From September 12 to 15, 2023, Kerala reported six confirmed Nipah virus cases, including two deaths. All cases involved males aged 9 to 45 in Kozhikode district.
The first case of Nipah Virus had an unknown source of infection. In the end of August, he was admitted with pneumonia and acute respiratory distress syndrome and unfortunately, he died a few days later. The five additional cases were close contacts, including family members and hospital staff. The second death occurred in someone who accompanied another patient and showed pneumonia symptoms.
As of September 27, 2023, health officials traced 1,288 contacts, including high-risk individuals and healthcare workers. All identified contacts are under a 21-day quarantine and the four remaining cases are reported to be clinically stable.
In response, the government created containment zones in nine villages, so he applied movement restrictions, social distancing, and mandatory masks. Major public events in Kozhikode district were suspended until October 1, 2023, so, Alerts were sent to neighboring districts to enhance surveillance.
The National Institute of Virology in Pune identified the virus in Kerala as the Indian Genotype. This strain is similar to the one found in Bangladesh.
Nipah virus is a zoonotic disease transmitted from bats and other infected animals and It often spreads through food contaminated with animal saliva, urine, or feces. Direct person-to-person transmission can occur but is less common.
There is no vaccine or approved treatment for Nipah virus, so, awareness and education are crucial. Case management focuses on supportive care for patients. Intensive care is recommended for those with severe respiratory or neurological issues.
Nipah virus infection can cause respiratory problems and severe encephalitis. Case fatality rates in outbreaks range from 40% to 100% and currently, no effective treatments or vaccines are available.
This outbreak is the third Nipah virus instance in Kozhikode. It is the fourth in Kerala since 2018 and the sixth in India. Like the 2018 outbreak, this began with a primary case, followed by family clusters and possible healthcare transmission. Only Bangladesh and India have reported Nipah virus outbreaks in the WHO South-East Asia Region
Public health messages should emphasize:
Reducing bat-to-human transmission:
- Boil freshly collected date palm juice and thoroughly wash and peel fruits before consumption.
- Discard any fruits showing signs of bat bites.
- Avoid areas where bats are known to roost.
Minimizing animal-to-human transmission:
- Infection has been reported in domestic animals like pigs, horses, and both domestic and feral cats.
- Use gloves and protective clothing when handling sick animals or their tissues, particularly during slaughter or culling.
- Avoid contact with infected pigs whenever possible.
Preventing human-to-human transmission:
- Steer clear of close, unprotected contact with individuals infected with Nipah virus.
- Practice regular handwashing after caring for or visiting sick individuals.
Infection prevention and control in healthcare settings:
- Isolate suspected Nipah virus patients in well-ventilated single rooms equipped with dedicated supplies and restroom facilities.
- Avoid placing these patients in shared rooms.
- Healthcare workers should adhere to contact and droplet precautions when interacting with suspected or confirmed Nipah virus patients.
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