Nipah virus: Results of 7 samples from high-risk group awaited

The National Institute of Virology (NIV), Pune, is expected to make available, later today, the test results of samples taken from seven members of the 20 high-risk primary contacts of the Nipah virus victim in Kozhikode in Kerala. Samples of the remaining 13 will be subjected to initial screening locally.

The NIV is helping set up a ‘point of care’ testing facility at the Medical College Hospital where samples can be screened initially. Suspected ones could then be sent to Pune for confirmatory tests and results could be known in 12 hours. There is enough stock of medicine but the monoclonal antibody is in short supply, sources say.

Three contacts develop fever
The Indian Council of Medical Research, New Delhi, assured the State Health Department that the requirement of the immunity-boosting monoclonal antibody would be sourced from Australia shortly.

A separate ward and a negative-pressure ICU are already operational at the Medical College Hospital.

Meanwhile, at least three persons in the high-risk primary contact list, which includes parents of the 12-year-old boy who died on Sunday morning from the Nipah virus infection, have developed mild fever. They are kept under close observation. Although deadlier than Covid-19, Nipah virus can be handled easier.

Sources said that concurrent prevalence of Covid-19 and Nipah viruses have started to take its toll on the human resources capacity available. At least 16 separate groups now involved in Nipah sourcing and tracing has translated into a huge drawdown from the healthcare resource pool managing Covid-19.

Covid-Nipah virus dilemma
The State Health Department is probing an allegation on the apparent ‘failure’ of the Medical College Hospital in taking a swab or identifying the disease (Nipah virus was identified at a private hospital later) despite having the experience of successfully managing the earlier outbreak in 2018.

Since then, the hospital was under instruction to check, without fail, any case with high fever and encephalitis. In the present case, the hospital had allegedly wasted 24 hours by idling the patient, exposing him to a number of healthcare workers, most of whom are now under observation.

The hospital is learnt to have argued that, although it was aware the patient was in a serious condition, it could do precious little since no ventilators were available. Most of them were occupied with Covid-19 patients, which highlighted the sharp focus on its dilemma, given the active Covid case load in Kozhikode.

Condition worsens suddenly
The boy’s case was initially suspected to be a case of viral fever. However, the patient’s condition worsened suddenly after he developed encephalitis and pneumonia. It was at the insistence of the parents that the patient was allowed to be moved to a private hospital where he later succumbed.

According to Jacob T John, leading virologist and former professor at CMC Vellore, it is more or less clear that fruit bats in Kerala may be carriers of the Nipah virus as evident from repeated outbreaks. These are nocturnal mammals and are known to feast on fruits during the nights.

“Humans must take care not to consume stray fruits that drop down into the homestead overnight and children should be properly guided on the same. Having said so, it is incumbent on the Health Department and Forests/Animal Husbandry Department to find the exact source of the outbreak,” said John.

AS Anoop Kumar, Senior Consultant and Chief, Critical Care, Baby Memorial Hospital, Kozhikode, who was instrumental in identifying the first Nipah virus outbreak in 2018, said that Kerala needs to set up an effective observation/examination and treatment protocol for all types of brain encephalitis cases. The Hindu BusinessLine