Experiential learnings from the Nipah virus outbreaks in Kerala towards containment of infectious public health emergencies in India.

Rima R Sahay,Devendra T Mourya,P T Ullas,Chandni Radhakrishnan,B Anu Kumar,Tarun Bhatnagar,A P Sugunan,Pragya D Yadav,Abhijeet V Kadam,Anita M Shete,Ganesh Mohan,Raman R Gangakhedkar,V K Sreekala,Krishnasastry Suma,Nivedita Gupta,Rajan Khobragade,Nikhilesh Menon

doi:10.1017/s0950268820000825

Abstract

Nipah virus (NiV) outbreak occurred in Kozhikode district, Kerala, India in 2018 with a case fatality rate of 91% (21/23). In 2019, a single case with full recovery occurred in Ernakulam district. We described the response and control measures by the Indian Council of Medical Research and Kerala State Government for the 2019 NiV outbreak. The establishment of Point of Care assays and monoclonal antibodies administration facility for early diagnosis, response and treatment, intensified contact tracing activities, bio-risk management and hospital infection control training of healthcare workers contributed to effective control and containment of NiV outbreak in Ernakulam.

Highlights

Nipah virus (NiV), a highly pathogenic Paramyxovirus, is one of the ten priority pathogens by World Health Organization Research and Development blueprint 2018 [1]
We identified a lack of emphasis on biosafety issues related to donning and doffing in the training programs of HCWs
Following the biosafety guidelines and standard operating procedures (SOPs) based on the experience of the 2018 NiV outbreak, the team set up an on-site field laboratory within 1 day for diagnostics including POC, qRT-PCR and ELISA

Summary

Introduction

Nipah virus (NiV), a highly pathogenic Paramyxovirus, is one of the ten priority pathogens by World Health Organization Research and Development blueprint 2018 [1]. The team’s responsibilities included establishing and coordinating facilities for prompt laboratory diagnosis of suspected patients; clinical examination and identification of cases; epidemiological studies and contact tracing; investigating the NiV presence in bats; and monoclonal antibodies (m102.4) preparations and administrations in Nipah cases, if necessary. The state government set up an isolation facility at GMC, Ernakulam for observation and management of suspected cases until their NiV confirmation.

Results

Conclusion