How Kerala won the battle against Nipah virus

Though Kerala has successfully contained the deadly Nipah virus outbreak, State Health Minister KK Shailaja says they have not let the guard down.

The virus claimed 16 lives. It began with the infection of four persons of a family in Perambra town near Kozhikode.

Scary picture

“From these four preliminary infections, one could expect at least 75 casualties, the scientists had warned us in May. We were scared,” Shailaja told BusinessLine .

Sitting in her chamber at Kerala House in New Delhi, dressed in a simple pink sari, the Minister looked relaxed, but said the last two months had been quite stressful for all involved in containing the virus outbreak.

“Kerala acquired personal protection equipment (PPE) worth ₹30 lakh from VP Healthcare in the UAE for health workers who were dealing with Nipah patients. VP Healthcare can send PPE worth up to ₹1 crore to Kerala, if needed,” she said. The Kerala Health Department was frantically looking for ways to contain the spread of the virus and had to home-quarantine close to 2,000 suspected carriers for 42 days.

“It was like a battlefield out there. Sabith, the first patient, died on May 5. His brother, Salih, died on May 18. His father Moosa and aunt Mariam tested positive for the virus too. We at once started tracing all the people who were in contact with these four,” Shailaja said.

Quarantine

By May 26, the Health Department had home-quarantined up to 2,000 people. They traced the persons who had visited Perambra Taluk Hospital within 15 days of Sabith’s admission there, or were in and around the hospital when Sabith was admitted.

“Three toll-free numbers were set up for people to give information and get clarifications. Advertisements in all media exhorted those who were in the vicinity of Sabith to report,” she said.

The toll-free lines were constantly ringing. “To trace 2,000 people was a huge task. So, we started a call centre and a team, including me, literally camped there for four days. Everyone was working round the clock. One of the toll-free numbers was being handled by me. I am mostly accessible and known to Keralites. I got a call from a suspected patient saying he was 300-400 metres away from Sabith and that he suspected having contracted Nipah. Another person called me to say he was having a headache and what he should do,” the Minister said.

“We identified suspected cases from the Perambra taluk hospital premises, where Sabith had been admitted first and then at Kozhikode Medical College. Sabith had severe cough, he was the first one to succumb to the virus. No one knew it could be Nipah back then and so many people were around him in the waiting area. The droplet infection spreads through the air.”

18 confirmed cases

Of the nearly 2,000 suspected patients, whose samples were sent for testing, 18 turned up positive, Shailaja said. “We were desperate for a treatment, so we airlifted a drug Nebavarine from a pharma company in Hyderabad. We placed the 18 confirmed cases in isolation. There is no proper medicine for Nipah but in literature and in previous experience internationally, Nebavarine had proved effective, we were told, so we gave the tablets to all the confirmed case. While 16 patients died, two recovered. One of the victims was the nurse who tended to them.”

Sabith’s was an ‘index’ case and since his samples could not be sent for testing, his was labelled a suspected Nipah death. After the Health Department identified 2,000 suspected and 18 confirmed cases from among them, no one from outside the group contracted the virus. The Minister considers this a commendable achievement. Of the 2,000 suspects, 100 patients with severe symptoms similar to those of Nipah, like high fever, cough and vomiting, were also kept in isolation wards.

“After we identified 18 patients with Nipah, we ensured that no one else contracted the disease from them. If they had not been isolated, there could have been many more casualties,” she said.

Quarantine lifted

“There is no need for quarantine now, as the virus incubates and exhibits symptoms in two to 15 days of entering the body. We are lifting the quarantine now,” she said.

The Minister met Union Health Minister JP Nadda and proposed to collaborate with Indian Council of Medical Research, World Health Organisation and experts to establish a research centre in Kerala to explore treatment options, including new drugs, for the Nipah virus.

COMMENT NOW