Batting for prevention: on Nipah cases in Kerala   

With two cases of Nipah virus detected in Kerala — including one fatality owing to the infection — the attention is rightfully, once again, on a preventable infectious disease that could leave havoc in its trail. An adolescent girl from Malappuram succumbed to the virus on July 1, and a 38-year-old woman from Palakkad is battling for life in the hospital. In the big picture, as many as 425 people who are in the contact lists of the two Nipah-infected persons in three districts in Kerala have been identified and are under surveillance. Of these, 228 are from Malappuram district, where Patient Zero was identified this time, 110 in Palakkad and 87 in Kozhikode. In Palakkad, one contact is being treated in isolation, while 12 people are currently undergoing treatment in Malappuram — five of them are in the intensive care unit. One of them tested negative for the infection, and the results for the others are awaited. Over 140 of those on the contact list are said to be health workers. While the health machinery in Kerala is engaged in tracing the original source of the infection, it is also tasked, particularly in the three districts of Malappuram, Palakkad and Kozhikode, to trace contacts, isolate them to prevent further spread, contain infection and treat all those who show symptoms. India has recorded several outbreaks of the virus since 2001, a year when 45 of the 66 people infected died in West Bengal. In 2018, it surged in Kerala, with 17 of the 19 cases with laboratory-confirmed Nipah infection dying without responding to treatment. Kerala continues to report outbreaks regularly since then.

What renders even a single case of significant concern to get the entire health-care machinery in a tizzy? Nipah is a transmissible viral infection with a high mortality rate, ranging between 40% and 75%, which implies that if the infection spreads, then, a number of people are likely to die. Future research might add an effective tool to the armamentarium to effectively treat Nipah infections without mortality, but as of now, the course of action is vested only in prevention and awareness generation. Nipah is transmitted by fruit bats which are the natural reservoirs of the virus. It is suspected that consuming contaminated fruits, bitten or licked by bats, may play a role in spreading the virus. It is also equally important to cast a watchful eye on climate change-related factors, particularly anthropogenic activity that is destroying natural habitats, and initiate a robust One Health programme that will weigh not just Nipah but also other pathogens that are capable of zoonotic spillover, transitioning from animals to humans and causing great harm.