The Nipah virus has re-emerged in Kerala. An 18-year-old girl from Mankada, Malappuram, who died on July 1, tested positive for the deadly virus on Friday. Another woman from Thachanatukara, Palakkad, currently in critical condition, also tested positive. She is undergoing treatment at a private hospital in Perinthalmanna.

Both cases initially showed positive results at the Kozhikode Medical College Hospital, which were later confirmed by the Pune-based National Institute of Virology.

So what exactly is the Nipah virus and why does it keep resurfacing in Kerala?

What is the Nipah virus?
Nipah virus (NiV) is a highly fatal zoonotic virus—meaning it spreads from animals to humans—that causes severe brain inflammation (encephalitis) and respiratory distress. First identified in Malaysia in 1999, Nipah has since triggered several deadly outbreaks in South and Southeast Asia.

Kerala’s recurring battle with Nipah
Kerala has now recorded six known Nipah outbreaks, making it India’s most Nipah-affected state:

2018 (Kozhikode): Kerala's first outbreak, reported in Kozhikode’s Perambra, killed 17 people. This included nurse Lini Puthussery, who had treated the index patient before diagnosis. Fruit bats were identified as the likely source.

2019 (Kochi): A 23-year-old student tested positive. He later recovered and no further cases were reported.

2021 (Pazhur, Kozhikode): A 12-year-old boy died, triggering containment measures.

2023 (Kozhikode): Six cases and two deaths between August and September.

2024 (Malappuram): A 14-year-old boy from Pandikkad died in July; another 24-year-old student died in September.

2025: In May, a 42-year-old woman from Valanchery in Malappuram district tested positive for the disease. In July, were reported in the state. The young woman from Malappuram died, while the patient from Palakkad remains under treatment.

Has Nipah affected other parts of India?
Yes. West Bengal reported two major outbreaks:

• 2001 (Siliguri): 66 cases, 45 deaths
• 2007 (Nadia): 5 fatalities

These outbreaks were linked to human-to-human transmission and close contact with infected patients, especially in hospital settings.

How does Nipah virus spread?
Nipah is carried by fruit bats (flying foxes) and can spread:

• Directly from bats to humans (via saliva, urine or contaminated fruits and sap)
• From infected animals (like pigs)
• From human to human through close contact with bodily fluids or contaminated surfaces

Symptoms of Nipah virus
Fever, headache, muscle pain, sore throat, vomiting, dizziness, drowsiness, altered consciousness, seizures, coma, encephalitis.

Containment efforts in 2025
After confirmation of the latest cases, 345 people are on the contact list - Malappuram: 211, Palakkad: 91, Kozhikode: 43 (all healthcare workers)

Containment zones declared
Malappuram: Wards in Makkaraparambu, Koottilangadi, Mankada, and Kuruv
Palakkad: Wards in Thachanatukara and Karimpuzha

Public health actions:

• Mask-wearing is now mandatory in containment areas
• A special isolation ward has been set up in KHRWS block, Kozhikode Medical College
• 26 response committees are active across the three districts
• Control rooms set up at state and district levels
• Kozhikode helpline: 0495-2373903
• Authorities are also investigating recent deaths from pneumonia or encephalitis, and tracing the travel history of the Palakkad patient.

Other preventive measures

• No cure or vaccine currently exists
• Avoid eating half-eaten fruits or raw date palm sap
• Don’t attempt to drive away bats using fire or explosives
• Maintain hygiene, report symptoms early, and follow public advisories

Why it matters
Nipah virus has a fatality rate of up to 75%, spreads silently, and has epidemic potential. In a densely populated and highly mobile region like Kerala, repeated outbreaks test the limits of the state's healthcare preparedness, contact-tracing capability, and public health awareness.