A second outbreak, just a year after the first, shows how ill-prepared Kerala is in terms of preventing recurrence
Only a year after India dealt with its first outbreak of the deadly Nipah virus infection (NiV)—it had claimed 17 lives between late May and early June 2018—another case of the infection was confirmed in a 23-year old from Kerala. As many as 314 people with whom the patient is supposed to have come in contact have been placed under quarantine; eight districts in Karnataka and seven in Tamil Nadu have been put on high alert. While government response across states has been swift, ensuring inter-departmental coordination for administration, and preparing isolation and intensive care wards, the second outbreak shows very little has happened on containing infection and preventing recurrence after last year’s outbreak. Given the limitations of the public healthcare infrastructure, the virulence of the pathogen and the deadly nature of the infection, prevention can mean the difference between a freak, solitary infection and an epidemic.
A major cause of Nipah’s return is a lag in government surveillance. Once the outbreak in Kerala last year was controlled, state and central authorities declared it a local occurrence and discontinued monitoring the virus. The government, however, has neither a vaccine nor a fail-safe cure for Nipah, which means such inaction is dangerous—2018 was not the first outbreak of Nipah virus in India; in 2001, the virus claimed the lives of 49 people in Siliguri, West Bengal, although the cause for these deaths was only identified post the fact. Ideally, Kerala should not only have monitored the virus but also tracked movement of persons from regions where the disease is endemic, such as Bangladesh where regular cases of NiV encephalitis have been recorded since 2001. The scramble to identify the source of the virus this time around speaks only to the state of unpreparedness of authorities to deal with a public medical emergency of this nature and magnitude.