As the health apparatus in Kerala is intensifying its efforts to contain a fourth episode of the Nipah infection in the State, Health Minister Veena George vouches for the effectiveness of the system to detect and treat such infectious diseases here. In an interview to A.S. Jayanth, she says a dedicated centre for disease control too will come up in the State.
Question: This is the fourth episode of a Nipah infection in Kerala, and third in Kozhikode. Many are wondering what could be the cause of the recurring instances of the infection here? We may say that the cases are detected because of the robust health infrastructure here, but why is the State government not doing enough to spot it before people die?
Answer: Kerala is not the only place or first place where this happened as it had earlier been reported more than once in West Bengal with fatalities. Kerala is among the States where the probability of the infection is high, as cited by the World Health Organisation.
In a scientific paper, published after the 2018 episode, the Indian Council of Medical Research (ICMR) had said the virus strain we have is something close to the Bangladeshi variant. From April-May up to September, the viral load in fruit-eating bats, the main carrier of the virus, will be higher. In the light of the previous episodes of the infection, a protocol for diagnosis is already in place. If someone has symptoms such as respiratory illness or encephalitis, the final doubt should be Nipah. Healthcare workers, from the ground-level staff to senior doctors, everyone has been trained in the past two years.
Also, after a lone Nipah case was reported in Kozhikode in 2021, the ICMR had set up a mobile lab at the Government Medical College Hospital here. The staff who came here trained the staff of our labs in Kozhikode, the National Institute of Virology lab at Alappuzha and the Institute of Advanced Virology lab at Thonnakkal, Thiruvananthapuram. Hundreds of body fluid samples of suspected patients with Nipah-like symptoms had been tested there. Some were sent to the National Institute of Virology, Pune. None of them were positive.
Question: A major criticism against the health system here is that it acts only when a crisis appears and forgets about it after the outbreak is contained. We are yet to have a permanent mechanism to effectively deal with such crises?
Answer: I don’t fully agree with that. Because we set up the lab facilities after the Nipah episodes. The health staff have been provided with a calendar on disease outbreaks. There is a plan to have a comprehensive treatment protocol for infectious diseases as well. Another major project in the pipeline is the Kerala Centre for Disease Control on the lines of the Centers for Disease Control and Prevention in the United States. It will have an Inter-Disciplinary Centre for Epidemic Forecasting and Mitigation.
Question: There has been a demand to set up a Public Health Directorate and a dedicated cadre to deal with public health emergencies such as this. Is the government taking any steps?
Answer: We have already decided to form a dedicated cadre and a directorate. One challenge is that we don’t have enough public health courses in Kerala. There is only one course under the Kerala University of Health Sciences now. We are planning to have more such courses. Also, more changes are expected when the Kerala Public Health Bill, 2021, which is under Governor’s consideration, comes into force.
Question: The Health department alone cannot tackle the outbreaks of diseases that are being reported now. Experts have suggested a multi-disciplinary approach involving departments such as Forests and Wildlife, Animal Husbandry, Local Self-Governments, and Agriculture. Any progress in that front?
Answer: We are planning to follow the ‘One Health’ idea and there is a Centre for One Health-Kerala. The Health department will lead from the front, coordinating with other departments. The State Health Systems Resource Centre is the nodal agency for the programme. The Public Health Act comes to the picture here. The District Medical Officer will be the convener the district public health authority and the Director of Health Services will head it at the State level.
Question: There was a plan to have a permanent Nipah isolation block at the Government Medical College Hospital, Kozhikode. But it could not be taken forward. What is its status now?
Answer: Administrative approval and technical sanction have been given for the project. Work on the block may start soon. Also, a BS level-III lab too will come up on the campus. The work is being taken up by the Central Public Works department. NIV is supposed to set up the facility and train the staff there.
