Wednesday 23 May 2018

Nipah just another viral infection & there is nothing to panic, say doctors as three dead in Kerala

After three lives lost to Nipah virus (NiV) and eight battling the disease in Kerala's Kozhikode district, both the state and the Central governments on Monday took comprehensive measures to contain the outbreak of the rare virus. Doctors say it is just another viral infection and there is nothing to panic.

"All the periphery hospitals of the Kozhikode Medical College Hospital are fully equipped to tackle the fever. All those who have fever need not rush to the medical college. At the moment, eight patients are undergoing treatment. Their samples have been sent to Pune and results are awaited," said Kerala Health Minister K.K. Shailaja.

Animal Husbandry department and Forest officials deposit a bat into a container after catching it inside a well at Changaroth in Kozhikode in the Indian state of Kerala on May 21, 2018. A deadly virus carried mainly by fruit bats has killed at least three people in southern India, sparking a statewide health alert May 21. Eight other deaths in the state of Kerala are being investigated for possible links to the Nipah virus, which has a 70 percent mortality rate. AFP
Shailaja said all arrangements are in place, things are under control and there is no need to panic. The state government has sanctioned an emergency fund of Rs 20 lakh to the Kozhikode Medical College to tackle the present fever outbreak.

Nipah virus, spread by fruit bats that infects both animals and humans, has claimed the lives of two brothers and their aunt in Perambara of Kozhikode district within a few weeks, and now eight more people are under close observation.

State health officials visited the victims' house and sealed the unused well that had lots of bats, said Shailaja and added that people are being educated to ensure that they do not eat any fruits that fall down from trees.

To strengthen Kerala government's fight against the virus, the Central government on Monday assured the state of all support and sent a multi-disciplinary Central team from the National Centre for Disease Control (NCDC) to the district.

"We are closely monitoring the situation. I have also dispatched a Central team to assist the state government and initiate required steps," Union Minister of Health and Family Welfare J.P. Nadda said in a statement from Geneva.

Nadda said he had a talk with Union Minister of State for Tourism Alphons Kannathanam and Kerala Health Minister Shailaja. Union Health Secretary Preeti Sudan also spoke to the Kerala Principal Health Secretary and reviewed the situation.

In a tweet late on Sunday, Nadda said: "Reviewed the situation of deaths related to Nipah virus in Kerala with Secretary Health. I have directed Director NCDC to visit the district and initiate required steps as warranted by the protocol for the disease in consultation with state government."

Animal Husbandry department and Forest officials inspect a well to catch bats at Changaroth in Kozhikode in the Indian state of Kerala on May 21, 2018.  AFP
The Central team includes Sujeet K. Singh, Director, National Centre for Disease Control (NCDC); S.K. Jain, Head Epidemiology, NCDC; P. Ravindran, Director, Emergency Medical Relief (EMR); and Naveen Gupta, Head Zoonosis, NCDC, along with two clinicians and one expert from the Ministry of Animal Husbandry.

Atul Gogia, Senior Consultant, Department of Medicine, Sir Ganga Ram Hospital, said: "Nipah virus is just another viral infection which affects the respiratory and central nervous systems with symptoms like drowsiness. Like most other viral infections, Nipah, too, has no treatment and can only be managed through intensive supportive care."

Gogia said the virus is spread by fruit bats, which are usually found in forests, but due to urbanisation, sometimes it is found even in cities.

While he did not rule out the possibility of an infected person travelling to other parts of the country and spreading the disease, he said there is no threat to other parts of the country including north India and Delhi and there is no need to panic.

The senior doctor, however, said people living in areas inhabited by bats or wildlife animals should be alert as there can be other infections that can afflict them.

Transmission of NiV takes place through direct contact with infected bats, pigs or from other NiV-infected persons.

The three fatalities from the Nipah virus were all from the same family, said Kerala state health minister K.K. Shailaja.

There is no vaccine for Nipah, which can cause raging fevers, convulsions and vomiting. The only treatment is supportive care to control complications and keep patients comfortable.

Media reports say five more people have died from high fevers in recent days, as well as a nurse who had treated people infected with the virus. But medical workers have not yet confirmed what killed those people. At least eight others sick with Nipah symptoms are being monitored.

People who had been in contact with Nipah victims have been put into isolation, Shailaja said.

Nipah, which was first identified during a late 1990s outbreak in Malaysia, can be spread by fruit bats, pigs and through human-to-human contact.

"We are closely monitoring the situation," India's health minister, J.P. Nadda, said in a statement.

Eight other deaths in the state of Kerala are being investigated for possible links to the Nipah virus, which has a 70 percent mortality rate.

"The government received four samples, out of which three deaths were because of Nipah," Kerala health secretary Rajeev Sadanandan told AFP. The victims died in Calicut district.

Sadanandan said the cause of other suspicious deaths could only be confirmed through tests.

"We have sent blood and body fluid samples of all suspected cases for confirmation. It will take 24-48 hours for the results to come."

India's health minister rushed medical experts to the state after a local politician reported that residents were panicking in Calicut district.

The team would "initiate required steps as warranted by the protocol for the disease", J.P. Nadda said on Twitter.

Indian bats cling onto the branches of a banyan tree on the campus of Gujarat College in Ahmedabad on April 29, 2018. AFP / Sam Panthaky
In Kerala, neighbours told local media that family members who died had eaten fruit picked from a compound where they were building a home.

Nipah induces flu-like symptoms that often lead to encephalitis and coma. Fruit bats are considered the main carrier of the virus for which there is no vaccination, according to the World Health Organization.

Nipah was first identified in Malaysia in 1998. It spread to Singapore and more than 100 people were killed in both places. On that occasion, pigs were the virus hosts but they are believed to have caught it from bats.
Medical personnel wearing protective suits check patients at the Medical College hospital in Kozhikode on May 21, 2018. AFP
In India the disease was first reported in 2001 and again six years later, with the two outbreaks claiming 50 lives.

Both times the disease was reported in areas of the eastern state of West Bengal bordering Bangladesh.

Bangladesh has borne the brunt of the disease, with more than 100 people dying of Nipah since the first outbreak was reported there in 2001.

In Bangladesh in 2004, humans became infected with Nipah as a result of consuming date palm sap that had been contaminated by infected fruit bats.

(Source: The Peninsula)

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