The death toll due to Nipah virus, the severe disease that infects both humans and animals, in Kerala has gone up to 11 even as the disease has been reported in one more district in Northern Kerala. The government has said that it has taken steps to curb the disease from spreading to other places.
Three people died in Malappuram, the district near Kozhikode where the disease outbreak was first reported, and the health department has confirmed that these deaths were due to Nipah virus infection. The National Disaster Response Force (NDRF) is expected to arrive at Malappuram to support disease management efforts.
The first death due to the virus, which is communicated through bats and pigs, in the state was reported at Perambra, Kozhikode, on May 19. The death toll has increased to 11 with two patients dying on Tuesday in Kozhikode. Kerala Health Minister K K Shailaja said that the government has tested blood samples of 18 people for suspected Nipah virus disease. Shailaja added that around 12 had been confirmed, while the virus was not present in the blood samples of others. Out of those confirmed infections, 10 have already died and two are in the hospital. The number of people who have died due to the virus includes one person whose blood sample was not tested, and including this, the total suspected cases were 19, according to reports.
The Union Health Ministry has said that with early and efficient containment measures, undertaken jointly by it and the state government, the outbreak is unlikely to spread. Union Minister for Health J P Nadda has urged citizens not to believe in rumours posted on social media and to not spread panic.
A team of experts in different disciplines from the National Centre for Disease Control (NCDC), which is located at Kozhikode, visited the house in Perambra where the initial death was reported and caught some bats and collected around 60 different samples, which were sent for examination. The increasing incidence of dengue fever, diphtheria and other communicable diseases in the region is another factor which complicates treatment.
The State government has said that it has effectively curtailed spreading of the disease, while the neighbouring state of Tamil Nadu has asked people to avoid travelling to areas where Nipah Virus has been identified in Kerala. It has also urged the public to not spread panic through social media. Kerala Chief Minister Pinarayi Vijayan had earlier said that his government was monitoring the situation. "All efforts are also being made to ensure that more lives are not lost," said Vijayan, adding that the government was handling the issue with "utmost seriousness".
The National Institute of Virology has confirmed from the studies of blood samples that three out of the four deaths in the initial stage attributed to fever were caused by the virus. When the first death was reported on May 19, the Union Health Ministry and World Health Organization (WHO) were contacted on that day itself, said the state government.
While there is no vaccine available for the infection, experts said that preventive measures can be the key to controlling the spread of the disease.
George M Varghese, associate professor in the Department of Medicine & Infectious Diseases at the Christian Medical College, Vellore, said that how the virus appeared in North Kerala has to be looked at for effective precaution. It has previously been reported in Malaysia, Bangladesh, and Siliguri in West Bengal. By nature, fruit bats will not travel more than a 50 kilometre radius and no case has been reported in the neighbouring area. One possibility could be that North Kerala sees large scale imports of dates from overseas during the Ramzan season and if the dates have been contaminated with the virus, it could result in the outbreak.
Nipah's human-to-human transmission was confirmed with the death of the nurses involved in the treatment of the infected. Precaution has to be taken since it may be spread through body fluids such as droplets of saliva from the patient. According to the WHO, the primary treatment is intensive supportive care. However, Varghese said that one of the anti-viral drugs, Ribaverin, might have some effect on the disease.
The disease spreads through fruit bats, or 'flying foxes', of the genus Pteropus who are natural reservoir hosts of the Nipah and Hendra viruses. The virus is present in bat urine and, potentially, bat faeces, saliva, and birthing fluids. Presumably, the first incidence of Nipah virus infection occurred when pigs in Malaysian farms came in contact with the bats who had lost their habitats due to deforestation. Furthermore, transmission between farms may be due to fomites -- or carrying the virus on clothing, equipment, boots, and vehicles. The virus can be transferred from one human to another through close contact, body fluids, and large droplets of saliva through cough and sneezing.