A 14-year-old boy from Mallapuram, who initially exhibited Acute Encephalitis Syndrome (AES) symptoms, was admitted to a healthcare facility in Perinthalmanna before being transferred to a higher health center in Kozhikode. Despite the medical intervention, the patient tragically succumbed to the disease. Subsequent testing of samples at the National Institute of Virology (NIV) in Pune confirmed the presence of Nipah virus infection.
Nipah Virus Disease (NiVD) is a zoonotic illness, meaning it is transmitted from animals to humans. The primary animal reservoir of the Nipah virus is fruit bats. Humans can contract the virus through direct contact with infected bats, consumption of bat-contaminated fruits, or through direct contact with the bodily fluids of infected individuals.
Symptoms of Nipah Virus Infection
The symptoms of Nipah virus infection can range from mild to severe and typically include:
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Fever
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Headache
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Drowsiness
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Respiratory issues
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Encephalitis (inflammation of the brain)
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Vomiting
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Muscle pain
In severe cases, the infection can lead to coma and death. The incubation period (the time from infection to the onset of symptoms) for Nipah virus ranges from 5 to 14 days, though longer periods have been reported.
In response to the confirmed Nipah virus case, the Centre has advised the Kerala government to implement several urgent public health measures. These include conducting an intensive search for additional cases within the family of the confirmed patient, their neighborhood, and similar topographic areas. Active tracing of contacts who may have interacted with the patient in the past 12 days is also essential to monitor and contain the virus's spread.
All identified contacts must be strictly quarantined, and any suspects should be isolated immediately. There should be prompt collection and transportation of samples from suspects and contacts for laboratory testing. Additionally, a joint outbreak response team from the National ‘One Health Mission’ under the Union Health Ministry has been deployed to support the state in investigating the case, identifying epidemiological linkages, and providing technical assistance.
At the State's request, the Indian Council of Medical Research (ICMR) dispatched monoclonal antibodies for patient management. A mobile Biosafety Level-3 (BSL-3) laboratory has also been stationed in Kozhikode to facilitate testing of additional samples from contacts. Unfortunately, the monoclonal antibodies could not be administered to the patient due to his deteriorating condition.
Kerala has previously faced outbreaks of Nipah virus. The most recent outbreak before this case occurred in the Kozhikode district in 2023. The virus poses significant challenges due to its high fatality rate and limited treatment options. Public health authorities emphasize the importance of early detection, strict quarantine measures, and thorough contact tracing to control the spread of the virus.
The detection of Nipah virus in Mallapuram underscores the need for vigilance and rapid response to infectious diseases. The coordinated efforts of state and central health authorities, along with the support from national research institutions, are crucial in managing and mitigating the impact of such outbreaks. Public awareness and adherence to health advisories remain vital in preventing the spread of Nipah virus and protecting public health.
