken in the nearby districts of Kozhikode and Ernakulam. Isolation wards have been set up in medical colleges in Thrissur, Kozhikode and Ernakulam. State health minister KK Shylaja said that the government has also stocked adequate medicines to provide timely treatment to the affected people. The minister has asked all government, private and periphery hospitals to remain cautious and report if any suspected cases come to their notice. Shylaja said there was no need for panic among the people as the department was fully equipped to deal with the outbreak of the virus. However, reports about the case in the mainstream and social media have triggered panic among the people across the state with many with even ordinary fever making a beeline to hospitals across the state. A doctor at Thrissur Medical College said that they were finding it difficult to cope with the rush. Dr B Padmakumar of Medicines department at Alappuzha Medical College said people are scared because most of the people who had come in direct contact with the person who first contracted the virus in 2018 had died. Majority of the deceased had infected the virus from the Kozhikode medical college hospital, where the affected were treated. The government was caught off guards when the Nipah virus had hit the state for the first time in 2018. Doctors at the Kozhikode Medical College did not suspect anything unusual when the first victim of the virus was referred from the Perambara government hospital on 4 May, 2018. The doctors had also not tested his blood even though he had showed unusual symptoms. He had died the next day. When his brother Salih was admitted with similar symptoms in a private hospital in the city, the doctors had initially suspected it as a case of Japanese encephalitis. The neurologists had sought outside help after the patient had shown signs that were not associated with encephalitis. After ruling out all common causes of encephalitis one by one, the samples of Salih were sent to Manipal Centre for Virus Research (MCVR), who confirmed Nipah, a virus that was not seen in Kerala before. Before the confirmation came, Salih had departed the world. The doctors also could not stop the death of another 15 people, including the nurse who had treated Sabith and his father and a paternal aunt. However, the measures taken by the health department to contain the virus had helped prevent the spread of the virus to more people in the affected areas and to new places. It was a massive operation involving all stakeholders — health workers, state government, scientists, researchers and the Central government. The measures included orienting hospitals and health workers on infection prevention and control practices, surveillance and contact tracing, contagion treatment protocols, the use of personal protection equipment, and safe burial practices. The success in containing the virus had received international recognition as well. The Institute of Human Virology in Baltimore had honoured Kerala chief minister Pinarayi Vijayan and state health minister Shylaja for the government’s efforts in curbing the outbreak. The medical community in the country also accepted it as a model for emulation by other states. This experience helped the state government in containing the risk of many zoonotic diseases spreading in the state following the August flood that killed large number of animals. However, health experts see the outbreak of Nipah as a sign of the emergence of zoonotic diseases and a major health challenge that the country is least prepared to face. Dr A Sukumaran, state epidemiologist with the Integrated Disease Surveillance Programme (IDSP) said that these diseases could be more threatening as there is little information on their origin and many of their epidemiological features remain unknown. The health authorities took three months to identify the source of the Nipah virus. Fruit bats were identified as the carrier of virus after two species of bats were tested. The first batch of 21 bats trapped and tested in May were found to be insectivores that do not carry the Nipah virus. The Indian Council of Medical Research (ICMR) confirmed the source after testing the second batch of 55 bats trapped by the officials of the animal husbandry. They included fruit bats, which tested positive for the Nipah virus. Sabith had contracted the virus after he consumed a fruit bitten by the virus-carrying fruit bats. His brother, father and a paternal aunt had contracted the virus after coming in contact with him. Dr Sukumaran said that the health authorities would not be able to deal with the zoonotic diseases unless people realise that their health is connected with the health of animals and the environment around them.