Nipah outbreak in Kozhikode: Miraculous return of 9-year-old to life, low mortality rate stand out

Kozhikode: When Nipah first hit Kerala in 2018, the state had two major worries: the high death rate in previous outbreaks and the lack of a specific drug or vaccine. Intensive care is required for all patients, and if the outbreak is not contained immediately, it can overwhelm the healthcare system.

In the 2018 outbreak, 18 people (excluding the index patient) tested positive for Nipah, and 16 succumbed to the virus, resulting in a death rate of 89%. Only two patients recovered.

In the 2019 Kochi outbreak, only one person was infected and recovered. However, in the 2021 Kozhikode outbreak, a 12-year-old boy succumbed to the virus, but there were no other cases reported.

In the fourth outbreak in the state, there were six total cases and two deaths, resulting in a recovery rate of 33%.

Boy returns to life

What stands out in this outbreak is the recovery of the nine-year-old boy who was on a ventilator for days. Medical experts say that recovery of such Nipah patients is uncommon, if not the first time in the world.

The nine-year-old boy was admitted to Aster Mims Hospital on September 9 with symptoms of fever, shortness of breath, and low oxygen levels in the blood. The boy's condition was extremely critical, and he experienced a number of complications, including seizures and a brain infection.

Dr. EK Suresh Kumar, Head of Pediatrics at Aster Mims Hospital, said that the boy's treatment was challenging, but that the team was determined to save his life. Dr Satheesh Kumar of Pediatric Critical Care also joined the team.

The child was the son of Mohammed Ali, a native of Maruthonkara, who died on August 30. Ali was the index case. The second death was on September 11.

The child was isolated in the ICU when admitted on the night of September 9.

On Sunday, the child's four-year-old sister and the mother's brother were also admitted to the isolation ward with similar symptoms, indicating a serious issue.

Dr. Sajith at a private clinic in Kuttiadi, who initially treated the boy, raised concerns about a potentially dangerous virus when he spoke to Dr Suresh. He had also informed about the pneumonia condition of the child's father who passed away recently and also that some other family members also showed the symptoms.

Upon alerting the health department, government authorities began monitoring.

Though the child initially showed improvement, the condition worsened on September 11 when it suffered a seizure. The child stopped breathing, and oxygen was supplied by a hand pump. The child was then transferred to a ventilator.

Health department sources in Kuttiadi revealed that Muhammadali, the child's father, had exhibited signs of brain fever shortly before his death. The confirmation of Nipah results arrived late at night from Kozhikode Medical College.

An MRI scan confirmed that the child's brain was infected. Later, analysis revealed that the brain stem, an important part that controls breathing and other functions, was damaged.

The child had repeated seizures. However, the boy responded to medicines. He was taken out of the ventilator days later when he started to breathe on his own. He was discharged after he started to take food through his mouth and walk.

As many as 11 nurses took care of the boy, with two people on one shift. Due to Nipah protocol, family members could not take care of him while in hospital. His mother spoke to health minister Veena George when he was admitted. The minister assured his mother that the boy would return home safe. And he did so, on Saturday, 21 days after he was admitted to Mims hospital.