As Kerala stumbles its way through the COVID crisis, the state has been hit with the resurgence of another deadly virus called Nipah or NiV infection.
On 5 September, it was confirmed that a 12 year old boy has died of Nipah virus in Kozhikode district of Kerala.
Outbreaks of Nipah virus have struck Kerala twice before, once in 2018 and then in 2019. Both times the infection was locally contained. But does the looming threat of COVID change the picture this time around?
Nipah is also far deadlier than COVID, so then what keeps it from becoming a potential pandemic like COVID-19? Why only in Kerala?
FIT breaks it down.
Nipah Virus Explained
First things first, here's a quick run down what the Nipah virus is.
NiV a pathogenic RNA virus, was first discovered in 1998 in pigs.
It is a zoonotic virus, which means it primarily spreads from animals to humans.
Its origins have been traced to fruit bats but has also been seen in domestic animals like horses, sheep, goat and dogs.
It is a deadly infection with a mortality rate of over 50 percent.
The infection has an incubation period of 4 to 14 days.
Nipah infection causes nonspecific symptoms like fever, body ache, cough and sore throat.
In serious cases it can also cause encephalitis (swelling in the brain) which can lead to seizures or even a coma.
Though instances have been noted, it rarely spreads from person to person.
There is no licensed treatment or vaccine for Nipah virus as yet.
How does Nipah compare to COVID?
Are there any similarities between the two viruses?
Dr Laxminarayan explains that they are both zoonotic pathogens and they both present similar nonspecific symptoms, "but that's as far as their similarities go."
"For one it is far deadlier than COVID-19" says Dr Ramanan Laxminarayan, epidemiologist and founder of Center for Disease Dynamics, Economics & Policy in Washington D. C., USA.
According to WHO (World Health Organization), Nipah virus has a fatality rate of 40 to 75 percent.
In that case, does it have the potential to cause a pandemic like situation like COVID?
To put it simply, it seems unlikely. While Nipah is more deadly, COVID is far more infectious, spreading easily from person to person.
"While COVID has a high infection rate of spreading from person to person, Nipah doesn't typically spread in this way. You would have to come into contact with an infected animal, or eat a fruit or vegetable that may have been eaten by one of them and contains their saliva."Dr Ramanan Laxminarayan, founder of Center for Disease Dynamics, Economics & Policy in Washington D. C., USA.
Nipah or COVID: Diagnosing the Symptoms
Since the symptoms of both COVID and Nipah can be very similar, it can be difficult to tell them apart just based on the symptoms.
RT-PCR nasal swab tests can be conducted to diagnose both the infections. However, Dr Laxminarayan says, "NiV tests are not easy available and very few labs do them in India."
There is also the catch of people mistaking early symptoms for COVID or general viral fever and not considering it could be Nipah. "In the case of Nipah, catching the infection early can make all the difference," he adds.
Containing the Virus
The first two times around, the Nipah virus outbreak in Kerala was locally contained. While 18 people died in 2018, only one person died of the infection in the 2019 outbreak. Contained being the keyword.
Because there is no treatment or vaccine for the infection, the infection was not eradicated, and rather was 'contained', which is the aim this time around as well.
On Monday, the Kerala health ministry released an updated management plan and treatment protocol for Nipah virus involving active tracing, triaging and isolating, similar to the COVID protocol.
Speaking to reporters on Tuesday, state health minister, Veena George, said 48 people who had come into contact with the deceased boy have been identified and isolated. 16 of them have tested negative so far.
Are Other States in the Clear?
Dr Laxminarayan says Kerala's health care system, and the efficiency in tracing and tracking is perhaps the reason cases of NiV has been recorded in Kerala.
"It was because it is Kerala that we even know about about these cases, if it were any other state, we perhaps wouldn't have had this kind of a data."
The possibility of an outbreak in other states, he says, is just as plausible. "It depends on the movement of the infected animals," he added.
How do we prevent that from happening then?
"We just need to be careful and be mindful of following protocol," he says
"Wash fruits and vegetables carefully, don't eat fruits that have fallen from the tree. Wash your hands. If you develop a fever and other symptoms, trace who you've come in contact with. We need to educate ourselves better so as not to panic and take necessary precautionary measures."Dr Ramanan Laxminarayan, founder of Center for Disease Dynamics, Economics & Policy in Washington D. C., USA.