Why Neighbouring States Should Be Worried About Kerala's Nipah Virus Outbreak With Bangladesh Variant

The Nipah virus is making news again after Kerala has recorded four cases of NiV, of which two recently succumbed to the infection in Kozhikode district. The death on August 30 was initially attributed to liver cirrhosis comorbidity. However, subsequent cases involving a 9-year-old boy and his 24-year-old brother-in-law, both testing positive for Nipah, have heightened concerns.

Health minister Veena George said that the strain of the virus identified in Kerala is the Bangladesh variant, which is transmitted from human to human and carries a high mortality rate, though it is less contagious.

The Bangladesh variant of Nipah virus was first identified in Bangladesh in 2001. It has since caused several outbreaks in Bangladesh, India, and Malaysia. The virus is thought to be spread through contact with the saliva, blood, or other bodily fluids of infected animals, such as bats. It can also be spread through human-to-human transmission, through respiratory droplets produced when an infected person coughs or sneezes.

It must be noted that the current Nipah outbreak in Kerala marks the fourth occurrence of the virus in the state since 2018. During the initial Nipah outbreak in 2018, Kerala reported 23 cases, resulting in the unfortunate deaths of 21 individuals. Subsequently, in 2019 and 2021, two more lives were claimed by Nipah.

Nipah virus is primarily transmitted to humans through direct contact with the bodily fluids of infected bats, pigs, or other individuals. It was first identified in 1999 during an outbreak that affected pig farmers and those in close proximity to pigs in Malaysia and Singapore.

The symptoms of Nipah virus infection are similar to those of other diseases, such as influenza and dengue fever. They can include fever, headache, sore throat, cough, vomiting, and respiratory problems. In some cases, the virus can cause encephalitis, a serious inflammation of the brain.

There is no specific treatment or vaccine for Nipah virus. Treatment is supportive and includes measures to manage the symptoms, such as providing fluids and oxygen. In some cases, antiviral drugs may be used.

The World Health Organization has classified it as a "virus of concern" for potential future epidemics due to its recurring spillovers from animal reservoirs to humans, according to Dr. Stephen Luby, an infectious disease expert and professor at Stanford University. Furthermore, once humans are infected, it can spread from one person to another.

The Nipah virus is not as easily transmissible as some other viruses. According to Luby, while there are occasional Nipah superspreaders who can infect a significant number of people, the average transmission rate is less than one person per infection.

However, it is crucial to note that with each infection, the virus is placed in an environment that favors human adaptation and improved transmissibility. This poses a risk of a new strain emerging that could spread more efficiently from person to person, potentially leading to a devastating outbreak. Given that Nipah virus infections result in a 70% fatality rate, such a strain could potentially be the most severe pandemic humanity has ever encountered.

Therefore, Luby emphasizes the importance of continuing investments in strategies aimed at reducing the risk of spillover from animal reservoirs and developing countermeasures for a range of high-risk pathogens.

Since Nipah virus is a serious threat to public health, other states should take steps to protect themselves from this deadly disease.