Kerala’s Tryst with the Nipah Virus

It was in 2018 that Kerala first had a Nipah virus outbreak. The state’s medical systems had never encountered the rare virus that has a high fatality rate and by the time it got its moorings, 17 people had died. Since then, the virus has kept returning at regular intervals but almost immediately gets picked out and the entire machinery swings into action. This time was no different.

On May 8, a 42-year-old woman from Malappuram district was confirmed to have contracted the disease. She had been admitted to hospital a week ago, first thought to have dengue and when the symptoms continued, doctors suspected Nipah and sent samples for testing. A positive result returned from the National Institute of Virology laboratory in Pune. Even before that, everyone who had been in contact with her—as many as 49 including family members and health workers—and could potentially have been infected were under observation. So far none, even those at high risk, have got the virus.

There has been an unusual element in the case this time. A cat of the patient was found dead. Nipah mainly spreads through fruit bats and in 2018 that was how the index patient had become infected. When he went to get treated, the nurse got it and the chain kept developing before isolation protocols involving the entire region contained the outbreak. It is not clear whether the cat had anything to do with it this time, though samples of it and other animals around the patient are being tested.

After 2018, Kerala has seen Nipah detections in 2019, 2021, 2023, 2024 and 2025, but it has never claimed more than two lives. Last year, there were two deaths, one in July and one in September. Both were also in Malappuram district. That also happens to be other interesting aspect of Nipah in Kerala. Except for one case in Kochi, all have been in Malappuram and neighbouring Kozhikode districts. This might be a reason why cases are caught early, because the health surveillance systems of these two districts are always on the alert for Nipah.

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