The outbreak of the deadly Nipah virus around Kozhikode, Kerala, is a test of India’s capacity to respond to public health emergencies. In 2018, the World Health Organisation listed Nipah as one of the 10 priority pathogens needing urgent research, given its ability to trigger lethal outbreaks and the lack of drugs available against it.
About the Virus:
- As an RNA (ribonucleic acid) virus, Nipah has an exceptional rate of mutation — that is, it can easily adapt to spread more efficiently among humans than it does now.
- Such an adaptation would result in a truly dangerous microbe.
- Nipah already kills up to 70% of those it infects, through a mix of symptoms that include encephalitis, a brain inflammation marked by a coma state, disorientation, and long-lasting after-effects, such as convulsions, in those who survive.
- In most outbreaks in South Asia so far the virus has displayed a “stuttering chain of transmission”. This means that once the virus spreads from fruit bats, its natural reservoir, to humans, it moves mainly to people in close contact with patients, such as hospital staff and family caregivers.
- This fits in with how outbreaks have historically begun in the subcontinent. In a 2007 outbreak in Nadia, West Bengal, for example, patient zero is believed to have acquired the virus from palm liquor contaminated by bat droppings.
Kerala’s Way of handling:
- The good news is that Kerala’s public health systems have acted with extraordinary efficiency so far.
- Doctors identified the virus in the very second patient, a diagnostic speed unrivalled in developing countries. This must be commended.
Big challenges remain:
- The death of a nurse shows that health-care workers may not be taking adequate precautions when dealing with patients, by using masks and following a strict hand-wash regimen.
- The virus has no specific treatment.
- The best defences against it are the age-old principles of infection control, which Indian hospitals have not mastered as yet.
- Kerala’s health authorities must ensure these principles are widely adopted, and no preventable transmission takes place.