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Nipah in Kerala: How to identify symptoms, protect yourself 

Nipah in Kerala: How to identify symptoms, protect yourself 

Experts suggest following strict guidelines such as practising hand hygiene regularly, wearing masks and gloves while dealing with sick persons to prevent the infection

As Kerala grapples with another Nipah outbreak, local health authorities have sounded the alarm and declared the affected areas as containment zones while issuing a set of guidelines for the public to follow.

As two more cases of Nipah virus were confirmed in Kerala’s Kozhikode district on Monday night, taking the total number of cases to four, a high alert has been sounded by local health authorities.

In a press briefing on Monday, Veena George, Kerala’s minister for health, woman and child development said that a 44-year-old man, who died at a private hospital in the district on August 30 after experiencing pneumonia-like symptoms, has been considered as the index case during this outbreak.

The man was initially suspected to have died of liver cirrhosis. However, his 25-year-old brother-in-law and nine-year-old son have now both tested positive for the virus and are currently under treatment. The results also confirmed that a 40-year-old man who died on September 11, 2023, had succumbed to the Nipah virus.

As part of surveillance, around 168 contacts of the two deceased persons have been identified. 

While a central team from New Delhi has already been sent to Kerala to take stock of the situation, a team of epidemiologists from Chennai and a team of experts from National Institute of Virology, Pune is also on their way to the state.

Containment zones declared; travel prohibited

Late on Monday night, local health authorities declared containment zones in Ayancheri, Maruthonkara, Thiruvallur, Kuttiadi, Kayakodi, Vilyapilli and Kavilumpara gram panchayats, prohibiting travel in and out of these areas with strict barricading.

The district collector, in a Facebook post, said that only outlets selling essentials (food, medicines) are allowed to stay open in these areas, from 7am to 5pm. “There is no time limit for pharmacies and other health centres,” she added.

How to protect yourself from Nipah

Social distancing and use of masks have been made mandatory in the containment zones.

Local authorities have issued a set of guidelines for the public to follow. Those with symptoms have been advised to not self-medicate and to contact the Nipah control room and follow their instructions while making sure to isolate themselves. Authorities have also advised the public to avoid eating fruits and vegetables that appear to be ‘bitten, broken or scratched by birds’ and toddy and other drinks that have been collected in the open and consuming things from uncovered pots.

“Water sources are to be protected from any bird droppings, urine or other pet secretions,” the instructions read.

Additionally, people are advised to avoid contact with excreta of pets and to be careful around those with symptoms. “Do not visit or treat sick people without safety measures. Do not handle utensils or clothes used by the patients in a careless manner.  People who take care of the patients must use masks and gloves,” the authorities have mentioned.

Nipah infection: From fever to seizures

What are some symptoms of Nipah infection?

Dr Sheela Mathew, former professor and head of the infectious diseases department, Kozhikode Medical College, Kerala, says “Nipah virus usually spreads from contaminated food or from person to person. Rarely, it can also transmit from animals like pigs to humans.”

“There are different ways in which a Nipah infection will present symptoms. People will experience differing symptoms and some people may not even have symptoms,” says Dr Mathew while pointing to a serosurvey that was conducted in Kerala which revealed that the 2018 Nipah outbreak generated asymptomatic cases of the infection.

“However,” says Dr Mathew, adding “typically, some of the first few symptoms that one may experience include fever, severe body pain and headaches.”

She says that in some cases, these symptoms can progress to acute respiratory infection during which one may experience severe cough, breathing difficulties and drop in oxygen levels while in some other cases lead to a severe brain infection.

“Some people may also experience an altered mental state where they may not be able to recognize people, may have panic attacks, feel drowsy etc. A few have reported experiencing seizures and muscle jerks. In some cases, it can affect the heart and cause a high pulse rate, drop in BP levels etc,” says Dr Mathew.

Hand hygiene is the key

Dr Mathew explains that since Nipah virus is an ‘enveloped virus,’ which means that it has an outer lipid membrane, it can be destroyed by using soap and water or an alcohol-based hand sanitizer.

Hand hygiene is hence the key,” she says, while adding that other precautions such as wearing masks in public, avoiding visits to the hospital and staying away from contaminated food must also be followed. 


Post the latest Nipah outbreak in Kozhikode, Kerala, authorities have issued instructions to the public to follow. These include wearing masks in public, using protective gears while caring for sick patients, strictly practising hand hygiene, avoiding consumption of fruits and veggies that appear to be contaminated or ‘bitten, broken, or scratched by birds’ and ensuring that the water sources like well are protected from any kind of bird droppings, urine or excretions. 

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