Kerala's New Nipah Case Takes Total Count To 5, 706 On Contact List

Kerala Health Minister Veena George on Wednesday confirmed another case of the Nipah virus, taking the total number of infections in the state to five. A 24-year-old health worker at a private hospital in Kozhikode has been diagnosed with the virus, the minister said.

As of now, 706 are on the contact list, of which, 77 are in the high-risk category, while 153 are health workers. Nobody in the high-risk category is showing symptoms currently.

As many as 13 people are presently in the hospital under observation, and are showing mild symptoms like headache.

The government has advised that the high-risk contacts should remain inside their homes.

Meanwhile, the Kerala government has formed 19 core committees to coordinate all measures. Volunteer teams have been formed by the local self government to help deliver necessities to those under isolation.

The brain-damaging virus has so far killed two people in Kerala.

Earlier on Wednesday, Ms Veena George said that the state is aiming for "proactive detection" of infection before cases are confirmed in labs. The health administration is monitoring clinical symptoms so that alerts can be sounded in advance.

The state administration, Ms George said, is focusing on tracing contacts of infected persons early and isolating those with symptoms.

Responding to a question in Assembly today, the health minister said seven village panchayats -- Atanchery, Maruthonkara, Tiruvallur, Kuttiyadi, Kayakkodi, Villyapalli, and Kavilumpara -- in Kozhikode district have been declared containment zones. The creation of containment zones is part of the state government's strategy to limit the spread of infection.

Education Minister V Sivankutty has also directed Public Education Director to organize online classes for students of all schools in the containment zone so that they can attend classes from home.

What is Nipah virus?

Nipah virus (NiV) is a zoonotic virus and is transmitted from animals (such as bats or pigs) to humans. It can also be transmitted through contaminated food or directly between people. 

Fruit bats of the Pteropodidae family are said to be the natural host of Nipah virus.

What are Nipah virus symptoms?

In infected people, Nipah virus causes a range of illnesses from asymptomatic (subclinical) infection to acute respiratory illness and fatal encephalitis. The virus can also cause severe disease in animals such as pigs, resulting in significant economic losses for farmers.  

According to the World Health Organization (WHO), infected people initially develop symptoms including fever, headaches, myalgia (muscle pain), vomiting and sore throat. This can be followed by dizziness, drowsiness, altered consciousness, and neurological signs that indicate acute encephalitis. 

Some people can also experience atypical pneumonia and severe respiratory problems, including acute respiratory distress. Encephalitis and seizures occur in severe cases, progressing to coma within 24 to 48 hours. 

Nipah virus incubation period 

As per the WHO, the incubation period (interval from infection to the onset of symptoms) is believed to range from 4 to 14 days. However, an incubation period as long as 45 days has been reported.

Most people who survive acute encephalitis make a full recovery, but long-term neurologic conditions have been reported in survivors.  Approximately 20% of patients are left with residual neurological consequences such as seizure disorder and personality changes. A small number of people who recover subsequently relapse or develop delayed onset encephalitis.

The case fatality rate is estimated at 40% to 75%. This rate can vary by outbreak depending on local capabilities for epidemiological surveillance and clinical management.