View source for Biology:Nipah virus outbreaks in Kerala

{{Short description|Nipah virus outbreaks occurring in India}}
{{Use Indian English|date=October 2022}}
{{Infobox outbreak
| name            = Nipah virus outbreaks in Kerala
| image           = File:Nipah virus from an infected VERO cell.jpg
| caption         = An electron micrograph of the Nipah virus
| disease         = [[Biology:Nipah virus|Nipah virus]]
| date            = 2018, 2021, 2023
| confirmed_cases = 
| deaths          = 
| fatality_rate   = 89.4% (2018)
}}
There have been several outbreaks of [[Medicine:Nipah virus infection|Nipah virus]] in Kerala, some of which have been traced to fruit bats. The [[Organization:National Institute of Virology|National Institute of Virology]] in Pune confirmed the first case of Nipah virus in Kerala in May 2018.

==History==
After Nipah virus outbreaks in India in 2001 and 2007 (both in the eastern state of West Bengal), an outbreak occurred in Kerala in 2018.<ref>{{Cite news|url=https://www.who.int/southeastasia/outbreaks-and-emergencies/health-emergency-information-risk-assessment/surveillance-and-risk-assessment/nipah-virus-outbreak-in-kerala|title=South-East Asia : Outbreaks and emergencies|website= World Health Organization|access-date=17 August 2020}}</ref> The 2018 Kerala outbreak was traced to fruit bats in the area, was generally confined to Kozhikode and Malappuram districts,<ref>{{Cite web|url=https://www.aljazeera.com/news/2018/05/deadly-nipah-virus-claims-lives-india-180528062759101.html|title=Deadly Nipah virus claims lives in India|website=www.aljazeera.com|access-date=2018-05-28}}</ref><ref>{{Cite news|url=https://www.hindustantimes.com/india-news/nipah-virus-outbreak-death-toll-rises-to-14-in-kerala-two-more-cases-identified/story-f4QenFXeOtJnWhw7NrVawJ.html|title=Nipah virus outbreak: Death toll rises to 14 in Kerala, two more cases identified|date=27 May 2018|work=The Hindustan Times|access-date=28 May 2018}}</ref> and claimed 17 lives.<ref>{{Cite news|url=https://www.frontline.in/the-nation/public-health/article24200872.ece|title=After the outbreak|work=Frontline|access-date=2018-07-10|language=en}}</ref> The outbreak was declared over on 10 June 2018.<ref name="contained"/> Another outbreak occurred in 2021, but was confined to the village of Pazhur in the Chathamangalam gram panchayat of Kozhikode district. It claimed one life, on 5 September 2021. An outbreak began in Kozhikode district in August 2023, claiming two lives and infecting four other people by 16 September of that year.<ref>{{Cite news|url= https://english.mathrubhumi.com/amp/news/kerala/nipah-no-indication-of-second-wave-yet-says-kerala-health-minister-1.8909223 |title= Nipah: No indication of second wave yet, says Kerala Health Minister|work=Mathrubhumi|access-date=2023-09-17|language=en}}</ref>

=={{anchor|Timeline}}2018 outbreak==

The outbreak's [[Medicine:Index case|index case]] was reported at a sub-divisional hospital in Perambra,<ref name=":0">{{Cite web|url=https://indianexpress.com/article/india/tracking-nipah-outbreak-sabith-patient-no-1-infected-all-but-one-5259668/|title=Tracking Nipah outbreak: Sabith, Patient No. 1, infected all but one|date=2018-07-15|website=The Indian Express|language=en-IN|access-date=2019-10-17}}</ref> Kozhikode district, on 2 May.<ref>{{Cite web|url=https://english.manoramaonline.com/news/kerala/2019/06/04/drug-remdesivir-cure-for-nipah.html|title=Have scientists hit upon a magical cure for Nipah?|website=OnManorama|language=en|access-date=2019-06-04}}</ref> The patient<ref name=":0" /> was brought to the Government Medical College, Kozhikode for further treatment, but succumbed to the virus. His brother, Mohammed Salih, was admitted to Baby Memorial Hospital in Kozhikode<ref>{{Cite news|url=http://www.newindianexpress.com/states/kerala/2018/may/25/kerala-health-department-these-doctors-were-the-first-to-figure-out-this-infection-was-different-1819115.html|title=Kerala Health Department: These doctors were the first to figure out this infection was different|work=The New Indian Express|access-date=2018-07-10}}</ref> with suspected viral encephalitis. A team of doctors at the hospital suspected Nipah, since his symptoms were similar to those of his brother (who had died by then).

The index patient had passed the virus to 16 people at Medical College Hospital, and two more were later infected. There were 10 deaths in the first week they included nurse Lini Puthussery, who had treated the index patient before diagnosis.<ref>{{cite news|url=https://www.hindustantimes.com/india-news/kerala-govt-confirms-10-deaths-due-to-nipah-virus-2-others-critical/story-RGUBQd6IgrSu0D164v8H1L.html|title=Kerala govt confirms 10 deaths due to Nipah virus, 2 others critical|date=22 May 2018|newspaper=Hindustan Times}}</ref><ref>{{cite news|url=https://www.ndtv.com/kerala-news/nurse-lini-who-treated-kerala-nipah-victim-left-heartbreaking-note-for-husband-1855625|title=Kerala Nurse Died After Treating Nipah Patient, Left Heartbreaking Note|date=22 May 2018|work=NDTV}}</ref> The outbreak began in Kozhikode district, later spreading to the adjacent Malappuram district. Health advisories were issued for northern Kerala and the adjoining districts of Karnataka, with two suspected cases detected in [[Place:Mangalore|Mangalore]] on 23 May 2018.<ref>{{cite web|url=https://timesofindia.indiatimes.com/city/mangaluru/nipah-virus-2-suspected-cases-reported-in-karnataka/articleshow/64274959.cms|title=Nipah virus: Two suspected cases reported in Karnataka - Times of India}}</ref>

Over 2,000 people in Kozhikode and Malappuram districts were [[Medicine:Quarantine|quarantine]]d and kept under observation during the outbreak.<ref>{{Cite web|url=https://www.firstpost.com/india/nipah-virus-kerala-districts-wear-deserted-look-as-2000-kept-under-observation-businesses-strained-nris-stranded-4493629.html|title=Nipah virus: Kerala districts wear deserted look as 2,000 kept under observation; businesses strained, NRIs stranded - Firstpost|website=www.firstpost.com|access-date=2018-07-10}}</ref> To fight the infection, M 102.4 (a human monoclonal antibody undergoing clinical trials) was imported from {{wipe|Australia}}.<ref>{{Cite news|url=https://english.manoramaonline.com/news/kerala/2018/05/25/nipah-drug-from-australia-reaches-kerala-say-reports.html|title=Nipah drug from Australia reaches Kerala, say reports|work=OnManorama|access-date=2018-07-10}}</ref> This was facilitated by Nipah researcher Christopher Broder.<ref name="The New Indian Express">{{Cite news|url=http://www.newindianexpress.com/states/kerala/2018/jun/10/silently-additional-chief-secretary-rajeev-sadanandan-gained-the-ammo-to-take-on-nipah-1826033.html|title=Silently, additional chief secretary Rajeev Sadanandan gained the ammo to take on Nipah|work=The New Indian Express|access-date=2018-07-10}}</ref>

After the index patient died, 16 other affected patients succumbed to the disease; two recovered fully. The outbreak was declared over on 10 June 2018.<ref name="contained">{{Cite news|url=https://www.thenewsminute.com/article/nipah-virus-contained-last-two-positive-cases-have-recovered-kerala-health-min-82809|title=Nipah virus contained, last two positive cases have recovered: Kerala Health Min|date=2018-06-11|work=The News Minute|access-date=2018-07-10}}</ref>

===Virology and epidemiology===
Presence of the virus in patients was confirmed with [[Biology:Reverse transcription polymerase chain reaction|RT-PCR]] tests conducted at the Manipal Institute of Virology and the National Virology Institute in Pune.<ref>{{cite web|url=https://timesofindia.indiatimes.com/city/kozhikode/10-deaths-in-kerala-due-to-nipah-virus-symptoms/articleshow/64251098.cms|title=Nipah virus scare: Health department issues alert - Times of India ►}}</ref> Although the first set of samples did not detect the virus in bats,<ref>{{Cite news | url=http://www.thehindu.com/news/national/kerala/origin-of-nipah-virus-yet-to-be-traced/article24068976.ece |title = Origin of Nipah virus yet to be traced|newspaper = The Hindu|date = 2018-06-02}}</ref> later tests indicated that fruit bats in the area were the source of the virus.<ref>{{Cite news|url=https://www.thenewsminute.com/article/fruit-bats-were-source-deadly-nipah-virus-kerala-union-health-minister-84088|title=Fruit bats were the source of deadly Nipah Virus in Kerala: Union Health Minister|date=2018-07-03|work=The News Minute|access-date=2018-07-10}}</ref>

=== Response ===
On 23 May 2018, the Kerala Health Department issued an advisory asking travelers to northern Kerala to be cautious.<ref>{{Cite news|url=https://economictimes.indiatimes.com/news/politics-and-nation/nipah-travellers-asked-to-avoid-4-kerala-districts/articleshow/64287931.cms|title=Nipah: Travellers asked to avoid 4 Kerala districts|date=2018-05-23|work=The Economic Times|access-date=2018-07-10}}</ref> Two days later, the Ministry of Health and Prevention of the [[Place:United Arab Emirates|United Arab Emirates]] advised postponing unnecessary travel to Kerala and avoiding its fruits and vegetables until the situation was under control.<ref>{{Cite web|url=https://www.khaleejtimes.com/news/uae-health/uae-ministry-issues-travel-warning-for-nipah-virus-outbreak--|title=Nipah virus: UAE issues Kerala travel warning|last=Zain|first=Asma Ali|website=www.khaleejtimes.com|access-date=2018-05-28}}</ref>

On 30 May 2018, construction began on the [[Organization:Institute of Advanced Virology, Kerala|Institute of Advanced Virology, Kerala]],<ref>{{Cite web|url=https://english.mathrubhumi.com/news/kerala/pinarayi-inaugurates-first-institute-of-advanced-virology--1.3557924|title=Pinarayi inaugurates first Institute of Advanced Virology|website=Mathrubhumi|language=en|access-date=2019-03-18}}</ref> in response to the outbreak.<ref>{{Cite journal|last=Ghafur|first=Abdul|last2=Kumar|first2=A. S. Anoop|last3=Devadasan|first3=N.|last4=Meena|first4=Amit|last5=Jose|first5=U. V.|last6=Zachariah|first6=Arun|last7=Mohandas|first7=A. C.|last8=Indu|first8=P. S.|last9=Michael|first9=C. J.|title=Outbreak Investigation of Nipah Virus Disease in Kerala, India, 2018|journal=The Journal of Infectious Diseases|volume=219|issue=12|pages=1867–1878|language=en|doi=10.1093/infdis/jiy612|pmid=30364984|year=2019|doi-access=free}}</ref> Two days later, the Thamarassery diocese in northern Kerala urged churches to stop placing communion on the tongue, postpone religious classes and avoid weddings, family gatherings and unnecessary travel until the viral spread was contained.<ref>{{Cite news|url=https://www.thehindu.com/news/national/kerala/holy-communion-to-be-served-on-hand/article24061311.ece|title=Holy Communion to be served on hand|last=Joseph|first=Mithosh|date=2018-06-01|work=The Hindu|access-date=2018-07-10|language=en-IN|issn=0971-751X}}</ref>

=== Recognition ===
[[File:Lini puthussery.jpg|thumb|Nurse Lini Puthussery, who treated the first victim, died in Kozhikode.|alt=A smiling woman|upright=0.8]]
Kerala's efforts to contain the outbreak under health minister K. K. Shailaja, health secretary Rajeev Sadanandan<ref name="The New Indian Express"/><ref>{{Cite news|url=https://www.thenewsminute.com/article/cooperation-key-three-kerala-govt-officials-what-they-learnt-tackling-nipah-82995|title=Cooperation is key: Three Kerala govt officials on what they learnt from tackling Nipah|date=2018-06-13|work=The News Minute|access-date=2018-07-10}}</ref> and the district collector were praised by many, including the Kerala High Court<ref>{{Cite news|url=https://timesofindia.indiatimes.com/city/kochi/nipah-outbreak-in-kerala-hc-commends-governments-efforts/articleshow/64577125.cms|title=Nipah outbreak in Kerala: HC commends government's efforts |work=The Times of India|access-date=2018-07-10}}</ref> and Robert Gallo of the Institute of Human Virology in Baltimore.<ref>{{Cite news|url=https://www.thenewsminute.com/article/institute-human-virology-baltimore-commends-kerala-govt-containing-nipah-84362|title=Institute of Human Virology in Baltimore commends Kerala govt for containing Nipah|date=2018-07-07|work=The News Minute|access-date=2018-07-10}}</ref>

Lini Puthussery, a 28-year-old nurse at the Perambra Taluk hospital who died of the virus, was called a hero by doctors and on social media.<ref>{{Cite news|url=https://www.economist.com/obituary/2018/06/02/lini-puthussery-died-of-the-nipah-virus-on-may-21st|title=Lini Puthussery died of the Nipah virus on May 21st|date=2018-06-02|work=The Economist|access-date=2019-10-18|issn=0013-0613}}</ref> A note she had written to her husband, Sajish, was circulated on social media.<ref>{{Cite news|url=https://www.bbc.com/news/world-asia-india-44207740|title='Hero' nurse who died battling Nipah|date=2018-05-22|access-date=2019-10-18|language=en-GB}}</ref> The Kerala Government Hospital Development Society (KGHDS) employees' union instituted an award in Puthussery's name to an outstanding person in the sector.<ref>{{Cite web|url=https://www.deccanchronicle.com/nation/current-affairs/190519/lini-puthussery-award-tuesday.html|title=Lini Puthussery award Tuesday|date=2019-05-19|website=Deccan Chronicle|language=en|access-date=2019-10-18}}</ref> The Best Nurse in Public Service Award was instituted in memory of Puthussery.<ref>{{Cite web|url=https://timesofindia.indiatimes.com/city/thiruvananthapuram/award-instituted-in-linis-memory/articleshow/64773163.cms|title=lini puthussery: Award instituted in Lini's memory {{!}} Thiruvananthapuram News |date=28 June 2018|website=The Times of India|language=en|access-date=2019-10-18 }}</ref> Jim Campbell, director of the health workforce of the [[Organization:World Health Organization|World Health Organisation]], tweeted: "Remember them, lest we forget: Razan al-Najjar (Gaza); Lini Puthusserry (India), Salome Karwah (Liberia)".<ref>{{Cite web|url=https://indianexpress.com/article/india/lini-puthussery-who-director-pays-homage-to-kerala-hero-nurse-who-died-battling-nipah-virus-5203862/|title=WHO director pays homage to Kerala’s ‘hero’ nurse who died battling Nipah virus|date=2018-06-05|website=The Indian Express|language=en-IN|access-date=2019-10-18}}</ref>

=={{anchor|2019 Incident}}2019 incident==
A 23-year-old student was diagnosed on 4 June 2019 in Kochi.<ref>{{Cite news |date=4 June 2019 |title=പരിശോധനാ ഫലം ലഭിച്ചു; യുവാവിന് നിപ തന്നെ |work=Mathrubhumi |url=https://www.mathrubhumi.com/health/specials/nipah-virus/nipah-virus-confirmed-health-minister-verify-1.3846610 |access-date=6 June 2019}}</ref> Over 300 people were put under observation, but no further cases were reported. The student later recovered.<ref name="PTI-Nipah-recovery">{{cite news |date=23 July 2019 |title=Ernakulam district declared Nipah virus free, says Kerala health minister |publisher=India Today |agency=Press Trust of India |url=https://www.indiatoday.in/health/story/ernakulam-district-declared-nipah-virus-free-says-kerala-health-minister-1572681-2019-07-23 |access-date=31 January 2020 |archive-url=https://web.archive.org/web/20190819060801/https://www.indiatoday.in/health/story/ernakulam-district-declared-nipah-virus-free-says-kerala-health-minister-1572681-2019-07-23 |archive-date=19 August 2019}}</ref> This is the fourth outbreak reported in India, with previous outbreaks in 2001 (45 deaths), 2007 (five deaths), and 2018 (17 deaths).<ref name="WHO_DON_28_May">{{cite web |date=31 May 2018 |title=Nipah virus - India |url=https://www.who.int/csr/don/31-may-2018-nipah-virus-india/en/ |url-status=dead |archive-url=https://web.archive.org/web/20180610081744/http://www.who.int/csr/don/31-may-2018-nipah-virus-india/en/ |archive-date=10 June 2018 |access-date=6 June 2018}}</ref><ref>{{Cite news |last=Sharma |first=Neetu Chandra |date=2018-05-22 |title=Third outbreak of Nipah Virus in India since 2001. What are the reasons? |work=Mint |url=https://www.livemint.com/Science/NoQYN3C3YhDUFyjK8nfrjI/Third-outbreak-of-Nipah-Virus-in-India-since-2001-What-are.html |access-date=2018-07-10}}</ref>

==2021 outbreak==

The 2021 outbreak began with the death of a 12-year-old boy in Pazhur, Kozhikode district, on 5 September.<ref name="New Indian Express">{{Cite news|url=https://indianexpress.com/article/india/suspected-case-of-nipah-virus-in-keralas-kozhikode-7489260/|title=12yr-old dies of Nipah in Kerala; 17 primary contacts placed under observation|date=2021-09-05|work=The Indian Express |access-date=2021-09-05}}</ref><ref>{{Cite web|title=Central Team Rushed To Kerala As Boy, 12, Dies Of Nipah Virus Infection|url=https://www.ndtv.com/kerala-news/kerala-boy-dies-due-to-nipah-virus-2530262|access-date=2021-09-05|website=NDTV.com}}</ref> The outbreak was localized in the village, which is in the Chathamangalam gram panchayat of the district, and claimed one life.<ref>{{Cite news|date=2021-09-05|title=Nipah resurfaces in Kerala's Kozhikode, Centre rushes support team|language=en-IN|work=The Hindu|url=https://www.thehindu.com/news/national/kerala/nipah-resurfaces-in-kozhikode/article36298311.ece|access-date=2021-09-05|issn=0971-751X}}</ref><ref>{{Cite web|date=5 September 2021|first=Disney|last=Tom|title=Kerala: 12-year-old dies of Nipah virus; all contacts traced, says health minister|url=https://timesofindia.indiatimes.com/city/kozhikode/kerala-12-year-old-dies-of-nipah-virus-all-contacts-traced-says-health-minister/articleshow/85941439.cms|access-date=2021-09-05|website=The Times of India|language=en}}</ref><ref>{{Cite web|date=5 September 2021|first=P. S. Gopikrishnan|last=Unnithan|title=12-year-old boy dies of Nipah virus in Kerala's Kozhikode|url=https://www.indiatoday.in/india/story/boy-dies-nipah-virus-kerala-kozhikode-1849329-2021-09-05|access-date=2021-09-05|website=India Today|language=en}}</ref><ref>{{Cite web|title=Health minister confirms Nipah death in Kozhikode|url=https://english.mathrubhumi.com/news/kerala/health-minister-confirms-nipah-death-in-kozhikode-nipah-strict-vigil-1.5974419|access-date=2021-09-05|website=Mathrubhumi|language=en}}</ref> This was Kerala's third Nipah virus outbreak,<ref>{{Cite news|last=Jacob|first=Shine|date=2021-09-05|title=Nipah resurfaces in Kerala; claims one life, two health workers infected|work=Business Standard India|url=https://www.business-standard.com/article/current-affairs/nipah-resurfaces-in-kerala-claims-one-life-two-health-workers-infected-121090500526_1.html|access-date=2021-09-05}}</ref><ref>{{Cite web|title=Latest updates: Andhra Pradesh reports 1,623 new Covid-19 cases, 8 deaths|url=https://timesofindia.indiatimes.com/city/live-news-from-cities-night-curfew-in-up-rajasthan-mp-jharkhand-chhattisgarh-05-september-2021/liveblog/85940019.cms|access-date=2021-09-05|website=The Times of India|language=en}}</ref> following outbreaks in 2018 and 2019. The central government rushed a team from the [[Organization:National Centre for Disease Control|National Centre for Disease Control]] to the state to provide technical support. Relatives of the dead boy and those involved in his treatment were placed under [[Medicine:Quarantine|quarantine]].<ref>{{Cite web|date=2021-09-05|title=12-year-old dies of Nipah virus infection in Kerala's Kozhikode|url=https://www.deccanchronicle.com/nation/in-other-news/050921/12-year-old-admitted-in-keralas-kozhikode-hospital-nipah-virus-infec.html|access-date=2021-09-05|website=Deccan Chronicle|language=en}}</ref><ref>{{Cite web|date=2021-09-05|title=Nipah virus: TN steps up measures to screen people at border areas after reports of infection in Kerala|url=https://www.cnbctv18.com/healthcare/nipah-virus-tn-steps-up-measures-to-screen-people-at-border-areas-after-reports-of-infection-in-kerala-10626251.htm|access-date=2021-09-05|website=www.cnbctv18.com|language=en}}</ref><ref>{{Cite web|title=12-Year-Old Succumbs to Nipah Virus in Kerala; Two Health Workers Who Were in Contact with the Patient Develop Symptoms {{!}} The Weather Channel - Articles from The Weather Channel {{!}} weather.com|url=https://weather.com/en-IN/india/health/news/2021-09-05-nipah-virus-kills-one-in-kerala-health-workers-symptomatic|access-date=2021-09-05|website=The Weather Channel|language=en-IN}}</ref><ref>{{Cite web|title=Amid Rising Covid Cases, Kerala Faces New Challenges With Nipah Virus|url=https://www.ndtv.com/india-news/amid-rising-covid-19-cases-kerala-faces-new-challenges-with-nipah-virus-infections-2530614|access-date=2021-09-05|website=NDTV.com}}</ref><ref>{{Cite web|date=2021-09-05|title=Jagran Explainer: How Centre and Kerala govt are preparing to deal with Nipah virus|url=https://english.jagran.com/india/jagran-explainer-how-centre-and-kerala-govt-are-preparing-to-deal-with-nipah-virus-10031673|access-date=2021-09-05|website=Jagran English|language=en}}</ref>

[[File:Nipah outbreak 2021 Kozhikode - 3 kilometers buffer zone map around the epicentre.pdf|thumb|alt=Map of the Kozhikode area, illustrating a three-kilometer buffer zone around the epicentre|2021 outbreak in Kozhikode, with a three-kilometer buffer zone around the epicentre]]
The [[Medicine:Index case|index case]] of the outbreak was reported at a private hospital in Kozhikode district on 5 September, when a 12-year-old boy from Chathamangalam died after testing positive for [[Medicine:Nipah virus infection|Nipah virus infection]].<ref>{{Cite web|last=ലേഖകൻ|first=മാധ്യമം|date=2021-09-06|title=നിപ പകർന്നത് ആടിൽ നിന്നല്ല, റംബുട്ടാനിൽ നിന്നാണോയെന്ന് പരിശോധിക്കുന്നു- ആരോഗ്യമന്ത്രി |url=https://www.madhyamam.com/kerala/checking-whether-the-transmission-of-nipah-was-from-a-rambutan-and-not-from-a-goat-health-minister-844907|access-date=2021-09-06|website=www.madhyamam.com|language=ml}}</ref><ref>{{Cite web|title=നിപ: കുട്ടിയുടെ അമ്മയ്ക്ക് പനി; ഉടന്‍ മെഡിക്കല്‍ കോളജിലേക്ക് മാറ്റും|url=https://www.manoramaonline.com/news/latest-news/2021/09/05/mother-of-12-year-old-boy-who-died-of-nipah-virus-has-shows-symptoms.html|access-date=2021-09-06|website=ManoramaOnline|language=ml}}</ref> The new Nipah infection, which spreads through the [[Biology:Saliva|saliva]] of [[Biology:Megabat|fruit bats]], came three years after a previous outbreak which claimed 17 lives.<ref>{{Cite web|date=2021-09-05|title=12-yr-old dies of Nipah in Kerala; 17 primary contacts placed under observation|url=https://indianexpress.com/article/india/suspected-case-of-nipah-virus-in-keralas-kozhikode-7489260/|access-date=2021-09-05|website=The Indian Express|language=en}}</ref><ref>{{Cite web|date=2021-09-05|title=Nipah death in Kerala: Symptoms, prevention, treatment. All you need to know|url=https://www.hindustantimes.com/india-news/nipah-death-in-kerala-symptoms-prevention-treatment-all-you-need-to-know-101630836947242.html|access-date=2021-09-05|website=Hindustan Times|language=en}}</ref><ref>{{Cite web|date=2021-09-05|title=TN steps up thermal screening at 9 border districts after Nipah virus death in Kerala|url=https://www.thenewsminute.com/article/tn-steps-thermal-screening-9-border-districts-after-nipah-virus-death-kerala-154893|access-date=2021-09-05|website=The News Minute|language=en}}</ref><ref>{{Cite web|date=2021-09-05|title=Breaking news: 4 killed, 17 injured after tractor-trolley overturns in MP|url=https://www.hindustantimes.com/india-news/breaking-news-updates-september-05-2021-101630798650701.html|access-date=2021-09-05|website=Hindustan Times|language=en}}</ref> The presence of Nipah virus in the boy was confirmed by [[Biology:Reverse transcription polymerase chain reaction|RT-PCR]] tests, and all three samples ([[Biology:Plasma cell|plasma]], [[Biology:Serum (blood)|serum]] and [[Biology:Cerebrospinal fluid|CSF]]) were found to be positive in tests at the [[Organization:National Institute of Virology|National Institute of Virology]] in Pune.<ref>{{Cite web|date=2021-09-05|title=Two Health Workers Show Symptoms of Nipah Virus Infection; Kerala Health Minister|url=https://www.news18.com/news/india/two-health-workers-show-symptoms-of-nipah-virus-infection-kerala-health-minister-4168064.html|access-date=2021-09-05|website=News18|language=en}}</ref>

== {{anchor|Response}}2023 outbreak ==
Six cases and two deaths were reported in August and September 2023.<ref>https://www.thehindu.com/sci-tech/health/one-more-tests-positive-for-nipah-in-kozhikode/article67310380.ece/amp/</ref><ref>{{Cite news |date=2023-09-12 |title=India's Kerala state reports two deaths from Nipah virus |language=en |work=Reuters |url=https://www.reuters.com/world/india/indias-kerala-state-reports-two-deaths-due-nipah-virus-official-2023-09-12/ |access-date=2023-09-13}}</ref><ref>{{Cite web |date=2023-09-12 |title=Kerala reports 4 cases of Nipah virus, 2 deaths. What we know so far |url=https://www.hindustantimes.com/india-news/kerala-reports-4-cases-of-nipah-virus-2-deaths-101694534327800.html |access-date=2023-09-13 |website=Hindustan Times |language=en}}</ref><ref>{{Cite web |title=Nipah Virus Outbreak in Kerala |url=https://www.manoramaonline.com/news/indepth/nipah-virus-outbreak-in-kerala.html |access-date=2023-09-13 |website=ManoramaOnline |language=ml}}</ref> One of the victims died on August 30 and the other died in early September, both in Kozhikode district. Two family members of a victim tested positive and were hospitalized.<ref name = "bbc1">{{Cite news |date=2023-09-13 |title=Kerala: India state on alert after Nipah virus deaths |language=en-GB |work=BBC News |url=https://www.bbc.com/news/world-asia-india-66793836 |access-date=2023-09-13}}</ref>

Indian Health Minister Mansukh Mandaviya announced that the central government had dispatched a team of experts to Kerala to assess the situation and help the state government manage the outbreak. Kerala Health Minister Veena George reported that tests had confirmed that the virus strain in the outbreak was identical to one previously found in Bangladesh, and teams from the [[Organization:National Institute of Virology|National Institute of Virology]] in Pune had established a mobile laboratory at Kozhikode Medical College for virus testing and bat surveys. George said that 168 contacts of the two deceased patients were identified and underwent virus testing. The state government established a control room in Kozhikode for continuous monitoring, and health workers were instructed to adhere strictly to infection-control protocols. Seven villages in Kozhikode were declared as containment zones, and some schools and offices in the district were temporarily closed. Kerala Chief Minister Pinarayi Vijayan said that the state government treated the deaths seriously, and urged the public to wear face masks and visit hospitals only for emergencies.<ref>{{Cite news |last=Jain |first=Rupam |date=2023-09-13 |title=India's Kerala shuts schools and offices to curb deadly Nipah virus |language=en |work=Reuters |url=https://www.reuters.com/world/india/indias-kerala-state-closes-schools-banks-seven-villages-due-nipah-deaths-2023-09-13/ |access-date=2023-09-13}}</ref><ref name = "bbc1"></ref>

== In popular culture ==
''Virus'', a 2019 Indian Malayalam medical thriller film co-produced and directed by Aashiq Abu and released on 7 June 2019, was based on the 2018 outbreak.<ref>{{Cite news |url=https://www.thenewsminute.com/article/malayalam-movie-virus-based-2018-nipah-outbreak-release-friday-103069|title=Malayalam movie 'Virus' based on 2018 Nipah outbreak to release this Friday |work=The News Minute |access-date=2019-06-05 |date=2019-06-05}}</ref>

== References ==
{{reflist}}
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==External links==
* Respond ReplyTicket from Malaysian Ministry of Health (Kementrian Kesihatan Malaysia) {{Cite web | url=https://drive.google.com/file/d/1LCidcf9XVShtKnnF_wW16vIgeJdRT0kd/view?usp=drivesdk |title = Share 'Tiket Maklum balas.PDF'}}
* Sharing of Information of Virus Posted in the WHO EIS on at Malaysian Time {{Cite web | url=https://drive.google.com/file/d/1zVDgPtjheWY6vT1Ym5qIktm79OmAz4aG/view?usp=drivesdk |title = Share 'DOC-20181030-WA0025.PDF'}}
* {{Cite web | url=https://www.ndtv.com/kerala-news/nurse-lini-who-treated-kerala-nipah-victim-left-heartbreaking-note-for-husband-1855625 |title = Kerala Nurse Died After Treating Nipah Patient, Left Heartbreaking Note}}
* {{Cite web | url=https://indianexpress.com/article/india/tracking-nipah-outbreak-sabith-patient-no-1-infected-all-but-one-5259668/ |title = Tracking Nipah outbreak: Sabith, Patient No. 1, infected all but one|date = 2018-07-15}}
{{Refend}}


[[Category:Paramyxoviridae]]

{{Sourceattribution|Nipah virus outbreaks in Kerala}}