Dr Kumar– director, critical care medicine, Aster, north Kerala cluster – and his team were alerted after an adult and three children from a family turned up with unusual clinical symptoms at Aster MIMS hospital on Sept 9-10.
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Nipah virus infection has resurfaced in Kozhikode district for the third time in the past five years, with tests conducted at National Institute of Virology, Pune confirming it in the death of a 40-year-old man, Mangalatt Haris of Ayanchery, on Monday as well as two relatives of a 49-year-old man,
While kids were admitted at paediatric wing, the adult was moved to pulmonology department.”Clustering of patients from a family sparked our first suspicion. When we looked at their medical history, we found that the father of the kids, aged 9 and 4 years, died on August 30 at another private hospital in Kozhikode with symptoms of pneumonia. We immediately contacted the hospital and learnt that though he was admitted with pneumonia, his condition worsened quickly leading to his death. He had tested negative for Covid and influenza,” said Dr Kumar.
Health minister Veena George speaks to media at the collectorate in Kozhikode on Tuesday
Later, when he spoke to the wife of the deceased, he found that the patient had symptoms like slurred speech, disorientation and diplopia (seeing two images) which were neurological symptoms. His nine-year-old son, who was admitted at Aster MIMS hospital with breathing difficulty, had a seizure and was put on ventilator support. That also raised suspicions as seizures were not a common symptom associated with pneumonia.
“All these factors led to a grave suspicion as the patients came from an area which was 10km away from Soopikada where the first case of 2018 was reported and preliminary lab test parameters gave an indication that it could be Nipah. Like 2018, our suspicion increased based on three factors: Unusual clinical symptoms, clustering and contact with an index case and the preliminary blood and other tests pointed to such a possibility,” he said.
Also, the hospital received another patient (a 40-year-old male) from Ayanchery panchayat on Monday. He was referred by a hospital in Vadakara with fever that progressed to difficulty in breathing by day three. He reached the emergency wing in a serious condition and even before treatment began, he died of cardiac arrest, said Dr Kumar.
“We found an unusual pattern in his disease progression different from pneumonia cases. We found that he had gone to a private hospital for his father’s treatment around the same time the first patient was present at the emergency wing of the hospital. We immediately accessed the discharge summary of the patient’s father, contacted the hospital and found that the first and second patients were there in the emergency wing from the night of Aug 28 till Aug 29 morning. We didn’t release his body and informed health department,” he said. Dr Kumar said his experience in identifying the first outbreak and witnessing symptoms and its progression in patients helped him this time.
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