Nipah: Centre raises alarm as fatality rate rises

With the Nipah outbreak in Kerala reporting 84% fatality, health authorities on Wednesday decided to provide separate ambulances for transporting the suspected patients to the isolation facilities for symptomatic treatment.

According to the Union health ministry, there is 13 confirmed case of Nipah, out of which 11 died. Eight of those deceased are from Kozhikode and the rest are from Malappuram.

In addition, there are 16 suspected cases from these two districts, out of which 15 are admitted in Govt Medical College, Kozhikode, and one person is in Manjeri Medical College in Malappuram. The laboratory results of these cases are awaited.

The central team reviewed the emergency health mechanism with district and state officials with the objective of not to miss out any other cases and to ensure that the disease doesn't spread to others particularly the family members of the infected individuals and the healthcare staff.

“It was decided to provide separate ambulances for transportation of the suspects. An action plan was also developed for the healthcare staff and simulation exercises were undertaken. Advisories were issued for sample collection and transportation,” a spokesperson of the Union Health Ministry said in a statement.

An analysis of 18 Nipah outbreaks in India and Bangladesh between 2001 and 2013 showed that only in three instances, the fatality was less than 50%.

The two previous outbreaks in India — Siliguri in 2001 and Nadia in 2007 — threw up a fatality rate of 68% and 100% respectively.

The central team — S K Singh, director, National Centre for Disease Control and P Ravindran, head of the Emergency Medical Relief department in the health ministry — not only reviewed the emergency scenario with state officials but also interacted with the public to allay fears about the virus.

The team also devised draft guidelines, case definitions, advisory for healthcare workers, information to the general public and advisories for sample collection. A draft reporting format was also prepared and shared with the state government.

While infected date palm sap was the prime source of Nipah outbreaks in Bangladesh, in Siliguri transmission of the virus was also reported within a health-care setting, where 75 % of cases occurred among hospital staff or visitors, said researchers from Bhopal-based High Security Animal Disease Laboratory — the only BSL4 level laboratory in India to handle the deadliest animal viruses.

“Strong evidence indicative of human-to-human transmission of NiV was found in Siliguri in 2001 and in Bangladesh in 2004. Approximately one-half of recognised Nipah case-patients in Bangladesh developed their disease following person-to-person transmission of the virus,” the scientists reported in Indian Journal of Virology in 2013.