Kerala on High Alert as Nipah Virus Returns: How to Identify Symptoms and Guard Against It

The illness isn’t as easy to catch as COVID-19 or the flu, and it probably won’t lead to a lot of people getting sick all at once. Dr. E Sreekumar, who is the director of the Institute of Advanced Virology-Thiruvananthapuram, explains, “Based on past experiences with similar illnesses and the way this virus behaves, it’s not likely to spread as quickly as the flu, COVID-19, or the highly contagious measles.”

Kerala on High Alert as Nipah Virus Returns: How to Identify Symptoms and Guard Against It

Two people have sadly passed away from the dangerous Nipah virus, and there are concerns about four more possible cases in the Kozhikode district of Kerala. This has raised serious concerns among health experts. Doctors and healthcare professionals are now gathering samples and sending them to the National Institute of Virology (NIV) to confirm whether these cases are indeed linked to the Nipah virus.

If the samples turn out to be positive for Nipah, it would mark the first cases in the country in four years. The most recent case was reported back in 2019, involving a 23-year-old student from Kerala. Fortunately, that outbreak was contained with just one case, and the student recovered from the illness.

When scientists looked closely at the virus, they found that its genetic makeup was quite similar to the one responsible for the 2018 outbreak in the same state. Tragically, that outbreak claimed the lives of 17 out of the 19 people who were infected.

What is Nipah?

Nipah is a viral infection primarily found in animals like bats, pigs, dogs, and horses. It’s what we call a zoonotic disease because it can leap from these animals to humans who have close contact with them, leading to severe illnesses.

What are the signs and symptoms?

It usually presents as fever and swelling of the brain called encephalitis.
Breathing difficulties
Cough and sore throat
Muscle pain and severe weakness
In extreme cases, disorientation and seizures

Why have the two cases led to alarms ringing?

Detecting cases of Nipah early and taking steps to prevent its spread is crucial. This is because Nipah has a high Case Fatality Ratio, which means a significant proportion of people who test positive for the infection sadly don’t survive.

To put it into perspective, during the 2001 and 2007 outbreaks in West Bengal, the Case Fatality Ratios (CFRs) for Nipah were extremely high, reaching 68 percent and a staggering 100 percent, respectively. In the 2018 outbreak in Kerala, the CFR was 91 percent, with only two of the infected individuals managing to survive.

In contrast, when we look at COVID-19 in India today, the CFR is much lower, at around 1.2 percent. This stark difference highlights how much more deadly Nipah can be in comparison to COVID-19.

Is it a fast or slow-moving virus?

It’s important to note that Nipah is not as easily spread as COVID-19 or the flu, and it’s unlikely to lead to a rapid surge in infections. Dr. E Sreekumar, the director of the Institute of Advanced Virology-Thiruvananthapuram, explains, “Based on past experiences with similar illnesses and the characteristics of this virus, it’s not likely to spread as quickly as the flu, COVID-19, or the highly infectious.”

How does the disease spread?

Nipah can be transmitted to humans when they have close contact with infected animals or when they come into contact with secretions that contain the virus. This can happen when people handle fruit trees, fruits, date palm sap, juice, or toddy that has been contaminated with the virus.

Nipah can also pass from one person to another through close contact, whether at home or in a hospital setting. Additionally, it can spread when people handle the bodies of individuals who have succumbed to Nipah.

Dr. Sreekumar further explains, “The infection can also be transmitted through tiny droplets in crowded, enclosed spaces. This is what happened during the 2018 outbreak in Kerala when the virus spread from the first patient to others in a small corridor while they were undergoing radiological tests at the hospital. However, it’s important to note that Nipah doesn’t easily spread in open, well-ventilated areas.”

While researchers have a basic understanding of how Nipah virus infection occurs, they have been working diligently to identify the precise source of the virus’s transmission from animals to humans in these cases. This knowledge is crucial because understanding the origin can provide valuable insights into preventing future outbreaks. By uncovering the exact pathways through which the virus crosses from animals to humans, researchers can develop more effective strategies to mitigate the risk and reduce the likelihood of future Nipah virus outbreaks.

Dr. Sreekumar has noted that in the case of the 2018 Nipah outbreak, the exact source of the virus could not be definitively identified. However, it was strongly suspected to be linked to fruit that had been contaminated by bats. The secretion from bats, especially fruit bats, on trees and fruits has been associated with Nipah virus cases, particularly in Bangladesh. While the source in the 2018 outbreak couldn’t be pinpointed with certainty, such investigations are critical to better understand and manage the transmission of the virus and prevent future outbreaks.

What can we do to protect ourselves?

Dr. Sreekumar emphasizes that if the cases are indeed confirmed, they would signify a local outbreak. This implies that people residing outside of the affected area are not currently at risk of infection. However, he advises caution to those in the vicinity where the cases were identified. In such areas, it’s essential for individuals to avoid close contact with the family members and other contacts of the two initial cases to help prevent the further spread of the infection within the local community.

Also Read:
Nipah Virus Takes Two Lives in Kerala State, India

In previous Nipah virus outbreaks, the government recommended several precautions to reduce the risk of infection:

  1. Thoroughly Wash Fruits: It is advisable to thoroughly wash fruits before consuming them. This step helps remove any potential contamination and reduces the risk of contracting the virus.
  2. Peel Fruits: Peeling fruits before consumption can further minimize the risk, as it removes the outer layer where contaminants may be present.
  3. Discard Fruits with Bat Bites: Fruits showing signs of bat bites should be discarded immediately. Bats can carry the Nipah virus, and avoiding such fruits is a safety measure.
  4. Boil Palm Sap or Juice: If you consume palm sap or juice, it is recommended to boil it before consumption. This process can help eliminate any potential virus present in the sap or juice.

Following these precautions can play a vital role in reducing the risk of Nipah virus infection, especially in areas where outbreaks have occurred or are suspected.

How would the government manage the outbreak?

As the samples of the two patients have been sent to the National Institute of Virology (NIV) for confirmation, the local government has proactively initiated contact tracing. This means that individuals who had close contact with the two confirmed or suspected cases are being identified and quarantined. Contact tracing is a standard practice during infectious disease outbreaks, and it helps contain the spread of the virus by isolating and monitoring individuals who may have been exposed to the infection. This measure is crucial for preventing further transmission and protecting public health.

Those individuals who have had close contact with the confirmed or suspected cases will be closely monitored for any symptoms of the Nipah virus infection. Simultaneously, specialized teams will begin investigating the source of the infection, particularly the transmission from animals to humans.

Dr. Sreekumar highlights that gaining a comprehensive understanding of the two cases and their history is essential to determine the likely pathway of infection. By thoroughly examining the circumstances surrounding these cases, researchers and health authorities can uncover vital information about how the virus was transmitted and further enhance measures to prevent and manage future Nipah outbreaks.

How is Nipah virus diagnosed?

Doctors can confirm a Nipah virus infection through a real-time polymerase chain reaction (RT-PCR) test, which involves taking samples from the nose or throat, cerebrospinal fluid (CSF), urine, or blood. In cases where the infection is in its later stages or after recovery, doctors can diagnose it by testing for specific antibodies in your blood using the ELISA test. This helps in identifying whether a person has been exposed to the virus, even if they have recovered from the illness.

How is Nipah virus treated?

Currently, there are no specific antiviral medications available for treating Nipah virus infection. Medical care primarily focuses on managing the symptoms. Here are some of the options for managing Nipah virus symptoms:

Hydration: Staying well-hydrated by drinking water is important to help the body fight the infection.
Rest: Getting plenty of rest allows the body to recover and strengthen its immune response.
Medication for Nausea and Vomiting: Doctors may prescribe medication to alleviate nausea and vomiting, which are common symptoms of Nipah virus infection.
Respiratory Support: In some cases, patients may require inhalers and nebulizers to assist with breathing if they experience respiratory difficulties.
Anti-Seizure Medication: In severe cases, when patients develop seizures, doctors may administer anti-seizure medications to manage this symptom.

Researchers are actively exploring potential treatments for the Nipah virus, including monoclonal antibody therapy. This treatment involves using specific antibodies to target and neutralize the virus. While it is still under investigation, it holds promise as a potential option for managing Nipah virus infections more effectively in the future.

Is there a cure for nipah virus?

Currently, there are no vaccines or specific medications available to cure Nipah virus infections. Medical care mainly revolves around managing the symptoms and providing supportive treatment to affected individuals. Researchers continue to work on developing potential treatments and preventive measures, but as of now, there is no established vaccine or cure for the Nipah virus

What is its Geography?

Nipah virus outbreaks are relatively infrequent in India compared to neighboring Bangladesh, where cases have been reported almost every year since the first outbreak in 2001. In Bangladesh, Nipah virus has taken on the characteristics of a seasonal disease, with infections occurring primarily between December and May. This seasonal pattern highlights the need for heightened vigilance and public health measures during these months to prevent and manage Nipah outbreaks.

India has experienced four distinct outbreaks of Nipah virus so far, with the first cases reported in 2001, particularly in West Bengal, which shares a border with Bangladesh. It’s important to note that once someone is infected with Nipah virus, the chances of a fatal outcome are indeed very high, underlining the severity of this disease and the importance of early detection and prevention measures.

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