Indian state battered by COVID-19 now on alert for Nipah virus

NEW DELHI: The southern Indian state of Kerala is quickly ramping up efforts to stop a potential outbreak of the deadly Nipah virus, even as the state continues to battle the highest number of coronavirus cases in the country.

Kerala is on high alert after a 12-year-old boy died of the rare virus on Sunday, spurring health officials to start contact-tracing and isolating hundreds of people who came into contact with the boy, who died at a hospital in the coastal city of Kozhikode.

On Tuesday, the state health minister told reporters that the samples of eight primary contacts have come back negative.

“That these eight immediate contacts tested negative is a great relief,’’ Veena George said.

Nipah, which was first identified during a late 1990s outbreak in Malaysia, can be spread by fruit bats, pigs and through human-to-human contact. There is no vaccine for the virus, which can cause raging fevers, convulsions and vomiting. The only treatment is supportive care to control complications and keep patients comfortable.

The virus has an estimated fatality rate of between 40% and 75%, according to the WHO, making it far more deadly than the coronavirus.

George said that more samples will be tested on Tuesday and that a total of 48 contacts, including the eight that have tested negative, are being monitored at a hospital. Officials will also be carrying out door-to-door surveillance and identifying secondary contacts.

Over the weekend, the federal government sent a team of experts to Kozhikode to help local officials trace contacts. They also suggested a list of recommendations, including bolstering health infrastructure in case of more cases and alerting neighboring districts.

The state dealt with Nipah in 2018, when more than a dozen people died from the virus. This time around, the concern is compounded by the fact that the state has grabbed national headlines in recent weeks for seeing the highest number of daily COVID-19 cases across India.

On Monday, Kerala registered nearly 20,000 COVID-19 infections out of India’s daily total of 31,222. While cases across the country have declined after a devastating surge earlier this year, the situation in Kerala remains concerning, with experts warning that the state cannot let its guard down.

Indian government on Monday recommended various measures to be taken by the Kerala government to curb the Nipah virus outbreak in the state, based on the first report submitted by a central team.

In a letter to state Chief Secretary V.P. Joy, Union Health Secretary Rajesh Bhushan said that an active search for cases needs to be undertaken in the containment area as per the micro plan provided by the central team.

“Both the hospital-based and community-based surveillance needs to be strengthened. Awareness needs to be created among the field formations for early detection of cases of Acute Encephalitis Syndrome/Respiratory Distress and risk communicated to the public,” he said.

Bhushan also asked the state to strengthen contact tracing measures and identify primary, and secondary contacts, as well as prepare a list of high-risk contacts.

All district administrations will have to comply with the accepted norms of home quarantine and there should be an intensive follow-up on such cases, he stressed.

The Health Secretary has also asked the state government to issue alert in nearby districts of Kannur, Malappuram, and Wayanad.

Noting that the Government Medical College, Kozhikode, has been identified as the treatment centre, he said that an adequate number of single room isolation facilities, and negative pressure ICU may be earmarked as stand-by.

He also called for establishing a referral system along with earmarked ambulances and trained staff and to maintain adequate stock of Ribaverin (anti-viral) and Personal Protective Equipments at the district level. He said that the ICMR is exploring the feasibility of getting appropriate monoclonal antibodies for treatment purposes.

Bhushan advised the state government to set up a 24x7 Control Room for daily reporting and sharing information with the media and to initiate coordination with the Animal Health and Wildlife Departments and other field officers to trap and collect samples from fruit bats for virological studies and other associated measures.