The outbreak of the NiV in Kerala has been unexpectedly jolting the health officials in the state. For a state that’s attuned to fever-related cases every monsoon, battling the NiV was a different experience.
Q. What is Nipah virus (NiV)?
A: According to the World Health Organisation (WHO), it is a zoonotic pathogen (transmitted from animals to humans) reported for the first time in Malaysia in 1998 in a village known as Kampung Sungai Nipah. The virus’s natural hosts are considered to be fruit bats although it has been found to have been transmitted to humans from pigs as well as seen in Malaysia. In later outbreaks in Bangladesh, people were found to have been infected after consuming date palm sap that was contaminated by virus-carrying fruit bats. The virus can be transmitted from humans to humans as well.
Q. How does the virus get transmitted?
A: Air-borne transmission of the virus can be ruled out, say health officials. WHO says humans could get infected if they come in direct contact with ‘sick pigs or their contaminated tissues.’ Secretions from fruit bats or pigs and droplets can also lead to transmission.
Q. What are the symptoms of Nipah?
A: Influenza-like symptoms such as fever, headaches, sore throat, vomiting, dizziness and muscle pain are the symptoms associated with the viral infection. The incubation period, or the period from infection to first symptoms, is generally 4-14 days though health officials say it can extend to 60 days as well.
Q. What’s the treatment process and is there a cure?
A: Since encephalitic-symptoms are seen in NiV, the fundamental mode of treatment is limited to intensive supportive care for neurological and respiratory complications.
No vaccine or cure has been invented yet.
Q: How is Nipah treated?
A: Since no cure/vaccine has been invented yet, treatment is limited to intensive supportive care which basically means treating the symptoms individually. For example, someone complaining of breathlessness can be put on artificial ventilators. The Kerala government is also supplying Ribavarin, known for its anti-viral properties.
Q. Have there been previous outbreaks of the virus in India?
A: Yes, there have been two previous outbreaks of the NiV in West Bengal in 2001 and 2007, first in Siliguri and then in Nadia districts. A total of 71 cases were reported in the two incidents sparking 50 fatalities indicating the high mortality rate of the virus.
Also Read | What is Nipah virus?
Q. How did the NiV break out in Kerala?
A: The source of the viral outbreak is believed to have originated in the Changaroth panchayat in Kozhikode district of northern Kerala. The first fatality, believed to be of the virus but not confirmed, was that of Mohammad Sabith, 23, on May 5 this year. Two weeks later, his elder brother and paternal aunt too succumbed to the illness, both of whom were tested positive for the virus. It was on the evening of May 20 that the blood and fluid samples of the two victims came back positive from the department of virus research at the Manipal Academy of Higher Education which were seconded by the National Institute of Virology in Pune.
Q. How serious is the NiV outbreak in Kerala this time?
A: The outbreak of the NiV in Kerala has been unexpectedly jolting the health officials in the state. For a state that’s attuned to fever-related cases every monsoon, battling the NiV was a different experience. Till Sunday (May 27), a total of 14 fatalities have been recorded, 13 of which have been confirmed for NiV. It is a serious health crisis for the state but doctors say that the virus has been largely contained and that all the fatalities can be tied to one single family. Since human-to-human contact is necessary for transmission, all the casualties were those who came in contact with the initial victims who were infected. Most of the deaths occurred at the Kozhikode Medical College where they were admitted.
Q. Has it been conclusively proved as to who are the carriers of the virus?
A: No. Samples of fruit bats and pigs, caught from Changaroth by doctors, sent for testing came back negative from Bhopal. It is not clear how or from where Sabith, the first victim, got transmitted. Doctors say it could be a matter of time before it is confirmed.
Q. How did the health ministry go about in attempting to contain the infection?
A: As soon as NiV infection was established, the health department proceeded to upgrade the safety protocols at the Kozhikode Medical College where the infected would be brought. Medical professionals working at local hospitals were given protective gear in dealing with patients. The panchayat, the epicentre of the virus, was directed by the department to conduct ward-level awareness meetings through ASHA and Anganwadi workers to dispel doubts of the people. The state reached out to the Centre for assistance in response to which the latter promptly sent a team headed by the director of National Centre for Disease Control (NCDC). A team from AIIMS also visited the affected areas and took samples for testing. Meanwhile, all those who reported fever-like symptoms were brought to Medical College and isolated in wards. Stern action was warned against those spreading fake news and rumours on social media platforms.