Recurrent Nipah outbreaks in Kerala: implications for health policy and preparedness

Abstract

Nipah virus (NiV) infection, a highly pathogenic emerging zoonotic disease associated with significant mortality rates, is prevalent in South East Asian countries.This infection typically manifests in small clusters, predominantly presenting as either encephalitis or acute respiratory distress.In India, NiV has been documented in the states of West Bengal and Kerala, with four of the six reported outbreaks occurring in Kerala.This study focuses on the epidemiology of NiV infection in Kerala, offering insights and implications for future policies.Epidemiologically, three of the four outbreaks in Kerala occurred in a specific geographic belt, suggesting a consistent factor in the spillover of infection from reservoir bats.The average age of affected individuals was 41 years, with a male predominance.The mean incubation period was determined to be 9 days, and transmission primarily occurred within healthcare settings due to lapses in infection prevention and control practices.Intensive response strategies including case isolation, contact tracing, and surveillance were consistently employed during all outbreaks.Challenges related to diagnosis and treatment were addressed through the development and regular updates of state guidelines for outbreak response.The article emphasizes the need for fortifying the state's health system to enhance preparedness for future outbreaks.This involves proactive measures such as improving infection control practices, expediting diagnostic processes, and exploring advanced treatment options.Strengthening the surveillance system, particularly for monitoring acute encephalitis syndrome (AES) and acute respiratory distress syndrome (ARDS) is crucial for the early detection and containment of potential outbreaks and thereby mitigate the impact of future outbreaks in the region.

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