Here We Go: Nipah Virus Outbreak Prompts Shutdowns and Containment Zones in Kerala, India

In recent years, India has experienced several outbreaks of the deadly Nipah virus.

The southern Indian state of Kerala has declared a state of emergency in its fight against the Nipah virus, a rare and deadly disease that has already claimed two lives.

Schools, offices, and public transport have been shut down in a bid to halt the spread of the virus. Indian health officials have implemented various containment zones to control the spread of the virus.

A five-kilometer containment zone was established around the residences of the two men who died of the Nipah virus on August 30, a 47-year-old man, and September 11, a 40-year-old man, according to Health Minister Veena George.

“As of Thursday afternoon, Kozhikode District Collector A Geetha had declared 53 wards as containment zones across nine panchayats (a village council). This number is likely to increase if more positive cases of the virus are reported in forthcoming days,” according to Hindustan Times.

The news outlet added, “The drill is the same as it was during Covid. All key entry and exit routes to and from these wards are barricaded and police personnel are posted . Shops selling essential items and medical shops can operate from 7 am to 5 pm. Those requiring urgent medical care and hospital attention are exempt from the restrictions.”

“Residents cannot step out unnecessarily. If they need any kind of help with regard to medicines or essential food items, we provide them through our volunteers, who are given badges by the panchayat. Schools and other educational institutions are also shut,” said the president of one of the village councils (panchayat).

As of Wednesday evening, the state government reported that at least 706 people, including 153 healthcare workers, were undergoing tests for the virus. Results are still pending, according to NBC News.

“We are focusing on tracing contacts of infected persons early and isolating anyone with symptoms,” said state Health Minister Veena George.

Pinarayi Vijayan, the Chief Minister of Kerala, issued a statement urging people to avoid public gatherings in the Kozhikode district for the next 10 days. “More people could be tested. Isolation facilities will be provided,” he assured.

The Nipah virus is spread through contact with the bodily fluids of infected bats, pigs, or people.

According to the WHO:

Nipah virus (NiV) is a zoonotic virus (it is transmitted from animals to humans) and can also be transmitted through contaminated food or directly between people. In infected people, it causes a range of illnesses from asymptomatic (subclinical) infection to acute respiratory illness and fatal encephalitis. The virus can also cause severe disease in animals such as pigs, resulting in significant economic losses for farmers.

Although Nipah virus has caused only a few known outbreaks in Asia, it infects a wide range of animals and causes severe disease and death in people, making it a public health concern.

Signs and symptoms

Human infections range from asymptomatic infection to acute respiratory infection (mild, severe), and fatal encephalitis.

Infected people initially develop symptoms including fever, headaches, myalgia (muscle pain), vomiting and sore throat. This can be followed by dizziness, drowsiness, altered consciousness, and neurological signs that indicate acute encephalitis. Some people can also experience atypical pneumonia and severe respiratory problems, including acute respiratory distress. Encephalitis and seizures occur in severe cases, progressing to coma within 24 to 48 hours.

The incubation period (interval from infection to the onset of symptoms) is believed to range from 4 to 14 days. However, an incubation period as long as 45 days has been reported.

Most people who survive acute encephalitis make a full recovery, but long term neurologic conditions have been reported in survivors.  Approximately 20% of patients are left with residual neurological consequences such as seizure disorder and personality changes. A small number of people who recover subsequently relapse or develop delayed onset encephalitis.

The case fatality rate is estimated at 40% to 75%. This rate can vary by outbreak depending on local capabilities for epidemiological surveillance and clinical management.

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Treatment

There are currently no drugs or vaccines specific for Nipah virus infection although WHO has identified Nipah as a priority disease for the WHO Research and Development Blueprint.  Intensive supportive care is recommended to treat severe respiratory and neurologic complications.

In 2022, the National Institute of Allergy and Infectious Diseases (NIAID), a division of the National Institutes of Health, initiated a preliminary clinical trial to assess an mRNA vaccine by Moderna aimed at preventing Nipah virus infections.

“The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, has launched an early-stage clinical trial evaluating an investigational vaccine to prevent infection with Nipah virus. The experimental vaccine is manufactured by Moderna, Inc., Cambridge, Massachusetts, and was developed in collaboration with NIAID’s Vaccine Research Center. It is based on a messenger RNA (mRNA) platform—a technology used in several approved COVID-19 vaccines. NIAID is sponsoring the Phase 1 clinical study, which is being conducted at the NIH Clinical Center in Bethesda, Maryland,” according to the press release.

Also, according to a report from Epoch Times citing expert testimonies who testified during Senate hearing, Wuhan lab was genetically manipulating deadly Nipah virus.

One of the scientists, Dr. Steven Quay, said “[A] laboratory-acquired infection with a modified Nipah virus would make the COVID-19 pandemic look like a walk in the park.”

Epoch Times reported:

A forensic analysis shows that the Wuhan Insitute of Virology (WIV) was genetically manipulating the Nipah virus, a highly lethal pathogen, in violation of the Biological Weapons Convention, according to an expert who testified at a Senate subcommittee hearing on Aug. 3.

The finding was another piece of evidence showing that the controversial Wuhan lab was conducting gain-of-function research—experiments that ultimately resulted in the COVID-19 pandemic via a leak from the facility, according to Dr. Steven Quay, CEO of Atossa Therapeutics. Gain-of-function research involves enhancing the potency or transmissibility of a virus.

Quay said he and other scientists conducted an examination of COVID-19 patient specimens from December 2019 sequenced and published by the WIV. Through that analysis, published in a preprint paper that hasn’t been peer-reviewed, they found 20 unexpected contaminants that they believe are evidence of other research conducted at the lab.

But the one contaminant not accounted for in papers published by WIV was cloning vectors of the Nipah virus, according to Quay.