The situation at a glance: On September 14, a new Nipah virus alert surfaced in Malappuram, Kerala’s most populous district, following the death of a 24-year-old man at MES Medical College Hospital on September 9. Initial silence from health authorities was lifted once the State virology laboratory reported a positive test for the deadly virus, pending confirmation from the National Institute of Virology (NIV) in Pune.
Immediate actions taken after the positive test
In response, health officials implemented the Nipah protocol by establishing 16 committees according to standard operating procedures. They began contact tracing of individuals who interacted with the victim, who exhibited symptoms about 10 days prior. On September 15, Kerala’s Health Minister, based on the national test results, confirmed that the individual, a student from Bengaluru, died from Nipah virus, a lethal zoonotic infection associated with severe respiratory and neurological conditions. Following the announcement, restrictions on public movement were enforced, and face masks became mandatory in Malappuram.
This marks the second Nipah-related fatality in the Malappuram district in under two months. On July 21, a 14-year-old boy succumbed to the virus in the same region. While caution was initially observed, attention shifted to a significant landslide event in the nearby Wayanad district shortly thereafter. Both Nipah cases occurred within a close geographical range, with the latest events highlighting the persistent threat of the virus.
Historical context of Nipah in Kerala
This incident represents the sixth occurrence of Nipah virus spillover in Kerala since its first case in 2018. So far, the virus has claimed 22 lives in the state. Initial outbreaks in 2018 resulted in 17 fatalities, with subsequent cases emerging in 2021 and again in 2023. The recent surge in cases within such a short time frame raises concerns about the virus becoming endemic to the area.
Investigation into the virus delay
The 24-year-old victim returned home from Bengaluru in late August and sought treatment for fever and mobility issues on September 5. He was admitted to the medical facility on September 8, exhibiting symptoms of meningitis or encephalitis, before passing away the following morning. A prudent assessment during his examination led to the collection of samples for testing, revealing traces of the virus.
Government’s proactive measures
The state government quickly acted by designating five civic wards in the surrounding panchayats as containment zones, closing schools, and restricting operational hours of local businesses. Social gatherings were prohibited, and mask mandates were enforced particularly for students and educators. Health authorities mapped the victim’s movements, tracing 267 potential contacts and placing them in quarantine. All tests conducted so far have returned negative results. Classmates in Bengaluru were also advised to self-quarantine as a precaution.
A control room for Nipah oversight has been established in Malappuram, with senior health officials monitoring the situation closely. Health workers are actively conducting surveys within a three-kilometer radius of the victim’s residence, providing support to local families while keeping track of any health irregularities. A total of 175 fever cases have been reported and placed under observation, with additional psychological support provided to nearly 300 individuals in the community.
Pathways of Nipah transmission
Nipah virus is predominantly linked to bats, which are believed to contaminate fruits eaten by humans. Transmission can also occur via contaminated food or direct human contact, especially in healthcare settings. The precise origin of the virus in the recent case remains uncertain, leading to ongoing debates among experts regarding the virus’s primary animal host. Previous eradication efforts targeting bat populations have not yielded conclusive results regarding the virus’s life cycle in the region.
Published – September 22, 2024 02:58 am IST
