THIRUVANANTHAPURAM: Health experts are increasingly calling for a reassessment of the containment measures implemented during Nipah outbreaks, emphasising the need to understand the disease’s epidemiology.
They argue that imposing strict restrictions on entire population in areas where outbreaks occur is overly harsh and ineffective, given that Nipah primarily spreads through close contact with infected individuals.
Despite the serious nature of managing a Nipah outbreak, which is characterised by high mortality rates, experts criticise measures such as designating containment zones, closing schools, and banning public gatherings.
Recently, the authorities declared five wards in Thiruvali and Mambadu panchayats in Malappuram as containment zones due to a Nipah outbreak. These restrictions will last for the 42-day incubation period, with periodic reviews. Similar measures were imposed on Pandikad and Anakkayam panchayats during a previous outbreak in July.
Having experienced five Nipah outbreaks previously, experts believe it’s time to reconsider containment strategies to reduce societal hardships from prolonged restrictions, shifting the focus towards enhanced surveillance and research. In its 26-year history, the Nipah virus has resulted in about 800 cases and fewer than 500 deaths globally.
The strain of the Nipah virus found in Kerala is thought to have originated in Bangladesh. It has a relatively low infectivity rate (an R0 value of 0.4) but a high mortality rate (ranging from 40% to 75%). Notably, around 80% of Nipah cases in India have been hospital-acquired.
“The chances of human-to-human transmission are limited to healthcare workers and other close contacts of the patient,” said Dr Purushothaman Kuzhikkathukandiyil, professor of paediatrics at MES Medical College, Malappuram.
According to him, unlike Covid patients who can be asymptomatic also Nipah patients show symptoms, making it unlikely for them to be in public spaces while contagious. “These individuals won’t transmit the disease beyond those directly involved in their care, such as ambulance staff and healthcare workers,” he explained.
Authorities often defend the stringent measures by citing the WHO’s classification of Nipah as one of the 10 viral diseases with pandemic potential. However, health experts argue that this classification is aimed at prioritising resources for developing diagnostics, treatments, and vaccines, rather than justifying severe containment measures. They point out that WHO guidelines do not advocate harsh responses to outbreaks of these pathogens.
Dr Althaf A, an epidemiologist and professor at Government Medical College, Thiruvananthapuram, who studied the 2018 Nipah outbreak extensively, stressed that efforts should concentrate on surveillance, early diagnosis, infection control, and research investment.
Three in Nipah contact list tested negative
Malappuram Health Minister Veena George on Sunday announced that the samples of three individuals from the contact list of the Nipah-infected individual in Thiruvali tested negative for the disease. To date, a total of 78 individuals on the victim’s contact list have tested negative. No new individuals were added to the contact list on Sunday.
Currently, 267 people remain on the victim’s contact list. One individual showing suspected symptoms was admitted to Manjeri Government Medical College Hospital that day. Including this case, four people are undergoing treatment for suspected Nipah symptoms at Manjeri Government Medical College, while 28 are receiving treatment for suspected symptoms at Perinthalmanna MES Medical College Hospital. Those on the contact list are being provided with comprehensive psychological support. On Sunday, mental support was extended to 276 people, including two specific individuals, through the Nipah control cell.
