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{{merge to|Nipah virus outbreak in Kerala|discuss=Talk:2021 Nipah virus outbreak in Kerala#Merger proposal|date=December 2021}}
{{Infobox outbreak
| name = 2018 Nipah virus outbreak in Kerala
| image = File:Nipah virus from an infected VERO cell.jpg
| caption = An electron micrograph of a Nipah virus
| disease = [[Nipah virus]]
| date = 2 May - 10 June 2018
| confirmed_cases = 19
| deaths = 17
| fatality_rate = 89.4%
}}

The '''2018 Kerala Nipah virus outbreak''' was an outbreak of the [[Nipah virus infection|Nipah virus]] in [[Kerala]], traced to the [[fruit bats]] in the area. The outbreak was localized in [[Kozhikode district|Kozhikode]] and [[Malappuram district|Malappuram]] districts of Kerala<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 web|url=https://www.facebook.com/KeralaHealth/posts/2532638213628329|title=Department of Health, Government of Kerala|website=www.facebook.com|language=en|access-date=2018-07-10}}</ref><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 contained and declared over on 10 June 2018.<ref name="contained"/> This was the third Nipah Virus outbreak in India, the earlier being in 2001 and 2007, both in the [[East India|eastern state]] [[West Bengal]].<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>

==Timeline==
The [[index case]] of the outbreak was reported at 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> in [[Kozhikode district]] on May 2.<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> This patient<ref name=":0" />—was later taken to the [[Government Medical College, Kozhikode]] for further treatment, where he later succumbed to the virus. Later, his brother Mohammed Salih was admitted to Baby Memorial Hospital, 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 Baby Memorial Hospital, Kozhikode suspected Nipah, as the symptoms were similar to that of his brother who had died by then. The samples were tested at the [[Manipal Academy of Higher Education|Manipal Institute of Virology]] where it was confirmed as a case of Nipah; samples were also tested positive at [[National Institute of Virology]], [[Pune]].

The index patient had passed the virus to 16 persons at Medical College Hospital; later two more were infected, increasing the total count of infected to 18. There were 10 deaths in the first week, including a nurse named Lini Puthussery who 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 and later spread to the adjoining Malappuram district. Health advisories were issued for Northern Kerala as well as the adjoining districts of [[Karnataka]], with two suspected cases detected in [[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 [[quarantine]]d and kept under observation during the period of 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 outbreak, M 102.4—a human monoclonal antibody for which clinical trials are still going on—was imported from [[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 renowned 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> The outbreak also lead to the revival of [[World Health Organization]]'s Nipah Drug Trials Group, led by [[Soumya Swaminathan (scientist)|Soumya Swaminathan]].

After Sabith, 16 of the affected patients succumbed to the disease and two patients recovered fully. The outbreak was officially 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>

===Other Nipah outbreaks===
A new case of a 23-year-old student was detected again on 4 June 2019 in [[Kochi]].<ref>{{Cite news|url=https://www.mathrubhumi.com/health/specials/nipah-virus/nipah-virus-confirmed-health-minister-verify-1.3846610|title=പരിശോധനാ ഫലം ലഭിച്ചു; യുവാവിന് നിപ തന്നെ|date=June 4, 2019|work=Mathrubhumi|access-date=June 6, 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 |title=Ernakulam district declared Nipah virus free, says Kerala health minister |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 |agency=Press Trust of India |publisher=India Today |date=July 23, 2019 |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 occurrence reported in India, with previous ones having occurred in 2001 (45 deaths), 2007 (5 deaths), and 2018 (17 deaths).<ref name="WHO_DON_28_May">{{cite web|url=https://www.who.int/csr/don/31-may-2018-nipah-virus-india/en/|archive-url=https://web.archive.org/web/20180610081744/http://www.who.int/csr/don/31-may-2018-nipah-virus-india/en/|url-status=dead|archive-date=June 10, 2018|title=Nipah virus - India|date=31 May 2018|access-date=6 June 2018}}</ref><ref>{{Cite news|url=https://www.livemint.com/Science/NoQYN3C3YhDUFyjK8nfrjI/Third-outbreak-of-Nipah-Virus-in-India-since-2001-What-are.html|title=Third outbreak of Nipah Virus in India since 2001. What are the reasons?|last=Sharma|first=Neetu Chandra|date=2018-05-22|work=Mint|access-date=2018-07-10}}</ref>

Three years later, on September 5, 2021, a 12-year-old boy died of the [[Nipah virus]] in Pazhur, [[Kozhikode]], prompting an investigation and the possibility of a [[2021 Nipah virus outbreak in Kerala|new outbreak]].<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>

==Virology and epidemiology==
The presence of the Nipah virus in patients was confirmed from [[Reverse transcription polymerase chain reaction|RT-PCR]] tests conducted at the [https://manipal.edu/dvr/research.html Manipal Institute of Virology] and the National Virology Institute, [[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>

Though 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 proved 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, Kerala Health Department issued a travel advisory asking travelers to the Northern districts of Kerala to be extra 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>

On 23 May 2018, State of Kerala, requesting medical advisory from Malaysian Health Department (Kementerian Kesihatan Malaysia), for treatment and medicines for Nipah virus.[https://drive.google.com/file/d/1LCidcf9XVShtKnnF_wW16vIgeJdRT0kd/view?usp=drivesdk]

On 25 May 2018, sharing of Information of Virus was posted in the WHO EIS at Malaysian Time.[https://drive.google.com/file/d/1zVDgPtjheWY6vT1Ym5qIktm79OmAz4aG/view?usp=drivesdk] On the same day, the Ministry of Health and Prevention of the [[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 [[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> which was founded 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>

On 1 June 2018, [[Thamarassery]] diocese in northern Kerala urged churches to stop giving Communion on the tongue, to postpone religious classes, and to avoid weddings and family get-togethers and unnecessary travel until the virus 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 ==
Kerala's efforts in containing the outbreak under the leadership of the Health Minister [[K. K. Shailaja]] and the 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 then district collector were lauded 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, [[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>

[[File:Lini puthussery.jpg|thumb|Lini Puthussery staff nurse died due to first Nipah virus outbreak. She was in the team that treated the first victim of the Nipah virus in Kozhikode]]
Kerala Government gave early increments to 61 people to reward them for their efforts in tackling this outbreak: 4 assistant professors, 19 staff nurses, 7 nursing assistants, 17 cleaning staff, 4 hospital attenders, 2 health inspectors, 4 security staff, 1 plumber, and 3 lab technicians. Twelve junior residents and two senior residents were also awarded gold medals of one sovereign each.

Lini Puthussery, a 28 year old nurse at the Perambra Taluk hospital who fell victim to Nipah was hailed on social media and by doctors as a hero for her sacrifice.<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 addressed to her husband Sajish was widely 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> 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, the Director of the Health Workforce of [[World Health Organization|World Health Organisation]] also paid tribute, tweeting "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>

Following the outbreak government modernized it's only virology lab in Alappuzha and decided to establish more virology institutes in the state.

== In popular culture ==
''[[Virus (2019 film)|Virus]]'', a 2019 Indian Malayalam medical thriller film co-produced and directed by Aashiq Abu, released on 7 June 2019 was based on 2018 Kerala Nipah virus 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}}
{{Refbegin}}

==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}}

{{Epidemics}}

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[[Category:2018 disasters in India]]
[[Category:2018 health disasters]]
[[Category:Disease outbreaks in India]]
[[Category:21st-century epidemics]]
[[Category:Paramyxoviridae]]
[[Category:Health in Kerala]]
[[Category:2010s in Kerala]]
[[Category:Disasters in Kerala]]
[[Category:History of Kerala (1947–present)]]

2018 Nipah virus outbreak in Kerala - Revision history

MetaBOT at 19:37, 8 July 2023