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Nipah Virus Outbreak in Kerala: Schools and Offices Closed, Containment Zones Declared

The southern Indian state of Kerala closed schools and offices and declared containment zones in some parts of the state amid the risk of a Nipah virus outbreak following the death of two people from the rare and deadly viral disease that damages the brain.

So far, more than 130 people have been tested for the virus following its fourth outbreak since 2018. At least 21 died in the 2018 outbreak, according to the Al Jazeera newspaper. The state Ministry of Health imposed strict isolation regulations in the last few hours.

Staff members install a sign reading “Nipah isolation ward, entry strictly prohibited” at a hospital where a ward is being prepared for suspected Nipah virus patients in Kozhikode district, Kerala, India, on September 12, 2023 | Photo: REUTERS

Lessons from the previous bouts of the infection, along with two consecutive years of facing the Covid-19 pandemic in 2020 and 2021, have helped Kerala confront the virus head-on in its fourth foray into Kozhikode villages.

The 2018 outbreak, which claimed 17 lives out of 18 confirmed cases, took the state health department by surprise. The government had no prior experience in managing a disease with such a high mortality rate. At that time, the disease was identified only when the virus had already begun to spread among humans and claimed some victims.

It was the consecutive confirmation of Nipah in 2018 and 2019 (then a case in Ernakulam) that forced the health department to come up with a systematic approach to deal with any future outbreak, according to the Indian Express.

In 2020, the state did not report any cases of Nipah, but the 2019 protocol was updated and sent system-wide. The protocol was updated again in 2021, making it more complete in all aspects, including the treatment algorithm.

Officials place a bat in a plastic bag after trapping it on September 7, 2021 in Kozhikode, India. Nipah virus is primarily transmitted by fruit bats. | Photo: 2021 DeFodi Images

In September 2021, when a 12-year-old boy died in Kozhikode due to Nipah, the state was in the trenches in its battle against a second wave of the Covid-19 pandemic. But this helped deal with Nipah, as that society in general was accustomed to quarantine and isolation.

What is Nipah?

The Nipah virus is also known to cause illness in pigs and people. NiV infection is associated with encephalitis (inflammation of the brain) and can cause mild to severe illness and even death.

Nipah virus infection can be prevented by avoiding exposure to sick pigs and bats in areas where the virus is present, and not drinking raw date palm sap, which can be contaminated by an infected bat.

Colored transmission electron micrograph of mature extracellular Nipah virus particles (red) near the periphery of an infected VERO cell (green). | Photo: Getty

Signs and symptoms

According to the Centers for Disease Control and Prevention (CDC), Nipah virus (NiV) infection can cause mild to severe illness, including inflammation of the brain (encephalitis) and potentially death.

Symptoms usually appear 4 to 14 days after exposure to the virus. The illness initially presents as 3 to 14 days of fever and headache and often includes signs of respiratory illness, such as cough, sore throat, and difficulty breathing.

A phase of brain inflammation (encephalitis) may follow, in which symptoms may include drowsiness, disorientation, and mental confusion, which may progress rapidly to coma within 24 to 48 hours.

Symptoms may initially include one or more of the following:

2023-09-14 18:12:30
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