A 24 year-old health worker has become Kerala's fifth confirmed Nipah case since its recent outbreak, as the government stepped up its efforts to cure a 9 year-old boy suffering from the deadly infection by ordering the only anti-viral treatment available.
The government has ordered monoclonal antibody from Indian Council of Medical Research to treat the child. It is the only available anti-viral treatment for Nipah virus infection, though it has not been clinically proven yet.
The virus strain seen in the state was the Bangladesh variant that spreads from human to human and has a high mortality rate, though it is less infectious, the government said.
The health worker employed at a private hospital in Kozhikode has been confirmed with Nipah virus infection after his samples turned positive, a statement from Kerala Health Minister Veena George said.
George further said the 9 year-old boy is on ventilator support at a hospital in Kozhikode, and his condition remains critical.
"We have ordered the monoclonal antibody with the ICMR and it would be brought to Kozhikode soon. The imported medicine is already available with the ICMR," she said.
The minister said the condition of all 76 people who are in the high-risk contact category remains stable.
She said 13 persons who have mild symptoms are now being monitored in the hospital, and only the child is in the Intensive Care Unit.
Testing of the samples is done regularly in the labs at Kozhikode Medical College and Thonnakkal virology lab, she said, adding the samples of those with intense symptoms will be sent to National Institute of Virology, Pune.
She was talking to the media in Thiruvananthapuram after attending a review meeting chaired by Chief Minister Pinarayi Vijayan in the wake of the brain-damaging virus that killed two people and infected as many in Kozhikode district.
The minister said the district collector has been authorised to issue orders directing people to avoid mass gatherings in Kozhikode till September 24.
"The district collector can decide whether to issue such a direction and the duration as per her analysis of the situation," George said.
The high-level meeting chaired by the CM analysed the situation thoroughly and "we have come to the conclusion that all the possible prevention measures are in place and there is no need to panic", she said.
Volunteer teams will be set up in the containment zones with the help of the people in the area, and these persons will be selected by the panchayats.
None of the 156 health workers who came into contact with the Niapah patients are in the high-risk category, as they had followed the basic infectious disease control protocol.
She said long-term surveillance is already in place, and any patient who comes in with symptoms of encyphalitis is tested for a possible Nipah virus infection.
The minister also said the WHO and ICMR studies had found out that the entire state of Kerala is prone to getting such infections, not just Kozhikode.
People living in forest areas have to take the highest precautions, George said, adding the latest case of the Nipah virus originated within five kilometres of a jungle area.
More than 200 persons have been given counselling through the call centres, the minister said.
She said some members of a central team have already reached Kozhikode, and others were expected on Thursday. The centre team also consists of a bat surveillance unit, which will be visiting the containment zones on Thursday.
Meanwhile, four more wards—three in Villyapally and one in Purameri Panchayats in Kozhikode district have been declared as containment zones in addition to those announced on Tuesday.
Considering the serious nature of the disease, the Kozhikode administration has already declared seven village panchayats--Atanchery, Maruthonkara, Tiruvallur, Kuttiyadi, Kayakkodi, Villyapalli, and Kavilumpara as containment zones.
No travel in or out of these containment zones will be allowed till further notice. The police have been asked to cordon off these areas.
Only stores selling essential commodities and medical supplies will be allowed to function.
Shops selling essential goods will be allowed to function from 7 am to 5 pm. No time bar has been given for pharmacies and health centres.
Local self-government institutions and village offices can function with minimum staff. Banks, other government or quasi-government institutions, educational institutions, and anganwadis should not operate, the district collector said.
The public should use online services and avoid going to local self-government institutions, she said.
Buses or vehicles plying on national highways through the containment zones should not stop in the affected areas.
Earlier in the day, responding to a query regarding the Nipah infection in the assembly, George said the virus strain seen in Kerala was the Bangladesh variant that spreads from human to human and has a high mortality rate, though it is less infectious.
She said that besides the teams from NIV, Pune, a group of epidemiologists would reach Kerala from Chennai to carry out a survey.
Additionally, the ICMR has agreed to fly down the monoclonal antibodies that are required to treat Nipah patients, she told the House.
Responding to submissions, George said that the state has two labs -- the Institute of Advanced Virology at Thonnakkal in Thiruvananthapuram and the Kozhikode Medical College -- to test and confirm Nipah, but they do not have the permission to declare the same.
"That permission is only with NIV, Pune. We are taking steps to obtain permission to declare Nipah at the two labs in Thiruvananthapuram," she said.
George also said that the treatment protocols were first issued in 2018, during the Nipah outbreak then, and later it was improved upon in 2021 and that was being followed presently also.
"There have been no complaints about the protocols. They are formulated by medical and health experts. If any changes are required to be made to them, the same will be done," she said.