THIRUVANANTHAPURAM: The recurrence of infectious diseases such as Nipah points towards the need to strengthen disease surveillance network in the state to prevent future outbreaks, health experts have said. They complained that the state’s machinery is in reactive mode and acts only when there is an outbreak.
They said an active disease surveillance mechanism was the need of the hour to identify the onset of an outbreak thereby minimising damage. The demand comes at a time when the Kozhikode Medical College Hospital (MCH), one of the top tertiary care hospitals in the state with a history of treating Nipah cases three years ago, allegedly delayed the detection of the infection in a 12-year-old-boy who later died. The lapses, said health experts, was a repetition of 2018 when the first four Nipah cases went undetected.
“Nipah symptoms are not light and a general physician should have suspected something. The presentation is similar to Japanese encephalitis and the symptoms should have been reported,” said Dr Althaf A, an epidemiologist and associate professor at Manjeri MCH.
“We were ahead of other states in establishing a communicable diseases monitoring system, but it was not foolproof. The implication of missing such cases is that Kerala could potentially be the place of origin of a next pandemic,” said Dr Althaf, who has conducted extensive studies on the Nipah outbreak of 2018.
“The system should be such that unusual cases are picked up even in a busy casualty environment, as the virus does not wait for expert attention,” said Dr Purushothaman Kuzhikkathukandiyil, professor of paediatrics at MES Medical College. Institutions have undergone modification after Covid and some of them squandered the advantage gained over the years, he said. Health experts said the lack of a sustained policy to strengthen public hospitals and existing disease monitor system was another shortcoming.
Sample this: The first prevention of epidemic and infectious disease cell was set up by connecting major medical colleges in 1980s. It helped the state in capturing dengue, Japanese encephalitis and leptospirosis outbreaks for the next two decades. A national-level institution, Communicable Disease Surveillance Programme (it later became Integrated Disease Surveillance Programme in 2004), was set up in 1998. Surveillance became a priority the world over after the 2002-2003, Severe Acute Respiratory Syndrome (SARS) outbreak.
The WHO came up with One Health, a multidisciplinary approach to attain optimal health for people, animals and the environment. Prevention of zoonotic diseases or diseases transmitted from animals to humans such as Nipah and Covid, are a major focus of the approach. Though fruit bats are considered to be carriers of the Nipah virus to humans, a clear link or interface between bats and humans is yet to be found. Dr Amar Fettle, state nodal officer for Covid and H1N1, said monitoring of rare diseases can be done only within the constraints of the system.