How Nipah virus’ high mortality rate endangers public health

Hyderabad: In a concerning development, the deadly Nipah virus has made a reappearance in the state of Kerala, raising alarm bells among health officials and local authorities.

Teams from the National Institute of Virology (NIV), Pune, have arrived in Kerala to set up a mobile lab at Kozhikode Medical College to test for Nipah and carry out a survey of bats. This collaboration aims to provide crucial insights into the virus’ transmission and behaviour.

The Kozhikode administration has declared several village panchayats as containment zones, restricting travel in and out of these areas. Kerala health minister Veena George said, “The virus strain seen in Kerala was the Bangladesh variant that spreads from human to human and has a high mortality rate, though it is less infectious.”

Only stores selling essential commodities and medical supplies will be allowed to function, with specific operating hours. Local self-government institutions and educational institutions are to remain closed.

Nipah’s virulence goes beyond physical harm

The current situation marks Nipah’s second outbreak in the region within two years, underscoring the gravity of the situation. In 2018, the Nipah virus outbreak in Calicut resulted in 17 fatalities out of 19 infected individuals.

Nipah virus, known for its high case fatality rate and lack of proven curative treatment, presents a significant challenge to public health. Dr Rajeev Jayadevan, a seasoned medical expert, explains that Nipah outbreaks have far-reaching consequences beyond immediate fatalities. They impact physical health, as well as social, emotional, and economic aspects of the affected communities.

One of the key factors in Nipah virus transmission is bats, specifically fruit bats. While not all bats carry the virus, when they do it can be detected in their saliva, urine, and reproductive fluids. Humans become ‘incidental hosts’ when the virus inadvertently enters their bodies. Pigs and occasionally other animals can also serve as ‘amplifier hosts.’

Quarantine, protective equipment can prevent transmission

Dr Jayadevan stresses the importance of minimising interactions with bats. While controlling bat populations is challenging due to their ecological significance, precautionary measures can be taken.

Avoiding the consumption of raw date palm sap and toddy from coconut trees in bat-infested areas is recommended to reduce the risk of transmission.

While bats are natural reservoirs of Nipah, the primary challenge lies in preventing human-to-human transmission. Most Nipah-related deaths result from such transmission. Building awareness, dispelling myths, and addressing misinformation are crucial components of efforts to curb the virus’ spread.

Efforts must focus on preventing human-to-human transmission, which primarily occurs through close contact with patients. Quarantining and closely monitoring contacts, maintaining safe distances from patients, and using protective equipment like N95 masks and gloves are essential measures.

Fever clinics and cough etiquette

Establishing fever clinics for efficient case management can help identify and isolate patients with fever, reducing the exposure of healthcare workers and others. Additionally, practising proper cough etiquette — covering the mouth with a cloth or elbow while coughing — can mitigate the risk of transmission.

Building awareness and practising preventive measures remain key to managing this formidable virus.