Translation Google
EDITORIAL
Nipah Prevention in the Dark
PUBLISHED: JULY 15, 2025 01:56 PM
This is the seventh outbreak of Nipah, claiming lives. We are still hearing
- the source is unclear. Despite the continuous outbreak of Nipah virus in
the state, our public health system has not yet been able to study it in
depth and formulate preventive measures. The question of how much
previous experience helps us in combating Nipah remains unanswered.
Nipah is further evidence that Kerala is still not giving enough importance
to the basic fact that identifying and preventing the source of the disease
is more important than ensuring treatment after the onset of complex
infectious diseases. Despite seven confirmed cases of Nipah in the state
since 2018, we still do not have enough clarity about the source and
spread.
In the wake of the second case of Nipah in Palakkad district, the Health
Department has issued a special alert to hospitals in Palakkad,
Malappuram, Kozhikode, Kannur, Wayanad and Thrissur districts. The
directive is to report any fever or encephalitis with Nipah symptoms. The
health department has found that the deceased is not in the contact list
of a native of Nattukal in Palakkad district who is undergoing treatment a
Kozhikode Medical College for Nipah, and is a native of Changaliri in the
nearby area of Kumaramputhur.
There is an argument that we did not know anything about Nipah when it
was first reported in the state. But that argument is no longer relevant.
Health experts observe that the failure to detect the disease at the
beginning and prevent its spread is being repeated. It has been proven
that the original source of the Nipah virus is bats. However, there is still
beginning and prevent its spread is being repeated. It has been proven
that the original source of the Nipah virus is bats. However, there is still
no clear understanding of how it spreads from bats to humans.
Monitoring and studying bats should have been an ongoing process
since 2018.
Even in hotspots where Nipah cases are continuously reported in the
state, accurate and comprehensive follow-up studies are not being
conducted. Every time Nipah cases come, studies are conducted to look
for the presence of the virus in bats. Health experts say that a detailed
study should be conducted to understand why the disease is being
reported in specific areas and that understanding the exact transmission
pattern will make preventive measures more effective.
Meanwhile, it is a great relief that the state is getting facilities for Nipah
sample testing and diagnosis. The construction of the Biosafety Level 3
(BSL3) lab at the National Institute of Virology in Alappuzha has been
completed and the trial run of the lab has begun. The Union Ministry of
Biotechnology will issue the BSL3 certificate only after the completion of
the three-month trial run. Once the certificate is received, Nipah
secretion samples can be tested and diagnosed here.
Only BSL3 grade labs are allowed to confirm Nipah infection. Currently,
the samples are being sent to the National Institute of Virology in Pune
for Nipah virus confirmation. The delay in this process has been a major
problem. The Virology Institute in Thiruvananthapuram and the Virology
Lab in Kozhikode should be more prepared to deal with the current
emergency.
Kerala's experience is that although the authorities have been active as
usual after the Nipah outbreak, this vigilance does not continue once the
disease recedes. Kerala must not delay any longer in combating this
complex virus that is poised to spread and in establishing clarity on the
source and spread of the virus. This is also the main responsibility of the
health department towards those who lost their lives in Nipah.
https://www.manoramaonline.com/news/editorial/2025/07/15/kerala-nipah-virus-outbreak.html
--------------------------------------
Veena George, the Minister of Health in Kerala, has responded to this editorial on her Facebook page:
Veena George's post
Veena George
1d ·
Malayalam Manorama is an organization that has been consistently spreading false news against the state health department and government hospitals. It has decided and has started legal action against it. The reason for this post is an editorial today. While hundreds of health workers in the state are trying to scientifically prevent and prevent the spread of a pandemic with a global mortality rate of over 70 percent, Manorama has made untrue statements under the title 'Gripping in the Darkness for Nipah Prevention - The Challenge of Unexplained Source and Mode of Transmission'. I am writing this here because it will cause concern and fear among people and spread misunderstandings, and it will adversely affect public health activities.
Let us examine what Manorama is saying and its truthfulness.
1) 'Comprehensive follow-up studies are not being conducted even in hotspots where Nipah is continuously reported in the state.'
Fact: We have an understanding of the possible routes of transmission of the Bangladeshi/Indian variant of Nipah virus to humans, without other animals acting as intermediaries (for example, fruits bitten by bats, bat excrement, etc.). We have found the presence of the virus widely in bats. The virus has not been found anywhere in the world in an environmental sample. The virus can only be present in such objects for a short time. However, we are still trying to do so. Although drinking a drink called date palm sap is believed to be a cause of Nipah infection in Bangladesh, the virus has not been found in any of them. The American CDC was able to detect even this possibility only after more than fifty Nipah cases had occurred there. Since 2018, studies on the possibility of Nipah infection in bats in Kerala have been ongoing in Kerala. It is still ongoing. Since Nipah is a highly virulent BSL 4 virus, only the National Institute of Virology, Pune, has permission to study the virus directly in bats. All the study data they have conducted is publicly available. There are few other regions where the possibility of Nipah infection in bats has been studied like in Kerala. Bat roost studies without directly studying bats are being conducted by the Health Department, the Forest Department, and the Wildlife Department of the Veterinary University. The Health Department has complete information on bat roosts in the areas where Nipah outbreaks have occurred. Mapping of all bat roosts is underway in districts including Wayanad, Kozhikode and Malappuram. Kerala's achievements in Nipah prevention, including studies conducted on bats, and lessons learned are detailed in the study published by the Kerala One Health Centre for Nipah Research and Resilience (
https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0003926 )
blichealth/article…).
We established the Kerala One Health Center for Nipah Research in Kozhikode in 2024 for Nipah prevention and community research. Studies on the ways in which Nipah spreads are ongoing in our country. The latest in that series is the pseudovirus studies currently being conducted with the help of the Institute of Virology. An attempt is being made to understand how the blood of animals in areas where Nipah has been infected reacts to the Nipah virus and whether any animals are involved in the spread of the disease. This is the first such study in the world in the case of Nipah virus.
2) 'Facilities are being prepared in the state for Nipah diagnosis and testing.'
Fact: This statement is completely false. The gold standard test for Nipah, RT-PCR, can be performed safely in BSL 3 facilities and in other labs using TrueNAT, which inactivates the virus before testing. We can perform PCR testing in our medical college labs (Kozhikode and Manjeri) and at IAV.
A BSL 3 lab is operational at the Institute of Advanced Virology, Thonnakkal, Thiruvananthapuram. Testing facilities were set up at Kozhikode Medical College following the outbreak in September 2021. Later, a lab was set up in Manjeri as well. TrueNAT tests can also be performed in many other labs. A full-fledged BSNL 3 facility will soon be operational at Kozhikode Medical College, just like the NIV's Alappuzha field station. We have put the maximum facilities that the state government can provide for Nipah testing at not one place, but at four places. For the last three years, Nipah has been tested in labs in Kerala and it is known whether it is positive or not.
3) The health department is active in Nipah prevention only during Nipah outbreaks.
Fact: Nipah virus prevention is a priority of the state health department. The State Health Department is working for prevention throughout the year, keeping in mind an action calendar (Nipah Calendar) in mind in all districts of Kerala in general, and especially in Malabar districts where Nipah is more likely to occur. This action calendar has been published as a government order. Encephalitis cases are being reported and tested. Samples of 5525 people have been tested for Nipah in 4 years. That too, samples are being tested throughout the year. That is why we are now able to detect the disease in the first patient and prevent the disease from spreading to others. The Nipah outbreak that occurred in 2023 had the lowest mortality rate in the history of outbreaks caused by the Bangladeshi/Indian variants. We were able to do that by using antiviral drugs extensively and providing supportive care to patients who had progressed to the severe stage. Since then, we have been providing protection to all at-risk people, in the context of the realization that antiviral drugs can protect those who are diagnosed early and those who are at high risk of developing the disease.
There is only one region in the world that has reduced the mortality rate from Nipah disease to less than 70 percent. That is Kerala. Kerala was able to reduce the mortality rate to 33 percent during the 2023 outbreak.
Based on the new information we obtain, our Nipah prevention activities, including treatment guidelines, are being updated frequently.
I request everyone to accurately evaluate the activities currently being carried out by the state government regarding Nipah disease prevention and provide the necessary suggestions objectively.
https://www.facebook.com/veenageorgeofficial/posts/1284263279731449?ref=embed_page
Download Report(PDF | 2.34 MB)