The Nipah Test: The Hindu Editorial
The outbreak of the deadly Nipah virus around Kozhikode, Kerala, is a test of India’s capacity to respond to public health emergencies. In 2018, the World Health Organisation listed Nipah as one of the 10 priority pathogens needing urgent research, given its ability to trigger lethal outbreaks and the lack of drugs available against it. As an RNA (ribonucleic acid) virus, Nipah has an exceptional rate of mutation — that is, it can easily adapt to spread more efficiently among humans than it does now. Such an adaptation would result in a truly dangerous microbe.
Nipah already kills up to 70% of those it infects, through a mix of symptoms that include encephalitis, a brain inflammation marked by a coma state, disorientation, and long-lasting after-effects, such as convulsions, in those who survive. Thankfully, in most outbreaks in South Asia so far, the virus has displayed a “stuttering chain of transmission”. This means that once the virus spreads from fruit bats, its natural reservoir, to humans, it moves mainly to people in close contact with patients, such as hospital staff and family caregivers.
But these caregivers are at high risk, because the sicker the patients become, the more virus they secrete. Preliminary reports suggest that the Kozhikode outbreak is also displaying a stuttering chain of transmission. Of the 11 confirmed Nipah fatalities, three were from the same family. While researchers are still investigating how they were exposed, a bat colony living in a well in the family’s yard is a strong suspect.
This fits in with how outbreaks have historically begun in the subcontinent. In a 2007 outbreak in Nadia, West Bengal, for example, patient zero is believed to have acquired the virus from palm liquor contaminated by bat droppings. The next wave of infections has historically occurred among close contacts and caregivers, such as nurses; the same pattern has been detected in Kozhikode as well.
But these are preliminary reports, and new information may change what we know about the present virus. Several patients with symptoms of infection are under observation. Only when clinical investigations are complete can it be determined how contagious the virus really is. If it is found travelling over long distances, the authorities will have to be ready with strategies to combat its spread. The good news is that Kerala’s public health systems have acted with extraordinary efficiency so far. Doctors identified the virus in the very second patient, a diagnostic speed unrivalled in developing countries.
This must be commended. But big challenges remain. The death of a nurse shows that health-care workers may not be taking adequate precautions when dealing with patients, by using masks and following a strict hand-wash regimen. The virus has no specific treatment. The best defences against it are the age-old principles of infection control, which Indian hospitals have not mastered as yet.
LEARN VOCABULARY FROM THE HINDU EDITORIAL
1) Outbreak
Meaning: A sudden occurrence of something unwelcome, such as war or disease.
Example: “The outbreak of World War II”
Synonyms: Eruption, Flare-up.
2) Lethal
Meaning: Sufficient to cause death.
Example: “A lethal cocktail of drink and pills”
3) Mutation
Meaning: The changing of the structure of a gene, resulting in a variant form which may be transmitted to subsequent generations, caused by the alteration of single base units in DNA, or the deletion, insertion, or rearrangement of larger sections of genes or chromosomes.
Example: “Mutation is, ultimately, the only way in which new variation enters the species”
Synonyms: Alteration, Change.
4) Encephalitis
Meaning: Inflammation of the brain, caused by infection or an allergic reaction.
5) Inflammation
Meaning: A localized physical condition in which part of the body becomes reddened, swollen, hot, and often painful, especially as a reaction to injury or infection.
Example: “Steroid injections can have a dramatic effect in reducing inflammation and relieving pain”
Synonyms: swelling, Puffiness.
6) After-effect
Meaning: An effect that follows after the primary action of something.
Example: “He was suffering the after-effects of the drug”
Synonyms: Repercussion, Aftermath.
7) Convulsion
Meaning: A sudden, violent, irregular movement of the body, caused by involuntary contraction of muscles and associated especially with brain disorders such as epilepsy, the presence of certain toxins or other agents in the blood, or fever in children.
Example: “Toxic side effects like convulsions”
Synonyms: Fit, Seizure.
8) Stutter
Meaning: Talk with continued involuntary repetition of sounds, especially initial consonants.
Example: “The child was stuttering in fright”
Synonyms: Stammer, Stumble.
9) Reservoir
Meaning: A population, tissue, etc. which is chronically infested with the causative agent of a disease and can act as a source of further infection.
Example: “There is a vast reservoir of herpes infection in the community”
10) Suspect
Meaning: Have an idea or impression of the existence, presence, or truth of (something) without certain proof.
Example: “If you suspect a gas leak, do not turn on an electric light”
Synonyms: Have a suspicion, Have a feeling.
11) Contaminate
Meaning: Make (something) impure by exposure to or addition of a poisonous or polluting substance.
Example: “The site was found to be contaminated by radioactivity”
Synonyms: Pollute, Adulterate.
12) Droppings
Meaning: The excrement of certain animals, such as rodents, sheep, birds, and insects.
Example: “Rat droppings”
Synonyms: Excrement, Excreta.
13) Contagious
Meaning: (Of a disease) spread from one person or organism to another, typically by direct contact.
Example: “A contagious disease”
Synonyms: Infectious, Communicable.
14) Combat
Meaning: Take action to reduce or prevent (something bad or undesirable).
Example: “An effort to combat drug trafficking”
Synonyms: Fight, Battle against.
15) Unrivalled
Meaning: Better than everyone or everything of the same type.
Example: “The paper’s coverage of foreign news is unrivalled”
Synonyms: Unequalled, Without equal.
16) Commend
Meaning: Praise formally or officially.
Example: “He was commended by the judge for his courageous actions”
Synonyms: Praise, Compliment.
17) Precaution
Meaning: A measure taken in advance to prevent something dangerous, unpleasant, or inconvenient from happening.
Example: “He had taken the precaution of seeking legal advice”
Synonyms: Safeguard, Preventative/preventive measure.
18) Regimen
Meaning: A prescribed course of medical treatment, diet, or exercise for the promotion or restoration of health.
Example: “A regimen of one or two injections per day”
