Fear of Nipah virus infection grips Indian state

Four deaths in the past three days (May 30-June 1) due to Nipah virus  (NiV) infection have put Kozhikode district, the epicentre of the disease with mortality rate of 75% and no vaccine, on the highest alert in southern India.

The latest victim Roja, 39, died on Friday at Kozhikode Government Medical College Hospital taking the death toll to 18. She was admitted to the hospital with strong symptoms of the infection three days ago. Although analysis of Roja’s blood sample proved negative, she died on Friday.

On Thursday, Rasin, 25, died from NiV which he may have got from another patient Ismail when the two were earlier undergoing treatment at the state-run hospital in Balussery in Kozhikode. Ismail was later shifted to the medical college hospital where he died on May 20.

Following Rasin’s death, the state health ministry has asked doctors, nurses and attendants of Balussery hospital to go on leave. Until now, authorities thought the virus spread only from the medical college hospital and Perambra’s state-run hospital.

Although state health minister KK Shailaja says NiV is well under control, medical experts have been unable to trace the origin of the virus in Kozhikode.

Authorities are making efforts to prevent a second wave of Nipah virus infection by widening the list of people who had contacted those who got NiV from the 18 victims.  Details of more than 1,900 such people have been listed by the health officials. They have been  advised to contact the authorities if they develop any symptom of the disease. Ambulances will pick them up from their homes.

Fear over Nipah virus is evident in Kozhikode district. Most people are talking about it and avoiding public transport, visits to hotels, banks, markets and theatres.
Many have stopped consuming fruits fearing NiV infection. Some of the busy roads in the district are deserted during day time. Fearing NiV infection, people with rain-related ailments are refusing to visit state-run hospitals.

Work at the district court has been suspended after TP Madhusudhanan, 56,  senior superintendent of  the court, succumbed to NiV this week.  The state high court has instructed busy courts to halt work until the situation stabilises. Lawyers and other court staff fear the chances of NiV infection are more in the court premises.

Seventeen people suspected of having NiV infection are under observation.

Tests of samples of  blood, fluids and droppings of insectivorous bats captured from the well of the Moosa home, where four people died from the infection, showed no sign of NiV virus. Tests of blood samples of fruit bats (of the Pteropodidae family, Pteropus genus), which act as intermediate hosts and pass the virus to humans, also showed negative.

Shailaja has urged the public not to panic but to be on the alert.

Kerala maintains high standards in health care . At the same time, since Kerala is a highly mobile society, the risk of the infection spreading to other states and countries, especially in the Middle East, is high. Considering this, dozens of people had been put into quarantine. However, the UAE has asked its citizens to put off “unnecessary” travel to Kerala. Import of fruits and vegetables from Kerala has also been suspended by the Gulf country.

A native of Kerala who went to Goa in western India with symptoms of NiV was put into quarantine at the Goa Medical College hospital on Monday (May 28).

Virus claims 4 of a family

Among the 18 who succumbed to the deadly virus were four members of the Moosa family in Changaroth village in Kozhikode.  Mohammed Sabith, a family member, was the first victim. Officials checked whether Sabith had recently visited Malaysia where the first-ever outbreak of NiV was reported at Kampung Sungai Nipah in 1998. However, reports said he recently visited the UAE, not Malaysia.

Earlier, the death of a nurse who attended four patients from the Moosa family unnerved her colleagues in Perambra hospital. Three of them are under observation after they complained of fever and headache. It is not yet confirmed whether they have been infected with NiV.

Their colleague Lini Puthussery, a mother of two, felt feverish a fortnight ago. Knowing NiV symptoms well, she asked to be quarantined. By the time her husband Sajish came from Bahrain, she was in the intensive care unit. She died early on May 21. Lini was hailed a hero by media, her colleagues and the government. There are many unsung heroes who are working in hospitals without leave to give intensive supportive care to Niv-infected patients.

According the WHO, pigs were the intermediate hosts when NiV first hit Malaysia in 1998. In subsequent outbreaks, there were no intermediate hosts. But in an outbreak in Bangladesh in 2004, fruit bats became the carriers. People there got infected with NiV after consuming date palm sap contaminated by bats.

NiV infection leads to encephalitis or inflammation of the brain. After exposure and an incubation period of 5 to 14 days, the illness causes fever and headache, followed by drowsiness, disorientation and mental confusion. These signs and symptoms can progress to coma within 24 to 48 hours.