High alert as 2 Kozhikode deaths are confirmed as Nipah; Union govt to send team to Kerala

Ministers, officials are in Kozhikode to oversee the situation. A control room has been opened and helpline numbers set up for the public.

ByChetana Belagere

Published Sep 12, 2023 | 12:18 PM Updated Sep 12, 2023 | 6:57 PM

Nipah confirmed in Kozhikode

The Kerala Health Department is on high alert after two unnatural, fever-related deaths reported in the Kozhikode district were confirmed as being caused by the Nipah virus on Tuesday, 12 September.

Samples from the deceased were sent to the National Institute of Virology (NIV) in Pune, and the results returned positive, Union Health Minister Mansukh Mandaviya announced.

Mandaviya said he was coordinating efforts with the state Health Minister Veena George, and that a central team of specialists would soon reach Kerala.

The samples of four more people — relatives of the deceased who are currently under treatment and in quarantine — have also been sent to the NIV. The results are expected by Wednesday.

During a press briefing on Tuesday morning, Veena George informed media that family members of the deceased 49-year-old man had been admitted to the hospital due to fever and were receiving treatment.

The deceased

A resident of Maruthonkara in the district died of suspected Nipah on 30 August and a native of Vatakara town also died of similar symptoms at a private hospital on Monday, 11 September.

It may be noted that Vatakara and Maruthonkara are located close to Perambra, where Nipah outbreaks were reported in 2018 and 2021.

Health authorities confirmed that as a precautionary measure, four family members, including three children of the patient from Maruthonkara, had been isolated.

Among those isolated, a nine-month-old infant and another nine-year-old are in a critical condition, with the latter on ventilator support.

Also, efforts are on to trace others who have come into contact with the two patients or their family members.

Kerala has already witnessed two outbreaks of the zoonotic disease between 2018 and 2021 in which 17, out of the infected 19, died. With the virus having a high case fatality rate and no proven curative treatment, the state Health Department is leaving no stone unturned to contain the potential spread of the virus.

Meanwhile, the Kerala government has set up a control room at the Kozhikode government guest house and advised people to use masks as a precautionary measure.

The public can call the following numbers to access the control room: 0495-2383100, 0495-2383101, 0495-2384100, 0495-2384101, and 0495-2386100.

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Ministers, officials in Kozhikode

Earlier, Health Minister Veena George and PWD Minister PA Mohamed Riyas reached Kozhikode and convened a high-level review meeting on Tuesday to assess the situation.

Additionally, the Health Department director is also in Kozhikode, overseeing the response efforts.

Meanwhile, AS Anil Kumar, the expert who previously detected the Nipah outbreak in Kozhikode, provided insights to the media regarding the virus.

He explained that initial symptoms of Nipah often manifest as headaches and fever, which are also common symptoms of influenza and pneumonia. Identifying patients afflicted with Nipah is indeed a challenging task due to these similarities.

He said that the two patients who died had similar symptoms and striking similarities with the symptoms of those who had died earlier of Nipah.

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Why such concern over Nipah?

The 2018 Nipah outbreak in Kozhikode caused widespread panic and confusion among the general population, forcing people to stay indoors and abstain from work and travel for several weeks, Kochi-based Dr Rajeev Jayadevan explained.

Consequently, it had an indirect and adverse impact on the livelihoods of numerous people. Also, due to unfounded apprehensions, hospitals and clinics in the Kozhikode region experienced a decline in patient visits, which indirectly contributed to delayed care.

What makes Nipah dangerous is the high mortality rate among the infected and the fact that it can spread to close contacts. However, since it is not as free-spreading as Covid, the total number of deaths remains relatively less.

Dr Jayadevan added that even though the total number of deaths from Nipah virus infection is lesser than Covid deaths, cancer, cardiac ailments, etc., the outbreaks indirectly affect the social, emotional, and economic health of large sections of healthy and productive people.

Meanwhile, Dr Mohammed Asheel, former executive director of social security mission, said there was nothing to panic. “We have a better system for surveillance and response. So let’s make sure people don’t get unnecessarily panicked even as keeping a strong vigil and public health action,” he told South First.

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What is Nipah virus?

Nipah virus, often referred to as Nipah, is a zoonotic virus with the capacity to pass on from animals to humans, subsequently spreading among humans. This virus derived its name from the Malaysian village where it was initially identified.

Fruit bats, scientifically known as flying foxes, serve as natural hosts for the Nipah virus.

Role of bats

Dr Jayadevan told South First that the natural reservoir of the Nipah virus is the fruit bat. He, however, clarified that not all bats carry the virus. But when present, the virus remains dormant in the bat’s body without causing any disease.

The virus can be detected in a bat’s saliva, urine, and reproductive fluids.

However, when a human consumes the contaminated fruit (half-eaten by bat), the virus enters the human body, causing illness. Hence humans are called incidental hosts.

The virus can infect humans either directly from a bat or after living temporarily in another animal, such as a pig.

It can be noted that in the Malaysian village outbreak, the pigs ate fruit fallen on the ground and contaminated with bat saliva. These infected pigs developed cough and passed the virus on to those who worked on the pig farm. Other mammals have also been occasionally identified as hosts.

Though it is not clear how the virus transfers from the bats to humans, doctors insisted that half-eaten fruit and unwashed fruit must be avoided.

Symptoms of Nipah 

Doctors said people infected with Nipah can show symptoms similar to the Covid infection. Cough, sore throat, dizziness, drowsiness, muscle pain, tiredness, and swelling of the brain (encephalitis), which can cause headache, stiff neck, confusion, seizures, and sensitivity to light are some common symptoms.

A person might also fall unconscious, ultimately leading to death.

“People infected with Nipah will usually have a history of consumption of raw fruits, date syrups or may have come in contact with those with Nipah infection,” Dr Sanjay G, a physician from Bengaluru’s Shanti Hospital, said.

“It is always best to avoid half-eaten fruits, or those fallen on the ground. Ensure fruits and vegetables are thoroughly cleaned before consuming,” he advised.

Doctors said that Nipah can be transmitted through contaminated food and also from human to human. Greater vigil and stricter adherence to safety norms are needed to contain Nipah.

Meanwhile, Dr Jayadevan said handling a dead bat with bare hands could also be potentially dangerous. He also advised caution when people frequent bat-infested areas.