Towards global health security: response to the May 2018 Nipah virus outbreak linked to Pteropus bats in Kerala, India

The Union Minister of Health and Family Welfare, Government of India, immediately deployed a multidisciplinary team led by the director of the National Centre for Disease Control (NCDC), including NIV; the All India Institute of Medical Sciences; the Department of Animal Husbandry, Dairying & Fisheries; the Division of Emergency Medical Relief and Ram Manohar Lohia Hospital in New Delhi to provide technical support and work with the Government of Kerala to achieve containment, including active case detection, contact tracing and observation, treatment and management, IPC, safe disposal of human remains, and training and use of PPE by healthcare workers. Additionally, under the leadership of the Director of the NCDC, the Government of India activated the NCDC Strategic Health Operations Centre (SHOC) to monitor the outbreak and issue daily situation reports, including to the Minister of Health, to support nationwide crisis management. .3 The Nipah link with the Pteropus bats was confirmed and established by NIV/ICMR, with 19.2% (10/52) of the bats testing positive (real time real-time reverse transcription polymerase chain reaction (RT-PCR) for detecting NiV RNA; (figures 1 and 2). [...]Kerala’s state government approached the Queensland Department of Health in Australia to secure limited human monoclonal antibody m102.4 for treatment and postexposure prophylaxis of additional cases. While there are no licensed vaccines or therapeutics for NiV apart from intensive supportive measures, such as mechanical ventilation and prevention of secondary infections, the antibody has undergone a phase I clinical trial, and there is evidence of effectiveness in non-human primates.4 5 Ribavirin has been effective in treating other febrile illnesses, although its clinical usefulness in treating NiV is uncertain.3 The state and central teams and all partners’ collaborative efforts on timely diagnosis, real-time data sharing, sample transport and contact tracing were key to successfully containing the outbreak.