Kerala is on high alert following the detection of Nipah virus cases in the state. State Health Minister Veena George has issued alerts for Kozhikode, Malappuram, and Palakkad districts.

Recent Developments

Two new Nipah virus cases have been reported in Kerala. One of the affected individuals, an 18-year-old woman from Malappuram district, died after treatment in a Kozhikode hospital. Another patient, a 38-year-old woman from Palakkad district, is in critical condition and undergoing treatment. Health officials are working to identify any potential links between the two cases, including the possibility of a shared social event. As of July 7, 2025, 425 contacts have been identified, with five receiving intensive care.

Causes and Transmission

The Nipah virus (NiV) is a zoonotic virus, meaning it can spread between animals and humans. Fruit bats of the Pteropus genus are the natural hosts of the virus. Transmission to humans can occur through:

• Contact with infected animals, such as bats or pigs.
• Exposure to the bodily fluids of infected animals (saliva, urine, blood).
• Consuming food contaminated with infected animal fluids, such as raw palm sap or fruits.
• Direct human-to-human transmission through close contact or bodily fluids.

Recurring Nipah outbreaks in Kerala are attributed to the region's ecology, which supports dense fruit tree cover and a large population of fruit bats. Changing land use patterns, human encroachment into bat habitats, and the consumption of fresh fruits or toddy can also increase bat-human contact.

Symptoms

Nipah virus infection can manifest with a range of symptoms, from asymptomatic infection to severe disease. Common symptoms include:

• Fever
• Headache
• Muscle pain (myalgia)
• Dizziness
• Breathlessness
• Drowsiness and altered consciousness
• Vomiting
• Sore throat

In severe cases, the infection can lead to encephalitis (inflammation of the brain), disorientation, mental confusion, seizures and coma within 24-48 hours. Some individuals may also experience respiratory problems. The mortality rate for Nipah virus infection is high, ranging from 40% to 75%.

Diagnosis and Treatment

Diagnosis of Nipah virus infection involves laboratory testing of samples such as throat and nasal swabs, cerebrospinal fluid, urine, and blood using real-time PCR. Antibody testing using an enzyme-linked immunosorbent assay (ELISA) can be conducted later in the course of the illness or after recovery.

Currently, there is no specific antiviral treatment for Nipah virus infection. Treatment focuses on supportive care, including:

• Rest and hydration
• Oxygen therapy
• Intravenous fluids
• Medications to manage fever and other symptoms

Monoclonal antibodies are being investigated as a potential treatment, and clinical trials are ongoing.

Prevention

Preventive measures are crucial to reduce the risk of Nipah virus infection:

• Avoid contact with infected individuals.
• Practice frequent handwashing with soap and water.
• Maintain distance from individuals exhibiting respiratory symptoms.
• Avoid consuming raw palm sap.
• Wash fruits thoroughly before consumption and avoid those that appear to have been eaten by bats or birds.
• Ensure meat and eggs are thoroughly cooked.
• Avoid visiting hospitals unless necessary, especially in areas with reported cases.
• Stay alert for symptoms like fever, headache, drowsiness, confusion, or respiratory issues and seek immediate medical care if they occur.
• Isolate suspected cases to prevent further spread.

Health officials have implemented enhanced surveillance and contact tracing to contain the spread of the virus. Public awareness campaigns are also underway to educate people about the risks and preventive measures.