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Kerala infectious disease & unidentified fever 2018; 534 fatalities; Nipah Virus outbreak in May - 21 fatalities from 23 cases.

Published Date: 2018-09-30 23:11:12
Subject: PRO/SOAS> Undiagnosed death - India: (Kerala) RFI
Archive Number: 20180930.6062059
UNDIAGNOSED DEATH - INDIA: (KERALA) REQUEST FOR INFORMATION
************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Sat 29 Sep 2018, 11:53 PM IST
Source: The Hindu [edited]
https://www.thehindu.com/news/natio...es-rumours-of-nipah-death/article25085071.ece


In the wake of rumours in the social media attributing the death of a person at a private hospital at Perambra to Nipah infection, the Health Department has clarified that lab results of the deceased are yet to be made available. Sources said the native of Meppayur died of fever recently.

After his family suspected a chance of Nipah infection, his body fluid samples, along with that of his wife and 2 children in the neighbourhood, were sent to the Manipal Academy of Virus Research. The results are expected by [Mon 1 Oct 2018].

The woman had complained of migraine. The children had fever one week ago and were under treatment.

All 3 are under observation at the Government Medical College Hospital, Kozhikode. District Medical Officer V. Jayasree refuted rumours in the social media and said that there was no cause for concern.

Meanwhile, Health Department staff visited houses in the village to examine whether there are more fever cases.

--
Communicated by:
ProMED-SoAs from HealthMap Alerts
<promed-SoAs@promedmail.org>

[Meppayur is an important place and town in Kozhikode district of Kerala state, South India (https://search.yahoo.com/search?ei=utf-8&fr=tightropetb&p=Meppayyur&type=107457_120717).

Until the laboratory test results are available, the cause of the death of the deceased and the illness affecting the 2 of his family members cannot certainly be known. We hope the concerned authority will test the samples already collected for the presence of Nipah virus in order to nullify the growing rumor of Nipah virus infection with valid evidence. ProMED-SoAs would appreciate receiving information from any knowledgeable sources in the area on the laboratory test results of the samples collected from the 3 affected family members.
 
Fever Death TVM: Vanaja 68/F DOD 30.9.18, Vatiyyorkavu
http://dhs.kerala.gov.in/pdf2018/drcd_01102018.pdf

In response to the ProMED RFI;
?Death due to H1N1, not Nipah?
STAFF REPORTER KOZHIKODE, OCTOBER 01, 2018 00:00 IST
UPDATED: OCTOBER 01, 2018 04:02 IST

Lab results have confirmed that the death of a Meppayyur resident recently was not due to Nipah infection, but due to H1N1 (Influenza) infection.

District Medical Officer V. Jayasree said here on Sunday that the dead man?s wife, now under observation at Government Medical College Hospital, Kozhikode, too had tested positive for the respiratory infection. The body fluid samples of the deceased, his wife, and two children in the neighbourhood were sent to the Manipal Academy of Virus Research after family members and others raised doubts about possible Nipah infection. Social media too had been rife with rumours that there had been another Nipah death in Kozhikode district. Dr. Jayasree warned of action against those who spread rumours.
https://www.thehindu.com/todays-pap...ath-due-to-h1n1-not-nipah/article25092295.ece
 
Sus Lepto Deaths
TVM: Surendran 54/M DOD 19.10.18,Vizhinjam
KTM: Babu 60/M DOD 20.10.18, Vazhur
http://dhs.kerala.gov.in/pdf2018/drcd_20102018.pdf

Susp. Dengue Death:
KLM: Anilkumar,52/M, D.o.D;15.10.2018, Parippally

Susp.Lepto Deaths:3: TVM:
1. Babu,50/M, D.o.D:22.10.2018, vellarada
2. Reveendran,61/M, D.o.D:21.10.2018, Kalliyoor
3. Shibu,40/M, D.o.D:20.10.2018, Kadakampally
http://dhs.kerala.gov.in/pdf2018/drcd_22102018.pdf

Fever Death:
TVM: Sadasivan, 54/M, D.o.D: 22.10.2018, Maranellur

Susp. Lepto Deaths-2:
KLM: Ramachandran Pilla,66/M, D.o.D:21.10.2018, Velinallur
MPM: Ashraf,32/M, D.o.D: 23.10.18, Kurumbalangode

H1N1 conf Death:
MPM: Abdul Resheed,39/M, D.o.D:20.10.2018, Nannambra

Pneumonia Death:
MPM: Ambujakshi,64/F, D.o.D:20.10.2018, Thuvur

Susp. Scrub Typhus Death:
KLM: Shyla,45/F, D.o.D:21.10.2018, Mancode Chithara
http://dhs.kerala.gov.in/pdf2018/drcd_23102018.pdf
 
Outbreak investigation of Nipah Virus Disease in Kerala, India, 2018
Govindakarnavar Arunkumar, PhD R Chandni, MD D T Mourya, PhD S K Singh, MD Rajeev Sadanandan, MPhil Preeti Sudan, MPhil Balram Bhargava, MD, DM, FRCP NIPAH: Nipah Investigators People And Health
The Journal of Infectious Diseases, jiy612, https://doi.org/10.1093/infdis/jiy612
Published: 26 October 2018 Article history

Abstract
Background
Nipah Virus (NiV) is a highly fatal emerging zoonotic virus with potential threat to global health security. Here we describe the characteristics of the NiV outbreak occurred in Kerala, India during May -June 2018.

Methods
We used real-time RT PCR in throat swabs, blood, urine and CSF to detect NiV. Further, the viral genome was sequenced and subjected to phylogenetic analysis. We conducted an epidemiological investigation to describe the outbreak and to elucidate transmission dynamics.

Results
During May 2 ? 29, 2018, 23 cases were identified including the index case; 18 were lab-confirmed. This NiV was closer to the Bangladesh lineage. Median age of cases was 45; 15 (65%) were male. The median incubation period was 9.5 days (6 ? 14 days). Of the 23 cases, 20 (87%) had respiratory symptoms. The case fatality rate (CFR) was 91%; two cases survived.. Risk factors for infection included close proximity (touching, feeding or nursing an NiV infected person) enabling exposure to droplet infection. The public health response included isolation of cases, contact tracing, and enforcing hospital infection control practices.

Conclusion
This is the first recorded NiV outbreak in South India. Early laboratory confirmation and immediate public health response contained the outbreak.
https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiy612/5144922#123069304
 
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