The outbreak of the virus infection, which is a newly emerging zoonosis that causes severe disease in both animals and humans, is suspected to be from an unused well which was infested with bats.
First identified among pig farmers in Malaysia, the disease also surfaced in Siliguri, West Bengal, in 2001 and again in 2007.
In a related development, a police probe, initiated to find out the travel itinerary of the virus' first victim Sabith, found out that he never visited Malaysia but had been in the United Arab Emirates, from where he had returned in October a year ago.
The central medical team has put Kozhikode and Malappuram on "high alert" and has advised authorities to set up facilities to screen suspected cases at exit and entry points of the districts. "They have tested negative for the Nipah virus", the official said.
"All the previous such epidemics were reported to be in clusters and historical evidence shows no simultaneous outbreaks", Vidya Menon, Clinical Professor at the Department of Medicine, Amrita Institute of Medical Sciences, Kochi, told IANS. Any contact with bats or pigs or with objects such as fruits that have come in contact with such animals should be avoided. Transmission occurs via respiratory droplets, contact with throat or nasal secretions from pigs, or contact with the tissue of a sick animal. The need to constitute a crisis management group was stressed upon in a meeting convened by the Chief Secretary on May 22 and a request was sent to the government.
The disease rapidly progresses with deterioration in consciousness leading in coma within five to seven days.
All the confirmed infections have involved people who caught the virus from the first victim while he was being treated, said microbiologist G. Arun Kumar. "Any patient showing symptoms of NiV will be kept in isolation".
The Collector said that the advisory has been issued by the hospitals to their staff and a press release has been given to them. Kerala government has declared a pay of Rs. 5 lakh to the casualties of Nipah infection. It is not a proven treatment, but it is approved because of a few studies that have proved the anti-viral's benefits. "The five-day session will also focus on training the doctors on using ventilator techniques effectively", said a Health Department officer. Clean the fruits thoroughly before eating. Food should be properly cooked before consuming.
The WHO, however, has not issued any specific advice to countries that have not been affected by the Nipah but has asked them to enhance the level of preparedness.