Nipah virus death: 11 contacts at risk; Centre recommends strengthening hospital, community-based surveillance

New Delhi, Sep 6: Kerala Health Minister Veena George said Monday that eleven contacts of a 12-year-old boy who succumbed to the Nipah virus were displaying symptoms, but that all were stable for now.

George said eight samples out of these were expected by late Monday night, and that samples of the other three could be tested at the Medical College in Kozhikode.

"There are 38 persons in isolation at the Kozhikode Medical College hospital of which 11 have shown symptoms. Samples of eight persons have been sent to Pune NIV for testing," the minister said.

Based on a report by a central team which was deputed in Kozhikode in Kerala in the wake of Nipah virus infection outbreak, the Centre has recommended strengthening both hospital and community-based surveillance in the district and undertaking an active search for cases in containment areas.

In a letter to Chief Secretary Dr V P Joy, Union Health Secretary Rajesh Bhushan on Monday stated that the nearby districts of Kannur, Malappurum and Wayanad need to be alerted and district authorities must identify primary and secondary contacts as well as prepare line listing of high risk and low risk contacts.

He also stated that all high risk contacts may be moved to identified facility quarantine and observed for symptoms.

The central team from the National Centre for Disease Control (NCDC) was deputed to Kozhikode on Sunday, in the wake of Nipah outbreak in that district. The team has so far attended meetings with the minister for forests and wildlife as well as the Kerala health minister.

"The central team has carried out field investigations along with district surveillance officer and other officials. It has also visited the epicentre, the house of a 12-year-old male diseased child, has interacted with family members, neighbours, field health functionaries, ward members, local elected representatives, ANMs, ASHAS and has reviewed event-based surveillance in the community," Bhushan said in his letter.

He said presently, NIV, Alleppy is providing laboratory support but in accordance with the request of the state government, DG, ICMR has initiated action to establish point of care testing at VRDL, Kozhikode.

The Government Medical College, Kozhikode has been identified as the treatment centre, the letter said.

Adequate number of single-room isolation facilities and negative pressure ICUs maybe earmarked as stan by, a referral system be established along with carmarked ambulances and trained staff and adequate stock of Ribaverin (anti-viral) and PPEs need to be maintained at the district level, the secretary recommended.

The ICMR is exploring the feasibility of getting appropriate monoclonal antibodies for treatment purpose, Bhushan said.

The secretary further highlighted the need for setting up a 24x7 control room for daily reporting and sharing information with the media.

Coordination with the Animal Health and Wildlife Department and other field officers may be initiated to trap and collect samples from fruit bats for virological studies and other associated measures, Bhushan suggested.

"I once again reiterate the commitment of the Union Health and Family Welfare Ministry to extend all possible technical support to the state government in addressing the present problem in an effective manner," Bhushan said in his letter.