Nipah Patients In Kozhikode Show Unusual Respiratory Symptoms, Raising Diagnostic Concerns

Nipah in Kerala: The doctor overseeing the treatment of four Nipah virus patients in Kozhikode, where two people have died and four others are undergoing treatment, has observed distinctive clinical symptoms in this outbreak compared to previous instances.

Dr. A. S. Anoop Kumar, the Director of Critical Care Medicine at Aster MIMS Hospital in Kozhikode, explained that this year's cases primarily manifest symptoms resembling respiratory infections. This presents a challenge in early diagnosis since many individuals contract viral fevers and influenza, which share similar symptoms, especially during the rainy season.

In contrast, during the 2018 Nipah outbreak in Kerala, which claimed 17 lives, and subsequent cases in the following years, patients exhibited symptoms of encephalitis. However, in the current outbreak, neurological symptoms have not been observed in patients.

Dr. Anoop, who played a pivotal role in detecting the Nipah virus in Kozhikode district in 2018 after several "unusual" fever-related deaths occurred within a short period in Changarothu village, stressed, "The predominant symptoms in these suspected patients, as well as the two fatalities, are typical respiratory symptoms. This complexity hinders prompt detection because viral fevers and influenza are widespread during the rainy season, even leading to localized influenza outbreaks. This makes early Nipah diagnosis particularly challenging. If the virus were to display symptoms of encephalitis, identifying suspected cases would have been more straightforward."

The respiratory infections in suspected Nipah patients this time have resulted in pneumonia and multi-organ failure, Dr. Anoop noted, also pointing out that the patients have low white blood cell (leukocyte) and platelet counts.

The doctor recommended that individuals exhibiting influenza-like symptoms should self-isolate.

Regarding Nipah virus strains, Dr. Anoop explained that there are two types: the Malaysian and the Bangladesh strains. He stated, "In Kerala, we have encountered the Bangladesh strain, which primarily facilitates human-to-human transmission of the virus."