Nipah virus confirmed in Kerala’s Kozhikode; state sets up isolation wards

The Union health ministry on Tuesday confirmed that the deaths of two people due to fever in Kerala's Kozhikode was because of Nipah virus. The results of samples from the National Institute of Virology (NIV) in Pune came on Tuesday evening.

The announcement by union minister Mansukh Mandaviya came as the state was awaiting confirmation from the National Institute of Virology in Pune Institute over samples sent for testing of one of the deceased and four of his kin after two “unnatural deaths” were reported. Two individuals from Maruthonkara's Kallad and Ayancheri's Mangalad had died in the district.

The Kerala government on Tuesday had set up a control room in Kozhikode and advised people to use masks as a precautionary measure. The Health department completed the survey of 90 families in Maruthonkara and Ayancheri gram panchayats.

Five family members of the Kallad native are under isolation. These include the victim's two children aged nine and four years, his wife, brother-in-law and a 10-month-old infant. Of the five, three have Nipah-related symptoms. The nine-year-old child is in a critical condition. Though doctors have confirmed that the 10-month-old has contracted common cold, the child is still under isolation. The wife has no symptoms.

Meanwhile, the cremation of the 40-year-old victim from Mangalad would be conducted only after the results from the testing lab. His family is also under isolation.

The state health minister Veena George had reached the district early on Tuesday and had a meeting with Director of Health Services KJ Reena, NHM district programme manager CK Shaji, district collector A Geetha at the district collectorate. Chief secretary Dr V Venu, and principal secretary to the health minister Mohammed Haneesh joined the meeting online.

Even as the samples had gone for testing, the authorities had drawn a contact list of 75 persons, who were categorised as persons with high risk, persons without symptoms etc. High risk patients will be admitted and isolated at the government medical college in the isolation ward that has been formed for them. Meanwhile, asymptomatic patients will remain at home or use the isolation facilities at hospitals.

A control room and a helpline number have been created in the district to handle the situation. ”We have opened a control room. For coordination, we have formed 16 committees and all the hospitals and the health workers have been instructed to follow the infection control protocol including wearing of PPE kits,” said George.

Deaths due to Nipah virus infection were reported in Kozhikode district in 2018 and 2021. The first Nipah virus (NiV) outbreak in south India was reported from Kozhikode on 19 May 2018.

World Health Organization (WHO) describes Nipah virus infection as a zoonotic illness that is transmitted to to humans from animals (such as bats or pigs) or can also be transmitted through contaminated food and can also be transmitted directly from person-to-person. Fruit bats of the Pteropodidae family are the natural host of Nipah virus. There is no treatment or vaccine available for either people or animals. The primary treatment for humans is supportive care.

In humans, symptoms range from asymptomatic infection to acute respiratory infection (mild, severe), and fatal encephalitis. Infected people initially develop symptoms including fever, headaches, myalgia (muscle pain), vomiting and sore throat. This can be followed by dizziness, drowsiness, altered consciousness, and neurological signs that indicate acute encephalitis. Some people can also experience atypical pneumonia and severe respiratory problems, including acute respiratory distress. Encephalitis and seizures occur in severe cases, progressing to coma within 24 to 48 hours.

The case fatality rate is estimated at 40 per cent to 75 per cent. This rate can vary by outbreak depending on local capabilities for epidemiological surveillance and clinical management.

Nipah virus was first recognised in 1999 during an outbreak among pig farmers in, Malaysia. No new outbreaks have been reported in Malaysia since 1999. It was also recognised in Bangladesh in 2001, and nearly annual outbreaks have occurred in that country since. The disease has also been identified periodically in eastern India.