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A 14-year-old boy from Kerala, who tested positive for Nipah virus, succumbed to the infection on Sunday. He had fever and showed symptoms of acute encephalitis syndrome – inflammation and swelling of the brain usually due to an infection. He was on ventilator since Friday.
The Centre has rushed a “One Health” outbreak response team to investigate the case. The team will identify epidemiological linkages and provide technical assistance to the state. The Centre has urged the state to carry out active search for Nipah virus cases in the family of the boy, neighbouring areas, and areas with similar topography. The state has also been asked to trace all contacts of the boy over the last 12 days. Strict quarantine of the contacts and isolation of those suspected to have the infection has been advised. Samples for the contacts and suspected cases have to be sent for laboratory testing.
The Indian Council of Medical Research (ICMR), on the state’s request, sent monoclonal antibodies against the infection to the state. While the monoclonal antibodies had reached before the death, it could not be used because of the poor general condition of the boy, according to a statement by the union health ministry.
The Centre has also sent a mobile BLS-3 laboratory to aid in testing.
What is Nipah?
Nipah is a viral infection that mainly affects animals such as bats, pigs, dogs, and horses but can jump to humans who come in contact with the infected animals and cause serious disease. Nipah usually presents as fever and swelling of the brain.
Outbreaks of Nipah are not very common in India, unlike our neighbouring Bangladesh that sees cases almost every year since the first case in 2001 when the first cases in the country were reported in West Bengal. Nipah has taken the form of a seasonal disease in Bangladesh, with people getting the infection between December and May. There have been a handful of outbreaks of the infection in the country, with the latest being in 2023 in Kerala.
What is the monoclonal antibody sent by the Centre?
Used early in the course of the disease, the monoclonal antibody can prevent severe disease. However, it cannot be used once encephalitis or brain swelling sets in. The monoclonal antibody is also effective against Hendra virus from the same family.
Dr Rajiv Bahl, ICMR director general, had previously said that India had 20 doses of the monoclonal antibody that had been imported during the 2018 outbreak. He previously said: “They weren’t used in 2018 because the outbreak was over by the time the antibodies reached India. For the current outbreak, we did not know whether we can use the five-year-old antibodies. However, the lab at University of Queensland in Australia that manufactures it has informed us that the sample maintained by them continues to be stable. The structures remaining stable means we can use these doses,” said Dr Bahl. The monoclonal antibodies have been stored at -80 degrees Celsius by the ICMR. Each infected person needs two doses.
What can be done to protect oneself?
Usually, Nipah outbreaks are localised, meaning people from the rest of the country are not at risk of the infection at present. People in the area where the cases were detected should refrain from coming in close contact with the family members and other contacts of the two cases. With the infection transmitted by fruit bats, the government also suggests precautions like washing the fruits and peeling them before consumption. Fruits with signs of bat bites should be discarded. Palm sap or juice must be boiled before consumption.
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