Nipah in Kerala from Bangladesh variant: State health minister

In contrast to 2018, where encephalitis symptoms predominated, the 2023 cases present with respiratory and flu-like symptoms.

Kerala’s Health Minister Veena George said that the Nipah virus strain seen in Kerala was the Bangladesh variant. This variant spreads from human to human and has a high mortality rate. However, it is not highly contagious, she stated in the state assembly on September 13.

Samples of two healthcare workers with Nipah symptoms have been sent to ICMR-NIV (Indian Council of Medical Research-National Institute of Virology) Pune on September 13. Currently, two people who are relatives of an earlier deceased patient are under treatment in the state. The state government has identified 702 people who have come in contact with three identified cases.

Kerala confirmed four cases of Nipah in the state on August 12. Two of the cases were already deceased by the time the state received confirmation from ICMR-NIV Pune. The first death happened on August 30 and the second death on September 11. The man who died on August 30 was 44 years old, while the second person who died was a 40-year-old. The state government is considering these two people as the epicentres for the disease and has declared containment zones in the 5-kilometre area surrounding it. Seven village panchayats in Kerala's Kozhikode district have been declared as containment zones following the two deaths.

The state health minister also said that the doctors of the patients currently under treatment have requested for monoclonal antibodies from ICMR- NIV for treatment.

The current cases of Nipah presented differently than the cases detected in 2018, said Dr. Anoop Kumar AS who was involved in the detection of the outbreak in 2018. The new outbreak is located 15-20 kilometres from the 2018 epicentre. “The medical team decided to isolate the patients and informed the state government of a chance for an outbreak. We ensured that the spread through contacts in the hospital is contained through early detection,” said Dr Kumar who is currently the Director of Aster North Kerala (Cluster) of Critcal Care Medicine. In 2018, there were incidents of virus spread in hospitals among healthcare workers and bystanders.

In contrast to 2018, where encephalitis symptoms predominated, the 2023 cases present with respiratory and flu-like symptoms. Dr. Kumar emphasises the importance of identifying Nipah, even when symptoms differ, given the ongoing influenza season. He added that mild symptoms have been observed in some patients, raising concerns about potential, unwitting carriers. Additionally, respiratory symptoms increase the risk of the virus spreading through sneezing and coughing, he added.