Kerala, India: Testing A Suspected Nipah Case In Kochi

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Last summer, in Nipah Transmission In Kerala Outbreak, we looked at the apparently robust household and nosocomial transmission of the Nipah virus from an index case to 17 others (and 1 secondary nosocomial transmission).

This outbreak, in a highly populated region of Southern India, was fortunately stopped at 19 cases, and declared over on July 1st, 2018.

But it occurred in an area more than 1000 miles removed from India's two previous outbreaks (West Bengal in 2007 & 2001), and serves as a reminder that exotic viral diseases can turn up in places where you don't normally expect them.

Today there are concerns once again in Kerala Sate of a new outbreak, and a 23 year old college student is being tested, and reportedly dozens of others are under close observation.

Typical of the reports we're seeing is this from NDTV.

Nipah Yet To Be Confirmed, Says Kerala Minister, 52 Under Surveillance

Nipah virus is transmitted from animals to humans and then spreads through people to people contact. It is associated with fatal encephalitis and respiratory illness. In initial stages it causes fever, headache, muscle pain, dizziness and nausea.

All India | Written by Sneha Mary Koshy  Updated: June 03, 2019 16:46 IST

Highlights:

• Man admitted in Ernkaulam hospital is suspected to have contracted Nipah
• Fifty-two people, among them 22 students, are under surveillance
• 11 students travelled with suspected patient to Thrissur for internship

Kerala Minister KK Shailaja said the state has taken all precautions to control the Nipah virus.

A 23-year-old man admitted in a private hospital in Ernkaulam is suspected to have contracted Nipah -- a virus that caused the deaths of 17 people last summer -- Kerala Health Minister KK Shailaja has said. Fifty-two people, among them 22 students, have been put under surveillance since. None of them have showed any symptoms yet, and have been allowed to stay at home.

        (Continue . . . )

Although this may turn out to be a false alarm, the Nipah virus - first identified in 1999 after hundreds of abattoir workers in Malaysia and Singapore were infected by pigs carrying the virus (see MMWR Update: Outbreak of Nipah Virus -- Malaysia and Singapore, 1999) - has been on our watch list for nearly two decades.

While outbreaks thus far have been scattered, limited human-to-human transmission has been documented (see EID Journal Person-to-Person Transmission of Nipah Virus in a Bangladeshi Community), making Nipah a legitimate public health concern.  

A little over a year ago, in the WHO List Of Blueprint Priority Diseases, we looked at 8 disease threats in need of urgent accelerated research and development.   Among them is the Nipah virus.

List of Blueprint priority diseases

(SNIP)

The second annual review occurred 6-7 February, 2018. Experts consider that given their potential to cause a public health emergency and the absence of efficacious drugs and/or vaccines, there is an urgent need for accelerated research and development for*:

• Crimean-Congo haemorrhagic fever (CCHF)
• Ebola virus disease and Marburg virus disease
• Lassa fever
• Middle East respiratory syndrome coronavirus (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS)
• Nipah and henipaviral diseases
• Rift Valley fever (RVF)
• Zika
• Disease X

I'll update this story when we test results are published.