Nipah virus outbreak leads to ten deaths in India

The death toll from an outbreak of priority virus, Nipah, is now being reported as at least ten; all confirmed deaths have been located in the Kozhikode district of Kerala, India.            

One of the deaths was nurse, Lini Puthussery, who was believed to be providing care to the first Nipah cases, if heathcare workers are vulnerable, this could make the outbreak very challenging to contain. It was also reported by Reuters on Wednesday morning that two individuals with suspected cases of Nipah are under treatment in Karnataka, a neighbouring state, although not confirmed this could indicate the outbreak is spreading geographically.

The population of Kerala state have been advised to remain vigilant, with the National Centre for Disease Control closely monitoring the situation. Shri JP Nadda, Union Minister of Health and Family Welfare, has assured all support to the Kerala Government and has directed a multi-disciplinary central team from National Centre for Disease Control to immediately visit the district.

In a statement from Geneva, Nadda commented: “We are closely monitoring the situation. I have spoken to Tourism Minister KJ Alphons and Kerala Health Minister KK Shailaja, and assured them all support of the central government. I have also dispatched a central team to assist the state government and initiate required steps.”

The Minister posted an update on Twitter earlier this week:

Health authorities in Kerala have been on high alert and have taken measures such as setting up medical camps and a control room to tackle this situation.

Nipah has previously been reported in India in 2001, and again in 2007, with the two outbreaks claiming 50 lives. The virus has been reported to have a fatality rate of up to 70%, making the latest cases a concerning development. There is no vaccine for either humans or animals; the primary treatment for human cases is intensive, supportive care.

Nipah virus, part of the Henipavirus family, is an emerging zoonotic disease that causes severe disease in both animal and humans, including respiratory illness and encephalitis. Nipah, like MERS, is also thought to derive from bats and was first identified in Malaysia in 1998.

In the 1998 outbreak, which caused 265 cases of acute encephalitis with 105 deaths, pigs were identified as an intermediate host and most human cases were associated with close contact to infected animals. However, in subsequent outbreaks in Bangladesh and India no intermediate hosts were identified, suggesting bat–human and human–human transmission occurred. This unclear, complex transmission presents a challenge as we may be unable to prevent disease spread in the face of a future pandemic, making Nipah a threat where preventative strategies are of the utmost importance.

In addition to their complex, multi-host transmission routes Nipah is an RNA virus, giving it the potential to rapidly mutate. If this zoonotic pathogens were to obtain more efficient human–human transmission, they could pose a huge public health risk globally, again highlighting the need for epidemic preparedness.

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