Nipah Reported In Kerala: Here’s Everything You Must Know About The Virus

Rapid response teams held meetings at the Ramanattukara Municipality in Kerala's Kozhikode following reports of a 43-year old man tested for Nipah virus at a Government Medical College. The National Institute of Virology (NIV), Pune, confirmed the diagnosis, prompting confinement measures in the region.

While the patient is admitted to the intensive care unit of Kozhikode Medical College, authorities have set in place quarantine measures with the district collector stating that 77 people were identified as having been in contact with the person, including 58 health workers and more than two dozen family members.

Of these, 13 have been kept under high-risk surveillance and are under quarantine according to the reports.

The patient, it is said, initially went to a hospital near his residence. He was discharged soon but deteriorating conditions brought him to a private hospital days later. Here, doctors first suspected Nipah after an MRI and cerebrospinal fluid examination, according to the Times of India.

Kozhikode collector M S Madhavikutty told media that containment drives have begun along with provision of personal protective gear and meeting of the response teams. A control room – with helpline numbers 04952373901 and 99072007767– has been set up at the district medical office to provide information to the public.

What is the Nipah Virus?

While Nipah Virus was first detected in 2018 in Kerala, its first outbreak was reported from Malaysia in 1999. According to the World Health Organisation, the virus is reported in Bangladesh, India, Malaysia, Philippines and Singapore.

Fruit bats from the Pteropodidae family are considered to be the natural hosts for the Nipah virus. Incidentally, the patient in Kerala has a godown in thick vegetation. Health officials revealed that the trader opened the godown after a long time and saw a large number of fruit bats. 

How does the virus spread?

WHO’s factsheet on Nipah states that from fruit bats, the virus can enter the human body through direct contact with infected animals such as bats, pigs or horses. It can also spread by consuming fruits or fruit products, such as raw date palm juice, contaminated by infected fruit bats.

Importantly, the virus can also spread between people especially among family members and healthcare workers. The WHO says the risk of spread can increase in health facilities owing to overcrowded, poorly ventilated hospital environments with inadequate implementation of infection prevention and control measures such as the use of personal protective equipment, cleaning and disinfection, and hand hygiene.

What are the symptoms?

A patient generally grows symptomatic after 3 to 14 days of the infection. These symptoms may include fever, chills, fatigue, drowsiness, dizziness, vomiting and diarrhoea. The WHO says headache or confusion in the brain or cough and difficulty in breathing is also seen.

The patient in Kerala was slurring in his speech as per media reports. In severe cases, neurological complications are noticed with brain swelling or encephalitis as well.

How deadly is Nipah?

Since 2018, Nipah has claimed around two dozen lives in Kerala alone. The WHO puts the mortality rate for Nipah Virus at around 40% to 75% but the Bangladesh strain reported from Kerala reportedly has an even higher fatality rate.

In Kerala almost all of the previous cases have been limited to the rain-fed months between May and September. Seasonal flu and viruses with similar symptoms can delay early diagnosis.

Also, in some cases the virus may even be asymptomatic or symptoms may be notable in a patient 45 days after infection, furthering chances of transmission.

Moreover, the WHO says that 1 in 5 recovered patients report long-term neurological conditions.

Add to this, the fact that without laboratory testing, it is difficult to tell Nipah from other infectious diseases, or other causes of encephalitis or pneumonia.

Treating and preventing Nipah

The WHO says there is no specific treatment for Nipah. The key, then, remains early diagnosis that enables early support and monitoring.

Prevention majorly means restricting transmission with WHO recommending stopping bats from reaching to fresh food products and fruits that should be thoroughly washed and peeled before consumption. Fruits with any sign of bat bites should be discarded.

Also, gloves and other protective clothing should be worn while handling sick animals, especially during slaughtering and culling procedures.

The WHO says close, unprotected physical contact with sick people should be avoided and regular hand washing should be carried out after visiting sick people along other preventive measures.