Nipah virus: Anatomy of an outbreak

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Nipah virus: Anatomy of an outbreak

At around 2 a.m. on May 17 morning, a grievously sick Mohammed Salih, a 28-year-old architect from Kerala’s Perambra town, was rushed by his family to Kozhikode’s Baby Memorial Hospital. Salih was vomiting, had a high fever, and was in a mentally agitated state. The doctor on call, critical care physician A.S. Anoop Kumar, knew these symptoms meant encephalitis, an inflammation of brain tissue that kills hundreds in India every year. Kumar tried to stabilise Salih, but by around 9 a.m., when the hospital’s neurologists came to examine him, it was obvious that something was very wrong.

Even though Salih was receiving top-end care, his condition was worsening rapidly. He had some very peculiar symptoms, recalls Chellenton Jayakrishnan, one of the neurologists who treated him. His heart was racing at over 180 beats per minute and his blood pressure had shot up. His limbs were limp, displaying no reflexes. These symptoms were unlike any encephalitis cases that the team had ever seen. Jayakrishnan and his colleagues ruled out, one by one, dozens of common causes of encephalitis. Salih couldn’t have Japanese encephalitis. The mosquito-borne infection typically doesn’t affect more than one person in a household, and his younger brother, Sabith, had died about 12 days ago after showing similar symptoms. His father and aunt, too, had contracted the infection.

Rabies, another possible cause of encephalitis, was ruled out too. “If the family had been exposed through a common pet, they would have fallen sick at the same time,” says Jayakrishnan. Salih had fallen sick days after Sabith did. So, was this a case of poisoning? The team ruled this out, too. Toxins could trigger encephalitis-like symptoms but were usually not accompanied by fever.

(Except for the headline, this story has not been edited by Daily Report and is published from a The Hindu.)


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