In the wake of the Nipah virus outbreak, Kerala’s Kozhikode has registered six cases positive for the virus. The virus outbreak was confirmed on 12 September after two fever-related deaths were reported in the district.
State Health Minister Veena George’s office on Friday, 14 September, said that a 39-year-old man has been confirmed with the Nipah virus after his samples turned positive.
He was under observation in a hospital.
He had sought treatment at a private hospital where Nipah-positive affected were treated for other ailments earlier, it said in a statement.
Of the three infected people under treatment, the condition of a nine-year-old child remains critical.
A two days holiday was declared in the Kozhikode district, for the dates 14 and 15 September.
Speaking to media in Thiruvananthapuram Veena George also said the district collector has been authorised to issue orders directing people to avoid mass gatherings in Kozhikode till 24 September.
Meanwhile, in a relief to the state government, the 11 samples sent for testing returned negative results for the virus. A government source confirmed the negative results.
The samples of another 15 people on the high-risk contact list have also been sent for tests.
On Thursday, the only available experimental treatment— monoclonal antibody— was delivered to the state by the Indian Council of Medical Research (ICMR).
The antiviral is the only option available to the government to treat infections, although its efficacy has not been clinically proven yet.
The m102.4 monoclonal antibody, an experimental therapeutic, was imported during the 2018 Nipah outbreak for the treatment of infected patients on compassionate grounds. It was not used back then as the outbreak had ended by the time it arrived.
George said the stability of the antiviral was discussed with a central expert committee.
“Further steps or course of action will be decided by the expert committee,” she said and referred to consultations between the state and the Union Health Ministry.
The standard operating procedures and protocols for its use were prepared at the time with the ICMR’s support.
Mobile lab for testing
A mobile laboratory was also sent to ground zero to enable the state to test samples.
The ICMR’s National Institute of Virology (NIV) in Pune sent its mobile BSL-3 (Biosafety Level-3) laboratory to Kozhikode to test samples for the virus in the district itself.
The ICMR’s mBSL-3, the first Biosafety Level-3 containment mobile laboratory in South Asia, will help with early testing and detection of the infection at the district level itself.
Earlier, the samples had to be sent to the National Institute of Virology in Pune.
The mobile laboratory was set up in February 2022 to investigate newly emerging and reemerging viral infections that are highly infectious and potentially lethal for humans.
Additionally, a fully-equipped mobile virology testing laboratory of the Rajiv Gandhi Centre for Biotechnology (RGCB) was dispatched to the northern Kerala district to strengthen virus testing and detection.
George also lauded the RGCB for stepping in to help with the containment efforts and said more samples can now be tested.
RGCB Director Prof Chandrabhas Narayana said the services of a group of six experts have been made available in the mobile unit, which can give results within six hours.
Concerns have arisen due to the contact list of patients, with 700 individuals having had contact with them. Among these, approximately 77 have been classified as high-risk cases.
A five-member central team comprising experts from the National Centre for Disease Control, RML Hospital and NIMHANS has been stationed in Kerala to take stock of the situation and assist the state government in the management of the Nipah infection.
Samples will also be collected from bats to check for the virus’ presence.
Union Minister of State for Health and Family Welfare Bharati Pravin Pawar reviewed the steps taken for the containment of the outbreak and visited NIV, Pune, to take stock of the preparations.
A total of 58 wards spanning nine panchayats in Vadakara taluk of Kozhikode district have been designated as containment zones. Only essential services entry/exit are permitted in these areas. Shops selling essential items can operate between 7 am and 5 pm, while pharmacies and health centres have no specific operating hours.
Buses and vehicles passing through the containment zones on national highways have been asked to refrain from stopping within the affected areas.
Kerala has previously experienced Nipah outbreaks in 2018, along with isolated cases in 2019 and 2021. In 2018, 17 out of 18 patients succumbed to the disease.
The virus strain seen in the state is the Bangladesh variant that spreads from humans and has a high mortality rate despite being less infectious, the government has said.
Health minister’s assurance
George said in the Assembly on Thursday that there was no need to be apprehensive about the Nipah outbreak, but added that people need to exercise caution as they go about their daily activities.
“There is no need for any apprehension. We can all together deal with the issue with caution,” she said.
George said the state has been vigilant and Kozhikode’s neighbouring districts— Kannur, Wayanad and Malappuram— should also be cautious.
The minister said 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.
Additionally, psychosocial support teams have been constituted to counsel the infected or their family members and the treatment protocol has been further improved, the minister said.
She also advised people to wear masks, maintain social distancing and approach health workers in case anyone shows symptoms of cold, fever, headache or cough.
The minister also said that in areas where bats are present, liquor collected in open vessels from coconut and palm trees should not be consumed.
Tourism not affected
Kerala Tourism Minister PA Mohammed Riyas said on Thursday that the state’s tourism sector was not affected by the Nipah scare.
“There is no restriction on travelling anywhere in Kerala. It is absolutely safe to travel to Kerala,” he told PTI in Thiruvananthapuram.
Riyas said there are still large numbers of domestic and international tourists coming to Kerala, and no travel advisories have been issued.
Riyas, who oversees the government’s measures to prevent the spread of the virus in Kozhikode, where the outbreak was reported, said even in containment zones there are not many issues, and there is no restriction on travel to the district either.
The key sector, which provides direct and indirect employment to several thousands of people and revenue for the state exchequer, had just recovered from the Covid-19 pandemic.
(With PTI inputs)