Nipah death in Malappuram; Kerala mandates masks, closes schools

Following the death of a 23-year-old man from Naduvathu (near Wandoor, in Malappuram district) who had contracted the Nipah virus, the government has implemented additional restrictions to curb the potential spread of the zoonotic virus.

Malappuram collector V.R. Vinod has requested mosque committees to cancel all the Mawlid processions scheduled for Monday, 16 September, due to the severity of the situation.

All schools, colleges, anganwadis and movie theatres in the area will remain closed, and public gatherings have been prohibited. Shops will be permitted to operate only from 10 a.m. to 7 p.m.

On Sunday, 15 September, the collector declared five wards as containment zones: wards 4, 5, 6, and 7 of Thiruvali panchayat and Ward 7 of Mampad panchayat.

Mask-wearing has been made mandatory.

Residents are urged to stay vigilant. “There is no need for alarm at this moment,” the collector stated.

A high-level meeting chaired by state health minister Veena George was held on Saturday, 14 September, to initiate the necessary protocol steps.

Currently, three individuals in the district are undergoing treatment for Nipah symptoms.

The health department is starting a fever survey in Thiruvali panchayat starting today, 166 September, as well. Sixteen committees — including health officials, ASHA workers and anganwadi staff from the block panchayat — have been organised for this purpose.

Earlier a child of 14 had also lost his life to the Nipah virus.

Contact list and testing

George reported on Sunday that the contact list of the deceased man includes 151 individuals. The deceased had traveled with friends to various locations, and those in close contact have been isolated. Samples from five individuals with minor symptoms have been sent for testing. Two individuals from the contact list have been admitted to Manjeri Medical College Hospital for observation.

The 23-year-old man, who was a student residing in Bengaluru, returned home recently for treatment of a leg injury. He later developed a fever and sought medical help at four different hospitals.

Initial tests at Kozhikode Medical College were positive for Nipah, and this was confirmed by a second test at the Pune virology lab. The National Institute of Virology in Pune confirmed the cause of death as Nipah on Sunday.

George confirmed that 16 committees were established to monitor and manage the situation following the positive Nipah test results. The health department has also sent to the Kozhikode lab five additional samples from symptomatic individuals under observation.

Thiruvali panchayat, situated between Manjeri and Nilambur towns, is on high alert. Efforts to finalise the contact list are nearing completion, and measures are in place to quickly identify individuals with symptoms.

The Malappuram district medical officer had suspected Nipah based on the symptoms of brain fever, leading to the initial tests at Kozhikode Medical College.

An emergency meeting was held by Thiruvali Grama Panchayat, where mask-wearing has been made compulsory and the commencement of the fever survey on Monday, 16 September, was announced.

Nipah symptoms

The World Health Organization (WHO) describes the Nipah virus (NiV) as a zoonotic pathogen, meaning it can be transmitted between animals and humans.

Nipah infection was first identified during a significant outbreak in Malaysia and Singapore between September 1998 and May 1999, which involved 276 reported cases.

In India, outbreaks occurred in West Bengal in 2001 and 2007, and more recently in Kerala in 2018, 2019 and 2021.

The first known outbreak likely involved transmission from infected pigs to humans. However, the primary natural reservoir for NiV here in India is the large fruit bat, specifically those of the Pteropus genus, commonly known as the flying fox.

NiV belongs to the Paramyxoviridae family, genus Henipavirus. It initially spreads from animals to humans, often through direct contact with infected animals or their bodily fluids, such as saliva or urine. This initial transmission from animals to humans is referred to as a spillover event.

Infection with the Nipah virus can result in a range of symptoms from mild to severe, including encephalitis, which is inflammation of the brain and can be fatal.

Symptoms typically emerge 4 to 14 days after exposure to the virus.

The illness often starts with fever and headache, accompanied by respiratory symptoms such as cough, sore throat and difficulty breathing. This can progress to encephalitis, with symptoms including drowsiness, disorientation and mental confusion, which may escalate to coma within 24–48 hours.

Severe cases may result in disorientation, drowsiness, confusion, seizures and death, with mortality rates ranging from 40–70 per cent.

Survivors of the Nipah infection may experience long-term effects, including persistent seizures and changes in personality.