Epidemics that weren’t: How countries shut down recent outbreaks

In the state of Kerala in southern India, Dr. Chandni Sajeevan, the chief of emergency medicine at Kozhikode Government Medical College Hospital, led the response to an outbreak of Nipah, a fruit bat-borne virus, in 2018. Seventeen of the 18 infected died, including a young trainee nurse who she took care of the first victims.

“It was something very scary,” said Dr. Said Chani. Hospital staff were given a crash course in intensive infection control and donned the ‘moon suits’ that seemed so alien in the pre-Covid era. The nurses were devastated at the loss of their colleague.

Three years later, in 2021, Dr. Chandni and her team were relieved when the bat breeding season passed without any infections. And then in May, deep in India’s terrible Covid wave, a 12-year-old boy was taken to a clinic by his parents with a high fever. That clinic was full so he was sent to the next one and then a third where he tested negative for Covid.

But an attentive doctor noticed that the child had developed encephalitis. He sent a sample to the national virology laboratory. It was quickly confirmed that this was a new case of the Nipah virus. By then, the child could have exposed several hundred people, including dozens of health workers.

The system dr. Chandni and her colleagues had set up after the outbreak got underway in 2018: isolation centers, moon suits that test anyone with a fever for Nipah and Covid. She held daily news briefings to quell rumors and keep the public on the lookout for people who might be sick – and away from bats and their droppings, which litter coconut groves where children play. Teams were sent out to capture bats for surveillance. Anyone exposed to the sick boy was placed in 21-day quarantine.

“Everyone, ambulance drivers, elevator operators, security guards — this time they knew about Nipah and how to behave not to spread it,” she said.

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