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Kerala: Under The Insurgency Of Nipah Virus – IMPRI Impact And Policy Research Institute

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Kerala: Under the Insurgency of Nipah virus

Bhanvi

Introduction

The Nipah virus is a zoonotic pathogen from the family Paramyxoviridae, genus Henipavirus. The zoonotic cycle of NiV includes fruit bats also known as flying foxes of the family Pteropodidae (natural hosts) and pigs (intermediate hosts). Infected bats act as a carrier for NiV and it is communicable to both humans as well as animals and various cases also suggest its transmission via nosocominal mode. The majority of the patients infected with the virus show symptoms of central nervous system damage along with acute encephalitis with fever, dizziness, or vomiting and till now no formal treatment has been developed for the same.

History of Nipah

The outbreak of Nipah virus (NiV) disease was first reported in Malaysian pigs in 1998-1999 and derived its name from the Malaysian settlement of Sungai Nipah (Nipah River Village) in Negeri Sembilan which led to a billion-dollar loss to the pig industry and later spread to Singapore.

Later it spread through horses and horse slaughter became the main reason for the spread of the putative NiV amongst the people in the Philippines in 2014 and gradually, it crossed the borders to reach India as well as Bangladesh via Siliguri in West Bengal in 2001 and 2007. The Indo-Bangladesh outbreaks were associated with the consumption of raw date palm sap that was contaminated by fruit bats and had a very high mortality rate.

Virus and the coastal areas

In 2001, India witnessed its first virus outbreak in Siliguri, West Bengal and then the second outbreak in 2007 with a 100% mortality rate in Nadia district, West Bengal. The third outbreak occurred in 2018 in the state of Kerala and killed 17 people and now after five years, there has been an outbreak of the virus which has killed two people in the same region of Kozhikode district of Kerala. It clearly indicates lack of proper preventative measures with the authorities as it has occurred for the fourth time. 

The irony of the situation is that several studies have been conducted and it has been concluded that the virus can’t be found in experimental bats after a few weeks, making it difficult to proceed with proper research so that curative medicines and techniques can be developed. 

“Finding that bats don’t have Nipah virus at the time of sampling certainly doesn’t mean that it didn’t come from those bats, particularly P. medius species of bats. On the contrary, it was found that “The overwhelming abundance of evidence really shows that this bat is the reservoir for Nipah virus on the subcontinent in Bangladesh and in India.”

It is not the scenario that fruit bats are found only in Kerala or West Bengal they are distributed throughout Southern India but cases are reported only in these states again and again over the period of time. The reason could be that they are not being reported in other states and testing is not being conducted in those states on the other hand since these states have previously witnessed these cases they are aware of the symptoms and are better equipped to cope with issues.

Challenges

  • Environmental and Climatic Factors-It has been stated that continuous changes in environmental and climatic conditions are responsible for distorting the breeding and feeding cycle of bats as since 2016 Kerala has been facing drought-like conditions due to El Nino. 
  • Impact on the economy– Due to frequent outbreaks, the economy gets halted as it calls for the complete shutdown of offices, schools, and other public places because it is a communicable disease as well.
  • Lack of Medical Infrastructure- Despite several outbreaks in the past proper medical infrastructure in terms of its surveillance along with curative techniques has not been developed yet.
  • Hampering Natural Habitat of Bats- Intervention in Reservoir Habitats of bats by humans via deforestation is hampering their pollinating and dispersal process impacts their immunology and results in the generation of viruses in them.
  • Ineffective Tracking Mechanism- There is a deficiency in the effectiveness of developing a tracking device that has been developed by Malaysia and Bangladesh that helps them prevent the spread of the virus, so organized infrastructure should be developed to deal with such outbreaks in the future.
  • Lack of Human Resources– Due to the lack of medical infrastructure there is a shortage of trained medical staff that can tackle such outbreaks more efficiently.

Suggestions

  • Awareness Techniques– Awareness needs to be spread regarding the preventive strategies that have also been put forward by The National Centre for Disease Control (NCDC) India in response to the outbreak such as strict hand hygiene with soap and water, especially after coming into contact with a sick person or animal and avoid consuming raw date palm sap or toddy.
  • Bamboo Skirt Method- Several Measures like the bamboo skirt method which cover both the shaved part of the tree and the mouth of the pot, making it difficult for the bat to access the sap. It can be used to prevent the contamination of date palm sap.
  •  Research on Enhancement of Medical Treatment- There are currently no specific vaccines or effective antiviral drugs available for the treatment of NiV infection. So a PPP model can be developed for carrying out research activities that can generate future benefits and also will create opportunities for India to share its medical knowledge with other countries that witness the same problem and will help India achieve its commitment to working on health infrastructure as has been declared in G20.
  • Need to Conduct Surveys- A systematic survey should be conducted along with a team of experts from various departments such as forest, wildlife, and animal husbandry will help us work on focus areas and efficient utilization of resources.
  • Use of AI– A proper tracking mechanism should be developed with the help of Artificial Intelligence that can help in tracking the infected bats as recently TrialGuard AI cameras are under the pilot project for tracking various poachers and wildlife.

Conclusion

 Since the country has the expertise to deal with various deadly outbreaks such as COVID-19, now the time has come to develop a  permanent protocol and testing system to deal with such outbreaks and should work on research and development to prevent the occurrence of these diseases in the future. The Nipah Virus occurred for the fourth time which is a serious cause of concern and needs to be dealt with as “Prevention is always better than cure”. Moreover, the time has come for India to strengthen its medical infrastructure both physically as well as human resources that will generate revenue opportunities by promoting foreign medical treatment and help India penetrate the economies of top advanced medical countries. 

References

A., & Shariff, M. (2019, January 1). Nipah virus infection: A review. https://doi.org/10.1017/s0950268819000086

Ambat, A. S., Zubair, S. M., Prasad, N., Pundir, P., Rajwar, E., Patil, D. S., & Mangad, P. (2019, September 1). Nipah virus: A review on epidemiological characteristics and outbreaks to inform public health decision making. https://doi.org/10.1016/j.jiph.2019.02.013

Ang, B. S. P., Lim, T. C. C., & Wang, L. (2018). Nipah Virus Infection. Journal of Clinical Microbiology, 56(6). https://doi.org/10.1128/jcm.01875-17

Banerjee, S., Gupta, N., Kodan, P., Mittal, A., Ray, Y., Nischal, N., . . . Wig, N. (2019, February 28). Nipah virus disease: A rare and intractable disease. https://doi.org/10.5582/irdr.2018.01130

Dr. S. Bhatia. (1953). https://www.tnaijournal-nji.com/admin/assets/article/pdf/12362_pdf.pdf. Nursing Journal of India, XLIV(07), 173–175. https://doi.org/10.48029/nji.1953.xliv702

Epstein, J. H., Field, H., Luby, S. P., Pulliam, J. R. C., & Daszak, P. (2006, February 1). Nipah virus: Impact, origins, and causes of emergence. https://doi.org/10.1007/s11908-006-0036-2

Joshi, J., Shah, Y., Pandey, K., Ojha, R. P., Joshi, C. R., Bhatt, L. R., . . . Pandey, B. D. (2023, August 10). Possible high risk of transmission of the Nipah virus in South and South East Asia: a review. https://doi.org/10.1186/s41182-023-00535-7

Philip, S. (2023, September 18). Why Nipah virus keeps returning to Kerala, how its symptoms have changed. Retrieved from https://indianexpress.com/article/india/nipah-kerala-fruit-bats-8942237/

Rahman, M. (2021). https://bbrc.in/wp-content/uploads/2021/06/BBRC_Vol_14_No_05_Special-Issue_42.pdf. Bioscience Biotechnology Research Communications, 14(5), 242–244. https://doi.org/10.21786/bbrc/14.5/43

Skowron, K., Bauza-Kaszewska, J., Grudlewska-Buda, K., Wiktorczyk-Kapischke, N., Zacharski, M., Bernaciak, Z., & Gospodarek-Komkowska, E. (2022, January 25). Nipah Virus–Another Threat From the World of Zoonotic Viruses. https://doi.org/10.3389/fmicb.2021.811157

Soman Pillai, V., Krishna, G., & Valiya Veettil, M. (2020). Nipah Virus: Past Outbreaks and Future Containment. Viruses, 12(4), 465. https://doi.org/10.3390/v12040465

The Absence of Evidence for Nipah in Fruit Bats Is Not Evidence of Absence. (n.d.). Retrieved from https://thewire.in/health/the-absence-of-evidence-for-nipah-in-fruit-bats-is-not-evidence-of-absence

Disclaimer: All views expressed in the article belong solely to the author and not necessarily to the organisation.

Acknowledgment: The author would like to thank Tanu Paliwal and Manya Deshpande for their kind comments and suggestions to improve the article.

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