Amidst its burgeoning COVID-19 case load, and reports of the Zika virus returning last month, Kerala has now reported a death caused due to the Nipah virus.
A twelve-year old boy from Chathamangalam village in Kozhikode district was reported to have succumbed to the Nipah after the National Institute of Virology detected the virus from the boy's plasma, serum, and cerebrospinal fluid (CSF) on Saturday night.
This is the third instance of the zoonotic virus being reported in the southern state in the last four years. While there was only one case diagnosed in Ernakulum in 2019, the year 2018 saw close to 17 deaths in Kozhikode. The adjacent district of Mallappuram also reported a few positive cases and Kannur was put on high alert.
Close to 251 people who were in close contact with the infected boy have been identified, according to state health minister Dr. Veena George. They have been put in quarantine. Around twenty of them are considered to be high-risk and many of the 188 are health workers at the different hospitals- Kozhikode Medical College and Aster Kozhikode where the boy was admitted from August 29. The boy complained of fever on August 27.
Two of the health workers quarantined at Kozhikode Medical College are said to have developed symptoms. The source of how the boy was infected by the Nipah virus is yet to be ascertained. Eight other samples have been sent to the NIV.
Normally, seen to transmit from bats to humans, it can also transfer between humans as was the case in 2018. The index (point of origin) case was a 27-year-old man who was infected after coming in contact with a fruit bat.
The recent case that was detected in Chathamangalam is only 50 km away from Changaroth village where the first case was identified in 2018. The 12-year-old is said to have eaten a rambutan fruit that could have been earlier consumed or touched by a fruit bat.
Tamil Nadu, which has nine districts of Kerala bordering it, has started screening of people travelling to the state from Kerala.
Symptoms Of Nipah Virus
Nipah causes a range of illnesses from acute respiratory illness and fatal encephalitis (inflammation of the brain). Similarly, it causes severe diseases in animals such as pigs, states the World Health Organisation (WHO).
Symptoms include fever, headache, drowsiness, respiratory illness, disorientation and mental confusion. These signs could also progress to coma within 24-48 hours as there is no vaccine available for the disease. These symptoms start to appear after five to 14 days after exposure to Nipah virus.
People are advised to avoid any exposure to sick pigs, bats and should also avoid drinking raw date palm sap in an area where the outbreak has been reported.
Where Has Nipah Been Reported?
The first Nipah outbreak happened in Kampung Sungai Nipah, Malaysia in 1998, followed by Bangladesh in 2014. In Bangladesh, date palm sap that had been contaminated by infected fruit bats was identified as the source of the virus.
The Nipah virus is highly contagious among pigs and spreads by coughing. This was identified as the main mode of transmission in the 1999 outbreak in Malaysia.
India reported its first ever Nipah outbreak in 2001 in Siliguri, West Bengal and it spread through human-to-human transmission.
Precautionary Measures And Treatment Of Nipah Virus
Once a person is diagnosed with Nipah virus, the patient has to be treated in an isolation ward, and in case a relative intends to meet the patient, they should wear a Personal Protective Equipment (PPE). In 2018, Kerala released advisories on avoiding bats and not eating fruits that might have been eaten by a bat, especially in an area where the outbreak has been reported.
According to the US Centres of Disease Control and Prevention, currently there are no licensed treatments available for the Nipah virus infection. The only kind of treatment is limited to supportive care, including rest, hydration, and treatment of symptoms as they occur.