Nipah Virus In Kerala: Caseload Climbs To 6, ICMR Says Mortality Rate 'Very High' Compared To Covid-19

One more case of Nipah virus infection was confirmed in Kerala's Kozhikode on Friday, taking the state's tally to six. So far, two people have died from Nipah virus in Kerala, both of whom had come into contact with each other. 

ICMR DG Rajeev Bahl said mortality among the infected is very high in Nipah (between 40 and 70 per cent) compared to the mortality in Covid, which was 2-3 per cent. On why cases keep surfacing in Kerala, Bahl said, "We do not know. In 2018, we found the outbreak in Kerala was related to bats. We are not sure how the infection passed from Bats to humans. The link couldn't be established. Again we are trying to find out this time. It always happens in the rainy season."

After the infections were confirmed, the Centre sent a team of central government experts to Kerala to take stock of the situation and assist the state government. The Centre on Thursday also sent anti-bodies and a mobile laboratory for the testing of samples. 

In separate but related developments, Kerala's neighbouring Karnataka has issued guidelines to strengthen disease surveillance in border districts in the wake of Nipah virus infections in Kerala. 

Here we list the latest developments related to the Nipah virus in Kerala. 

1 more Nipah virus case confirmed in Kerala

Kerala Health Minister Veena George on Friday said that Nipah virus infection has been confirmed in a man, taking the tally in the state to six. 

The patient is a 39-year-old man and remains hospitalised, said George in a Facebook post. 

All of the Nipah virus infections have so far occured in Kerala's Kozhikode. This is the fourth outbreak of Nipah virus in Kerala since 2018.

High-level meeting held at Kozhikode, testing criteria widened

In the wake of two fresh Nipah virus infections, a high-level meeting chaired by Kerala Health Minister Veena George was held on Friday in Kozhikode.

Besides George, Keraka ministers P A Mohammed Riyas, Ahamed Devarkovil, and A K Saseendran took part in the meeting, reported PTI.

Following the meeting, George said those affected, including the nine-year-old boy on ventilator support, were stable. She further said that those under treatment are suspected to have got the infection from the person who died on August 30.

George said that even though the protocol says that only those with symptoms would be tested, the government has decided to test every at-risk person.

"So, we have decided to test all those who are under high-risk contacts even though they don't have any symptoms. Currently, we have two additional facilities in Kozhikode. We have a mobile lab from the Rajiv Gandhi Centre for Biotechnology (RGCB) with two machines that can test 96 samples at a time...But here we have decided to test the samples of all those who are in the high-risk category of contacts. We have the mobile lab from RGCB and the lab at Kozhikode Medical College Hospital," said George.

Educational institutions shut, 7 containment zones formed

In the wake of Nipah virus outbreak in Kozhikode, all educational institutions in the district were on Thursday closed for two days.

Additionally, seven village panchayats have been converted into containment zones. 

Nipah virus usually spreads from animals, primarily bats, to humans, but can also spread through close contact among humans. 

Since close contact with animals —primarily bats but also pigs, goats, horses, dogs, cats— is key to the spread of the virus, the Kerala government has advised the people living in forest areas to take the highest precautions, reported PTI, adding that minister George noted that the fifth case of the Nipah virus originated within 5 kilometres of a jungle area.

Friday prayers in mosques called off: Report

As containment zones have been formed in Kozhikode and social distancing and othe precautionary measures have been prescribed, a report said that mosques in the districts have called off prayers on Friday.

A large number of Muslims go to mosques to offer prayers through the day on Friday. However, such prayers have been called off for now "co-operate with the government authorities to control this disease", reported India Today.

"In the wake of the outbreak of Nipah virus in our area, the district collector and police authorities have directed us to not gather people in the mosque. Complying with the orders we have decided to close the mosque until further orders. Friday prayers will not be held today. We will co-operate with the government authorities to control this disease," said Kuttiady Juma Masjid Mahallu Committee Secretary Zubair P to India Today.

Centre sends Nipah anti-bodies, mobile lab

The Centre on Thursday sent monoclonal antibodies for the treatment of a Nipah virus patient to Kerala. 

The Centre also sent a bio-safety level-3 (BSL-3) mobile laboratory for the testing of samples to confirm the presence of Nipah virus. 

The Kerala government had requested antibodies for the treatment of a nine-year-boy who is admitted to the intensive care unit (ICU). 

Earlier, the Kerala government had said that monoclonal antibodies have been ordered from Indian Council of Medical Research (ICMR) to treat the child and it is the only available anti-viral treatment for Nipah virus infection, though it has not been clinically proven yet, reported PTI.

Bangladesh strain of Nipah virus found in Kerala

The Kerala government had confirmed that the Nipah virus strain circulating in the current outbreak is the Bangladesh variant. 

The particular strain spreads among people and has a higher mortality, though it is less infectious, reported PTI. 

Nipah virus is a zoonotic disease, which means its spreads from animals to humans. It primarily spreads from bats but can also spread from other animals infected by the virus. It spreads when people or animals come into contact with bodily fluids like blood, stool, urine, or saliva or an infected animals or eat food contaminated by an infected animals. The virus also spreads from close contact with an infected person. 

There is no particular cure or vaccine for Nipah virus. The treatment is symptomatic, which means that symptoms are treated instead of the disease — just like Covid-19. The Cleveland Clinic says that the virus has mortality rate of 40-75 per cent. 

In Kerala, the PTI on Thursday quoted George as saying that the condition of all 76 people who are in the high-risk contact category remains stable.

Wear masks, don't collect liquor from trees openly: Govt

In the wake of six infections and two deaths, the Kerala government has instructed people to wear masks, practise social distancing, and approach the authorities in case symptoms of cold, fever, headache or cough appear. 

Since a common medium of the spread of virus is through the mixing of bats urine, stool, or saliva from the trees they stay on into the drinks collected by locals from the fruits of those trees, the Kerala government has also advised people to not collect and consume liquor in open vessels from the palm and coconut trees in areas where bats are present. 

Additionally, George said that a 19-member core committee, call centres, and a control centre have been set up in Kozhikode, along with isolation, ventilator and ICU facilities in the medical college there, reported PTI.

Additionally, psychosocial support teams have been constituted to counsel the infected or their family members and the treatment protocol has been further improved, said George, as per PTI.

Karnataka issues guidelines for border areas

In the wake of six infections and two deaths from Nipah virus in Kerala, Karnataka has issued a guidelines for disease surveillance in border areas.

In a circular to all district officials, the Commissioner of Health and Family Welfare Services issued a set of guidelines, such as avoiding unnecessary travel to affected areas, putting up checkposts at points of entry for fever surveillance, making approprirate preparations for any possible infections, and to test and monitor suspected cases of Nipah virus infection.

Situation not as bad as 2018: Ex-Kerala health minister

Former Kerala Health Minister KK Shailaja has said that the situation in the state is currently not as bad as 2018. 

The current Nipah virus outbreak in Kerala is fourth. Previously, outbreaks have occured in 2018, 2019, and 2021. 

In 2018, the death toll from Nipah virus was 21, according to Mint newspaper. 

As for the current outbreak, Shailaja said the virus is not new anymore and there are protocols and procedures in place to handle the situation.

"In 2018, it was a new virus to us, and we did not have any experience battling such an infection. Now, we have everything in place to contain it effectively," said Shailaja, as per The Federal, emphasising that the state has a protocol and Standard Operating Procedure (SOP) to effectively fight the infection and prevent its spread.