Nipah : These Doctors are the real Heroes
17 lives, Their happiness. Their dreams.
That’s what Nipah snatched from the people of Kerala. But the happy news is no new Nipah cases has been reported since May 17. All the credit goes to the doctors who took initiative in identifying the virus as soon as possible. This has helped save lives and earned Kerala the appreciation of the World Health Organization.
Dr.Anoop Kumar, Dr.Jayakrishnan, Dr.Arun Kumar. Image credits: Manorama.
When a feverish 28-year old Muhammad Salih was admitted to Baby Memorial Hospital, Kozhikode on May 17, no one knew it was the start of an epidemic. The team of doctors who took charge of his case doubted his symptoms as acute encephalitis. But usually, in patients with acute encephalitis, their blood pressure and heartbeat go down. But in his case, the blood pressure was fluctuating, his heartbeat was irregular and he was sweating copiously.
Dr. A.S. Anoopkumar, critical care specialist at the hospital knew that there is something unusual in this case. Dr. Ajith.k.Gopan and Dr. G.Gangaprasad were the first two who attended the patient. They took the MRI scan and tested the spinal fluid. But they couldn’t find anything unusual. That is when Dr.Jayakrishnan, from neurology department of Baby Memorial Hospital, remembers about a topic he read about recently. As it turned out, Jayakrishnan had read a book about various types of encephalitis. No symptoms of the patient were matching with the common encephalitis diseases. Also, Sabith, Salih’s brother has already succumbed to similar symptoms just a week ago and their father and aunt had contracted the infection too. So Dr.Jayakrishnan concluded that the patient had a rare condition. Kerala has had never reported a Nipah case before. But Dr.Jayakrishnan has already read about the Nipah virus in the book just a month before and the patient showed all the clinical symptoms of the Nipah virus infection. That is when the team, on May 18, decided to send the samples of cerebral spinal fluid, secretion from the throat, blood and urine samples to the Manipal Center for Virus Research(MCVR).
Usually, it takes two days to courier the samples to Manipal Institute, which is 300 km away from Kozhikode. But in this case, quick identification of virus was essential. Without much time left to wait, the team convinced Salih’s relatives to take the samples to Manipal immediately. They agreed and took the samples to Manipal. When the samples arrived there, Dr. G Arun Kumar, the head of the virology department, who has a history of investigating several mystery outbreaks, doubted it as Nipah. He took the samples of Salih for a test called Real-Time Polymerase Chain Reaction (RT-PCR), which detects viral genetic material and unofficially confirmed the pathogen to be Nipah by the evening. Since it is a highly contagious disease, the samples were sent to Pune National Virology Institute and they officially confirmed the presence of the virus on May 20. But by the time the result came, Salih passed away. Also, his aunt Mariam and father Moosa who began to show similar symptoms too passed away on May 19 and May 24 respectively. The virus has claimed 17 lives till now.
Still, the collective effort of the doctors has contributed in detecting Nipah and nipping it in the bud. This has helped the state health department in taking measures to isolate others suspected of carrying the virus, thus reducing the infected numbers. While Bangladesh took 3 years to confirm the virus, it took only 48 hours for Kerala to identify the virus. Thanks to the collective effort of the doctors.
Really commendable and very critical clinical diagnosis these doctors have made. The very famous dictum in Pathology that “the eyes will see only what the mind know”. So since the doctors were aware of Nipa encephalitis they could make the correct diagnosis. Congratulations to the Doctors of Baby Memorial Hospital, calicut