Understanding and Combating the 2023 Nipah Virus Outbreak in India: Prevention and Cure, Restrictions Eased in Kerala

 

Nipah Virus is believed to be transmitted primarily trough bats (Photo: Pexels-Stephen Chantzis)

The Nipah virus, a zoonotic disease that can spread between animals and humans, has once again reared its deadly head in Kerala, India. This marks the fourth outbreak of the virus in the region within the last five years. The most recent case was reported on September 15, 2023, bringing the total number of confirmed infections to six, with two unfortunate fatalities. 

The virus, which was first identified over two decades ago during an outbreak among pig farmers in Malaysia, is believed to be transmitted primarily through bats. It can cause mild to severe symptoms, including encephalitis (brain infection), and has a high mortality rate ranging between 40% to 70%. In the 2018 outbreak in Kerala, India's first ever, 18 people were infected with the virus, resulting in 17 deaths.

The current outbreak occurred in the Kozhikode district of Kerala, prompting authorities to establish containment zones and close schools as a precautionary measure. Seventy-six individuals who had contact with the infected are under close observation for signs of the disease. Despite the high mortality rate, the virus does not spread efficiently from person to person, offering some relief amidst the crisis.

The Nipah virus is not airborne but is mostly transmitted through droplets. Therefore, with proper infection control practices, the possibility of virus transmission in hospitals is low. However, if a person comes into contact with an infected bat's or pig's blood, urine, or saliva, they can contract the virus. For instance, if a bat's saliva remains on a piece of fruit it had licked and a person later consumes that fruit, they can contract the Nipah virus.

Prevention and Cure

As of now, there is no medication or vaccine to treat the Nipah virus. The authorities are working tirelessly to contain the outbreak and prevent further spread of this deadly disease.

In the absence of a vaccine, prevention focuses on reducing exposure to the virus. This includes avoiding contact with sick animals, not consuming raw date palm sap that could be contaminated by infected bats, and adhering to standard infection control practices during an outbreak.

The primary treatment for humans is supportive care, which involves managing symptoms. Preventive measures include infection control practices like using protective equipment, disinfecting surfaces, and avoiding areas with known Nipah virus outbreaks or sick animals.

Despite the lack of a specific cure or vaccine, research and development efforts are ongoing. The World Health Organization has identified Nipah as a priority disease for research and development, highlighting the urgent need for accelerated efforts in this area.

Restrictions Eased

On September 23rd, 2023, the district authorities in Kozhikode, Kerala, announced a significant easing of containment zone restrictions due to the absence of new Nipah virus cases since September 16th. The containment zones encompassed all wards within nine village panchayats in Vadakara Taluk, an area that includes approximately 26 villages and is the headquarters for 22 panchayats. 

The authorities also relaxed restrictions in all wards of Feroke Municipality and seven wards of Kozhikode Corporation, which were previously designated as containment zones. As per the District Collector's order, all shops within these zones can now operate until 8 pm, and all banks can function until 2 pm. 

However, despite these relaxations, there was no reprieve for the urban containment zones in Feroke municipality and the seven wards in Kozhikode Corporation. The decision to maintain restrictions in these areas was taken during a review meeting chaired by Minister for Public Works P.A. Mohamed Riyas. Any further relaxations will be based on the instructions of the expert committee.

This outbreak of the Nipah virus, a zoonotic virus that first struck Kerala in 2018, is the fourth in the state in recent years. The most recent outbreak prior to this occurred in 2021. Despite the relatively small geographical area usually affected by such outbreaks, they can be deadly, and there is concern among scientists that increased spread among people could lead to the virus becoming more contagious. 

The lifting and relaxation of restrictions come as a relief to the residents of Kozhikode, who have been living under strict regulations due to the Nipah virus outbreak. However, the situation remains precarious in the urban containment zones, where health workers continue to visit households to raise awareness about the outbreak.