The Nipah scare: What went wrong in Kerala

The failure to identify the primary source of Nipah virus in Kerala has been the most glaring omission and is a must to prevent further episodes of the infection say health expertsA zoonotic virus transmitting from animal to humans spread through contaminated food or directly between humans on exposure to secretions Nipah has surfaced again in Kerala for the third time in a span of four yearsSo far the fruit bat has only been identified as the animal host reservoir from which the virus can spread the disease to other animals like pigs dogs cats and goatsThe recent death of a 12yearold boy in Kozhikode marks Nipahs third attack in the stateIt was first confirmed in the Kerala district in MayJune 2018 and claimed 17 lives Fruit bats were suspected to have passed on the infection to the index case then though no clear evidence was availableThe failure to identify the source of the virus in the primary case in 2018 was a major drawback The fact that the disease has resurfaced around Kozhikode region points to the fact that the virus is still endemic to the region Dr Kiran G Kulirankal Assistant Professor Division of Infectious Diseases Department of General Medicine Amrita Hospitals Kochi told IANSAnother sporadic case of Nipah resurfaced in June 2019 from Kochi after about a year and at a geographically different location Though the patient survived the source of the infection was again not determinedIt was estimated that bats were infected with the Nipah virus and that battobat transmission was fast The bats are only carriers and hence do not die It is only when transmission to human beings happens that the threat arisesLack of scientific proof of the primary source was glaring in both the episodes When a similar epidemic in Malaysia occurred in 19981999 they could control the epidemic by determining that pigs were the intermediate host for Nipah and largescale culling and good animal farming practices prevented further occurrence Dr Jitesh K Senior Consultant Internal Medicine Meitra Hospital Kozhikode told IANSKerala can prevent further episodes by having clarity on the animal source infection he addedHowever the risk this time is much higher since the attack is amid a Covid surge in the state as well as the regionCan it surface as a coinfection Experts suggest the possibility cannot be ignoredThe fact that the fatality rate for Covid 19 is between 12 per cent while the fatality rate of Nipah varies between 4075 per cent is one to worry about In a state already caught in a very serious battle against Covid 19 the outbreak came as a double blow Kulirankal saidEarly isolation and testing is the key to containment of the disease The chances of coinfection are rare but cannot be ruled out he notedThe incubation period of the disease is 4 to 14 days and sometimes upto 60 days The usual symptoms are fever headache sore throat vomiting and dizzinessAs there is no cure or vaccine available till date intensive supportive care is the mainstay treatment and only choice for treating severe respiratory or neurological complications the doctors saidIn the current case nearly 140 highrisk contacts of the deceased young boy have tested negative But nearby states have been put on high alert for the diseaseThe fight is still not over The threat of another outbreak cannot be ruled out as long as the source remains unknown Kulirankal saidIt is imperative for the state to determine the source of Nipah whether its a bat or some intermediate host like pigs or other wild animals according to JiteshThe state should also recognise that Nipah has become endemic and all the breakouts happen mostly during May and December months so preventive activities should happen during these months he addedPublic must be aware against trespassing into bat habitats and avoid eating contaminated fruits or interacting with domestic animals without proper protectionThis story has been sourced from a third party syndicated feed agencies Midday accepts no responsibility or liability for its dependability trustworthiness reliabilitsy and data of the text Midday managementmiddaycom reserves the sole right to alter delete or remove without notice the content in its absolute discretion for any reason whatsoever