In view of the Nipah virus outbreak, Kerala Health Minister Veena George said that nine states in India, including Kerala, are at risk of Nipah virus occurrences, citing the studies conducted by the Indian Council of Medical Research (ICMR) and the World Health Organization (WHO).
She said that extensive surveillance confirmed bats as the source of Nipah infection in Kerala. The Nipah virus strain detected in the state is identified as the Indian Genotype (I Genotype), which bears similarities to the strain found in Bangladesh. However, the minister also said, the Nipah outbreak in Kerala is completely under control, and more than 200 samples from the high-risk contacts were tested negative.
In an interview with PTI, the minister said so far 1,233 contacts have been traced and categorised into high-risk and low-risk contacts.
“A very positive thing is that all four patients under treatment are now stable, and the condition of the nine-year-old boy, who was on ventilator support, is improving clinically. He is now out of ventilator support and is being given minimal oxygen support,” George said.
A round-the-clock control room and 19 teams on the field have helped in the strict implementation of the protocol, bringing things under control. So far, we have six positive cases, and all the samples tested for the last three days were negative,” the minister said.
The Central teams who have been working with the Kerala health department have expressed their appreciation for the work the department has done to effectively contain the outbreak. “They (the Central team members) sit in all discussions. Our team leaders will explain every day in the convergence meeting how a contact, which is very important, a very high-risk contact was identified. So the Central teams have really appreciated our work,” George said.
Three Central teams, one from ICMR, one from NIV, Pune, and one from the Epidemiological Institute, Chennai are in Kerala. They had earlier visited the containment zones and Nipah epicentre in 2018 and have also conducted bat surveillance.
The system responded very well as per the protocol and guidelines, which were twice modified in 2021 and then in 2023, in the treatment and containment of Nipah, the minister said.
“Primarily, we are giving antiviral medicines like Remdesivir. The dosages for infants and adults are all well written. The protocol is being followed by both government and private hospitals,” George said.
Understanding the vulnerability of Kozhikode to the disease outbreak, a strict protocol has been followed since 2018. “We have set up a testing lab at the Medical College, Kozhikode. In August this year, we tested 35 samples for the Nipah virus. This year, hundreds of samples were tested. If anyone has encephalitis, then that sample will be sent for testing for Nipah,” the minister said.
The system has always been on high alert, and a diagnosis protocol was ready. Many studies have been conducted in Kozhikode from 2018 onwards including bat surveillance, she said.
“We are on constant alert, constant vigil, that will continue, and integration of some departments, like we have developed a “one health programme” in Kerala based on our experiences on Nipah. Because this is an era of zoonotic diseases, we cannot stay away from the concept of “one health” and it is only the state of Kerala that has developed that concept,” George said.
“One health” is a programme launched by the state health department where all the concerned departments will get a platform for convergence in fighting against infectious diseases outbreak.
The minister said for better convergence of departments in case of any infectious disease outbreak, the government is planning to set up a One Health Institute in Kozhikode.
Asked about restrictions for anyone visiting Kerala or Kozhikode, she said there is no travel ban. “See, we have a protocol; according to our guidelines, when a Nipah case is reported, the area within the five-kilometre radius is declared as a containment zone. There is movement restriction only in that particular area,” George said.
She said not even the whole of Kozhikode district is affected, but only few wards. Terming contact tracing as very challenging, George said many people do not admit that they were in contact with the positive patient initially. So when health workers called up, they were reluctant to admit the places they visited.
“For example, if a patient visits a hospital, it is easier for us to get the details of other patients and also the list of health workers. But some patients may have more than one bystander, and we may not know that,” George said.
She said these people later admitted their presence after a counselling session. To handle such cases, the Kerala government sought the help of the police department to confirm the location through mobile tower analysis.
The health minister said that in none of the previous outbreaks, the entire contact list could be traced. The total number of cases of Nipah infection confirmed in the state are six, of which two persons have died and four persons are being treated. CNBCTV18