Efforts are also underway to procure the cell line which Australia used to develop the antibody. Once ICMR gets the cell line, India can start manufacturing it.
The antibody to fight the Nipah Virus will reach India on Thursday night, Rajeev Sadanandan, Additional Chief Secretary, Health and Family Welfare, Government of Kerala, has confirmed to TNM. He added that the package from the University of Queensland will first reach Delhi, from where it will be brought to Kerala.
The Human Monoclonal Antibody (M 102.4) is a non-patented drug, developed by Dr Christopher C Broder from Australia. The antibody is still referred by a number and not a name as clinical trials are yet to be completed. This is an antibody and not a vaccine, which can neutralise the effects of the Nipah Virus. It has been found to be effective in vitro (in cells or microorganisms placed in a test tube or culture dish). Reports say it has not been tested on humans so far but can be used on compassionate grounds.
For the last few days, the Kerala State Health Department and Indian Council of Medical Research (ICMR) had been trying to procure it through the WHO.
Efforts are also underway to procure the cell line which Australia had used to develop the antibody. Once the ICMR gets the cell line, India can start manufacturing the antibodies.
With the arrival of the antibody, there is much hope for those who are under critical care due to the Nipah Virus.
Regarding the current death toll and suspected cases, Kozhikode District Medical Officer Dr Jayasree told TNM, “Of the 17 confirmed cases of Nipah, so far 15 deaths have occurred. This number does not reflect Sadik’s death. Two confirmed cases have been under treatment. As of May 30, the suspected cases stands at 8.”
Mohammad Sadik was the first person who died of Nipah virus infection in Kerala. However, it could not be ascertained because samples were not collected from him. Only an epidemiological link could be established later to his sick family members whose samples were collected and confirmed to have the virus.
Incubation period and disease transmission
Experts say the mean incubation period of Nipah Virus is around 10 days. The mean falls within a range. The outer range is 18 days. The first incidence of infection took place around May 1. Other cases were noticed on May 17. So what can be assumed is that by 18,19 May, if all precautions had been taken, then by June 5, infected cases, if any, should come to light. But this does not apply if there are secondary or tertiary transmissions.
Rajeev Sadanandan added, “If we don’t have a third wave of infection, then it can be said that the danger is over by June 5”
Dr Arun Kumar, Head of the Manipal Centre for Virus Research (MCVR), said, “In case of Nipah, only when the patient becomes very sick, they will be transmitting the disease. The transmission is primarily through droplet transmission. It is in the later stages of the illness that the patients develop cough. That is a time, transmission can happen. Cough generates droplets and droplets can transmit only within a 1 meter distance.”
He elaborated, “So the people who cared for the infected patients, they will definitely be within 1 meter and they have contracted the disease. This is against the people at home or when the patient was less sick. Which is why some of the family members or the people who were in close contact in the initial stage of the disease, have been spared from contracting the virus. That is why we don’t see clusters around these cases in the community.”
He also highlighted that a link has been established, that every single confirmed case so far have had contact with the indexed patients in two different places viz at the Perambra Taluk Hospital and at the Kozhikode Medical College.
To much relief, it was confirmed on Tuesday that the two children of nurse Lini Puthusshery do not have Nipah infection. Lini Puthusshery, a nurse from the EMS Memorial Cooperative hospital at Perambra who had attended to Sadik, succumbed to the infection and passed away on May 21. Since last few days, the children had been put under observation. Now with results out, the possibilities have been ruled out.
Dr Arun stressed on vigilance and said, “The vigilance will continue. From the last reported case to 42 days we will keep up the vigilance. We don’t want to miss a single case. Because if we miss a single case, that will lead to another hospital outbreak. If suspected cases go for treatment at a place where the staff does not expect Nipah, then it can transmit there. We don’t want that to happen. Right now, no secondary transmission has happened. All are primary transmission.”
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