Clinical symptoms seen in people who contracted the Nipah virus in Kozhikode, where two people have died and four others are undergoing treatment, are different this time from the symptoms seen in previous outbreaks, said the doctor leading the team treating the four patients.
Dr A S Anoop Kumar, the director of critical care medicine at Aster MIMS hospital in Kozhikode, said all the cases seen this year mainly show symptoms of respiratory infection. This, he said, makes early diagnosis difficult as many people contract viral fever and influenza, which have similar symptoms, during the rainy season.
In the outbreak in Kerala in 2018, when 17 people had died, and in two cases seen in subsequent years, patients were showing symptoms of encephalitis, he said. This time, however, such neurological symptoms were not seen in patients.
In 2018, Dr Anoop had played a key role in detecting the Nipah virus in Kozhikode district after a few “unusual” fever deaths were reported in a family within a short span of time at Changarothu village.
“What are predominant in these suspected patients and the two dead are common respiratory symptoms. This makes detection very difficult. Because during the rainy season, viral fever and influenza are very common. We even have local influenza outbreaks. This makes early diagnosis of Nipah very difficult. Whereas, if the virus demonstrates symptoms of encephalitis, it would have been easier to find suspected cases,” Dr Anoop said.
The respiratory infection in suspected Nipah patients this time have led to pneumonia and multi-organ failure, he said, adding that the count of white blood cells (leukocytes) and platelets are also low in the patients.
The doctor also suggested that people with symptoms of influenza remain in self-isolation.
Nipah has two strains, Malaysian and Bangladesh, he said. “In Kerala, we had reported the Bangladesh strain, which mainly causes human-to-human transmission of the virus,” he added.