It was a relief to know that my grandfather skipped the funeral of Mohammed Ali, considered the index case of the new Nipah outbreak in Kerala’s Kozhikode district. It was unlike of him to miss it, but fortunately, he did.
As declared by the state health minister on Tuesday, the 49-year-old is among the two people who died due to the Nipah virus. Two others, Ali’s son and his brother-in-law, are under intensive care after testing positive for the zoonotic virus.
While my grandfather throws a tantrum for being stuck in the containment zone, others are worried about the return of the deadly virus. Ali’s home is less than 15 km from Chengaroth where the first outbreak in south India was reported in 2018. Chengaroth and Maruthonkara, my maternal place, share boundaries with Janaki forest, home to fruit bats that are proven to be carriers of the virus.
Ali, who returned from the Middle East about two years ago to take care of his ailing father, had farms near the forest patch located in the foothills of ecologically rich western ghats. It’s presumed that he got infected by the bat and it got transmitted to others. Ali died on August 30, unaware of his infection, dozens of people known to me attended the funeral.
The other deceased, Haris MK, is a relative of my aunt and lives less than three kilometres from my home in Villiappally. “You must have met him,” my cousin said as he mourned for his “close friend”. He worked as an electrician in Qatar and returned home for vacation last month. Haris visited three clinics before consulting Dr. Jyothikumar in Vadakara who suspected Nipah.
Nipah spillovers are predicted in the region by studies. There have been at least two Nipah cases in Kerala since the 2018 outbreak that took 20 lives out of 22 people infected. A 21-year-old college student survived Nipah in 2019 and a 13-year-old boy died in 2021.
Haris was shifted to a private hospital in Kozhikode where he died on September 11. Authorities were quick to connect the dots and send samples to the National Institute of Virology under the Indian Council of Medical Research in Pune.
A probe into the movements of patients found that both the deceased were in the same hospital, from where the infection must have been transmitted.
As Minister Veena George dictated the places under the scanner, It became the first time I was covering my hometown.
I don’t have to look for leads in this story as they came to me through my family WhatsApp groups. Messages about Haris’s demise were already there before Nipah was confirmed. It was followed by photos of Rapid Action Forces heading to our village. The same disinformation messages from 2018 resurfaced, only that this time it had a heads-up that read “forwarded many times”.
People close to patients are urging for prayer. They are worried about Ali’s 9-year-old son who is in critical condition. It is a tragedy, but many are too anxious to bother.
By evening on Tuesday, half of the people in Kozhikode City were wearing masks. Packets of masks were back on the table of the shop next door to our office. People are now very familiar with a high-risk virus outbreak. If the Nipah outbreak in 2018 was a prelude, the global pandemic due to the coronavirus has given enough lived experience.
Kerala already has a Nipah protocol. After the 2018 outbreak, the Institute of Advanced Virology was established in 2019 by the state government to focus on “research, diagnosis and management of emerging and re-emerging infectious viral diseases.”
The functioning of the activities of Institute of Advanced Virology (IAV) was declared on 15 October 2020. Even Kozhikode has a lab that can test Nipah. But as per protocol, the results from Pune NIV are valid to confirm the virus.
Nipah is considered one of the most dangerous pathogens circulating in the wild. It was reported in Malaysia and Bangladesh before it was found in Kerala. As per the National Centre for Disease Control, citing the Central High Level Team, Nipah Virus Disease is not a major outbreak and only local occurrence is limited to two districts in Kerala i.e. Kozhikode & Malappuram.
“Available data suggests that there is no need for the general public to be apprehensive about the safety of individuals and their family members,” the guidelines read.
I have had countless encounters with bats in our maternal home. There were times when it was ok for it to be in the room as long as it stayed idle and not fly around. There was no second thought about eating a fruit that we could find in our backyard. You just don’t eat the part where it’s bitten, the logic was clear and professed. We had that feeling that we were co-existing with nature. Well, it is untrue.
An investigation by Reuters focused on the region said it had become one of the “likeliest places on Earth for a spillover to people from bats”. Reuters dubbed these areas “jump zones.”
The report said deforestation and development bring humans ever closer into contact with once-remote breeding grounds for bats and the viruses they carry. Kerala, a densely populated state, is home to more than 40 species of bats.
Quick growth, the Reuters analysis showed, made conditions ripe for spillover across 83% of Kerala at the time of the Nipah outbreak in 2018, up from 58% in 2002.