The government has set up containment zones and closed educational institutes in the affected area. Testing is being carried out on those in contact with the infected individuals, and experts from three organizations have arrived to assist with treatment and surveillance.

The Nipah virus causes fatal encephalitis and can be transmitted through contact with infected animals or contaminated food.

Authorities in Kerala scrambled to contain the spread of the Nipah virus on Thursday, drawing up a list of around 950 people who could have been exposed to the disease, setting up containment zones, and shutting down all educational institutes in Kozhikode district in a bid to isolate the deadly pathogen that attacks the brain and is often fatal.

At least five people tested positive for the virus and two have died – the first on August 30 and the second on September 11. Eleven samples collected by the authorities on Wednesday came back negative for the virus on Thursday, offering some hope of containment. On Thursday, the administration collected another 15 samples from the list of people who were in contact with the five people and sent them for testing to NIV Pune. Of this, at least two people – both health care workers – were symptomatic, said the state’s health department.

State health minister Veena George said the government held a high-level meeting on Thursday morning and the principal secretary met officials of the Union government. Experts from three organisations – National Centre for Disease Control, RML Hospital, Delhi, and NIMHANS – arrived in the state to help in treatment and surveillance.

“We have decided to take samples of all the persons who are in the high-risk contact list of the first person, who died on August 30,” said George. The full contact list currently has 950 names, out of which 213 are in the high-risk category, said state health officials. A total of 287 people on the contact list are healthcare workers, they said.

The state government said that it will take body fluid samples of all of those who are in the high-risk contact list linked to the first Nipah victim, a 47-year-old who died on August 30.

George said the decision was taken at a meeting with officials of the Union government, who are visiting the Nipah-affected nine wards in two panchayats in Kozhikode district.

The Nipah virus (NiV) is a highly pathogenic virus that causes fatal encephalitis – swelling of the brain – and acute respiratory distress in humans.The virus is transmitted to humans by direct contact with the respiratory secretions or body fluids of infected animals, such as bats and pigs, or by consumption of contaminated fruits or palm sap. Both animal-to-human and human-to-human transmission have been documented in several research papers.

India has witnessed at least five outbreaks since 2001, from West Bengal, and Kerala, with the latest being the fifth. The first was in Siliguri, West Bengal; the other four have been in Kerala.

On Thursday, health workers visited 5,161 homes across affected panchayats as part of a survey and found 51 individuals had symptoms of fever, said district medical officer Dr KK Rajaram. “They do not have contact with the Nipah infected, but they have been told to remain in isolation,” he said.

The district administration tightened restrictions in Kozhikode, barring entry to public places such as beaches and parks. Public meetings and entry to temples in large groups were banned. Visitors will not be allowed in hospitals and only one person will be allowed to accompany a patient. The tapping and sale of toddy was stopped until further notice.

The public was asked to desist from visiting areas with a large concentration of bats and pigs. Schools and other educational institutions were shut on Saturday as well.

Restrictions were particularly tight in nine panchayats in Kozhikode district that were turned into containment zones, with hundreds of Asha (accredited social health activist) workers visiting homes of residents every day, conducting medical check-ups , monitoring people, and collecting data. The epicentres of the outbreak are the Kallad ward in Maruthonkara panchayat and Mangalad ward in Ayancheri panchayat. The 47-year-old man who died on August 30 was a resident of Maruthonkara, the 40-year-old who passed away on September 11 lived in Ayancheri.

On Thursday, the only available experimental treatment – monoclonal antibody – was delivered to the state by the Indian Council of Medical Research (ICMR). George said that the stability of the antiviral was discussed with a central expert committee. “Further steps or course of action would be decided by the expert committee,” she said.

The m102.4 monoclonal antibody, an experimental therapeutic, was imported for the treatment of infected patients on compassionate grounds during the 2018 Nipah outbreak in Kozhikode. At the time, it was not used because the outbreak had ebbed by the time it arrived. The standard operating procedures and protocols for its use were prepared back then with the support of ICMR, she said.

In addition, ICMR’s National Institute of Virology (NIV) in Pune also sent its mobile BSL-3 laboratory — the first biosafety level-3 containment mobile lab of South Asia — to Kozhikode to test samples.

A fully-equipped mobile virology testing laboratory was sent by the Rajiv Gandhi Centre for Biotechnology (RGCB) to the district to strengthen the testing and detection of the virus. RGCB Director Prof Chandrabhas Narayana said the services of a group of six experts was made available in the mobile unit, which can give results within six hours of receiving samples.

George said there were 14 persons in isolation without any epidemiological link with the people who died. The minister also said that the vitals of the nine-year-old son of the first Nipah victim, who is being treated for the disease, are stable.

(Hindustan Times)