Kerala on high alert as Nipah resurfaces, 12-year-old dead

Ramesh Babu and Rhythma Kaul

THIRUVANANTHAPURAM/ NEW DELHI:

A 12-year-old boy died on Sunday after being infected with the Nipah virus in Kerala, prompting the Centre to rush a team of experts to the state that is also recording a surge in coronavirus disease (Covid-19) cases, officials familiar with the matter said.

The boy was initially admitted to a hospital on August 25 and later shifted to the government medical college and then to a private hospital on September 1. His samples were to the Pune National Institute of Virology, which confirmed the presence of the virus, state health minister Veena George said.

“A case of Nipah virus has been detected in Kozhikode district of Kerala. A 12- year-old boy who presented with features of encephalitis and myocarditis was reported on September 3, 2021… The boy was hospitalised and has passed away,” the Union health ministry said in a statement and added that “the central government has rushed a team of NCDC (National Centre for Disease Control) to the state” to provide technical support to local authorities.

The virus that causes high fever, headache and coma in extreme cases is spread by fruit bats. Body fluids can cause human-to-human transmission of Nipah, which can have a mortality rate of up to 75%, according to the World Health Organization (WHO). There is no treatment or vaccine available for either people or animals. State health authorities said they were trying to ascertain the source of the infection but like previous cases, fruit bats were likely to be the primary cause this time, too.

The public health measures that the Centre has advised to the state include active case search in the boy’s family, village and areas with similar topography (especially Malappuram); active contact tracing during the past 12 days at least; strict quarantine of the contacts and isolation of any suspects; and collection and transportation of samples for lab testing.

George said they have identified 188 primary and secondary contacts of the boy and placed them under observation. “We have identified 188 contacts till now. The surveillance team has marked 20 of them as highrisk contacts. Two of these highrisk contacts have symptoms. Both are health workers,” she said.

Kerala has witnessed localised outbreaks of the disease in the past. In May 2018, the virus claimed 17 lives in the state.

The state government assured the public that the situation was under control.

“No need to panic. But a high vigil is the need of the hour. We have a strict Nipah protocol and we will go by this,” George said.

Critical care expert Dr AS Anoop Kumar who played a key role in containing the 2018 outbreak, said they were better prepared to deal with the disease this time around.

“Situation is not like 2018 when we were totally in the dark. Since a majority of people are observing physical distance and masking it can be contained effectively,” Kumar said.

According to WHO, Nipah virus was first identified during an outbreak in Malaysia in 1998. “Both animal-to-human and human-to-human transmission have been documented. From 1998 to 2015, more than 600 cases of Nipah virus human infections were reported. Subsequent outbreaks in India and Bangladesh have occurred with high case fatality,” said a WHO document.

SPECIES THAT SPREAD INFECTION Pteropus giganteus, Eonycteris spelaea, Cynopterus sphinx, Scotophilus kuhlii and Hipposideros larvatus are species of fruit bats found in India and have been known to be infected with the Nipah virus

Consuming food and fluids contaminated with saliva and droppings of infected bats

SYMPTOMS

llllEating fruits and drinking raw date palm sap contaminated with saliva of infected bats

Avoid fruits bitten by birds or animals

Scrub hands after being in close contact with the sick

Wear double masks and gloves while looking after the sick

Wear PPE kits if visiting hospital

llInfection of domestic animals (cattle, pigs, goats) from eating food contaminated by infected bats’ saliva or droppings

No vaccine for animals or humans

The primary treatment for humans is supportive care

HISTORY

It was detected in Malaysia first time in 1999 among pig farmers

In India, the first case was reported in Siliguri (West Bengal) in 2001

In 2018, an outbreak was reported in north Kerala

In 2011, 50 people died in neighboring Bangladesh

Confirmed deaths due to Nipah Siliguri, West Bengal, 2001

llllHuman-to-human, through contaminated body fluids of an infected person

Nadia, West Bengal, 2007

Kozhikode