Kerala is turning to be a hotspot of Nipah virus as the outbreak menaces the state again after years. The latest outbreak displays that Kerala is prone to battle the Nipah epidemic, most likely once in two years. The state had reeled through the Nipah outbreak in 2018, 2019, and in 2021. In September 2021, the third outbreak of Nipah was contained in Kerala and was declared over.

Now, two years later, in September 2023, Kerala is now reporting what has become the fourth outbreak of Nipah. Upon reporting a few cases of Nipah in the past few days, the state's health department has been beefing up the measures to identify the hotspots and to curb the spread. According to reports, two epicentres have been identified for the Nipah outbreak in the Kozhikode district of Kerala after four Nipah cases were confirmed. 

Of these four, two had died and the rest two are currently being treated. Following the outbreak in Kozhikode that was an epicentre for Nipah outbreak in 2021, the health department has announced a list of containment zones in the district. While addressing the media, Kerala's Health Minister Veena George said, "We are focusing on tracing contacts of infected persons early and isolating anyone with symptoms. Public movement has been restricted in parts of the state to contain the medical crisis." 

She further said that the virus of the current Nipah outbreak that was detected in Kerala was the Bangladesh variant, which spreads from human to human with a high mortality rate but has a history of being less infectious. Reuters has quoted a state health official saying that an adult and a child were still infected in hospital and more than 130 people have been tested for the virus, that would spread through a contact with the bodily fluids of infected bats, pigs, or people. 

In the wake of the outbreak, the Kerala government had ordered to close some schools, offices, and public transport on Wednesday in the affected areas. So far, Kerala has reported two deaths due to the current Nipah outbreak and the first victim was a 44-year-old man and was a resident of Marutonkara village in Kozhikode. While he died on August 30, the health minister said that the cause of death of a 44-year-old man who died on August 30 initially considered to be liver cirrhosis. 

In contrary, the current ones who are getting treated - an adult and a child- are the 9-year-old son and 25-year-old brother-in-law of the man who died on August 30 and they had also tested positive for Nipah virus. Furthermore, as per the statement of the health officials, the second victim due to the outbreak, a 40-year-old man who died on September 11, had spent an hour in close proximity with the first victim, the 44-year-old man, in a private hospital. 

The health officials have said that the 40-year-old man could have contracted the virus from the 44-year-old man. Following the outbreak and deaths, the health department had declared several wards in the panchayats of Ayanchery, Maruthonkara, Thiruvallur, Kuttiadi, Kayakkodi, Villiappally, and Kavilumpara in Kozhikode as Nipah containment zones. The hundreds of contacts that were identified include the family members and neighbours of the victims and health workers. 

The state health department is sending the samples to the National Institute of Virology in Pune for testing and three federal teams, including experts from the National Institute of Virology, arrived in the state on Wednesday - September 13 to conduct more tests and to survey the fruit bat population from the isolated villages. The outbreak has drawn an intervention from the Union Ministry of Health, which has said that the central teams are sent to assist the Kerala government. 

By confirming that the two deaths were due to Nipah virus, Union Health Minister Mansukh Mandaviya said that four suspected cases are under surveillance and their samples have been sent to the National Institute of Virology. "This isn't a new virus and we have some experience with this", the Union Minister stated, adding that the government medical colleges in Kerala were issued guidelines on the precautions to be taken and also provided with protective kits. 

In a social media post on Tuesday, Kerala Chief Minister Pinarayi Vijayan said that the state government was viewing the two deaths seriously and the health department has issued an alert in the district. He further appealed to the public that there was no need to worry as most of those who were in close contact with the deceased persons are under treatment. It has been reported that the government has installed a control room in Kozhikode and advised people to use masks as a precautionary measure. 

Tamil Nadu is on high alert

Kerala's neighbour Tamil Nadu is taking measures towards leaving no room for the Nipah spread in the state, in the midst of curbing the spread of Dengue. On Wednesday, Tamil Nadu's Directorate of Public Health and Preventive Medicine has issued an alert to the states bordering with Kerala in the wake of Nipah spread. The directorate said that the passengers who are coming from Kerala will be screened at the border check posts and that adequate teams have been deployed. 

In a statement, TS Selvavinayagam, the Director of Public Health and Preventive Medicine, said, "In view of Nipah virus cases reported from Kerala, passengers from Kerala will be screened at border check posts by a health team. Teams have been deployed round the clock in six districts of Tamil Nadu that share borders with Kerala." Nilgiris, Coimbatore, Tiruppur, Theni, Tenkasi, and Kanyakumari are those six districts that have been brought under a tight watch.

While addressing the reporters in Gudalur in the Nilgiris district, Tamil Nadu Health Minister Ma Subramanian appealed to the people that there was no need to panic and that the screening would be done for the people with fever symptoms. Looking back at the history, the Nipah virus was first identified in 1999 during an outbreak of illness among pig farmers and others in close contact with the animals in Malaysia and Singapore. 

Kerala's history of Nipah outbreaks and the symptoms 

The Nipah outbreaks in Kerala have been in a fashion that the people are used to them but it wasn't as deadly as the COVID-19 pandemic. In its first outbreak in 2018, Kerala had reported 23 infections of which 21 had died, while the Nipah outbreaks in 2019 and 2021 had killed two more people. The history of the Nipah outbreaks in Kerala tells us that each episode of the outbreaks hasn't lasted longer as they were contained and declared over in the same year they emerged. 

With an experience of battling such outbreaks of Nipah and COVID, the Kerala government hopes to swiftly contain the current episode of the Nipah outbreak, that had already claimed two lives. According to the World Health Organization (WHO), the Nipah virus is caused by fruit bats and is equally harmful to humans as well as animals. As far as the symptoms of Nipah is concerned, the virus can cause respiratory illnesses, fever, headache, cough, muscular pain, dizziness, and nausea.