Dr Abin Thomas, Research Fellow The first Nipah outbreak, caused by a brain-damaging virus, in Kerala in May 2018 exposed one of the contemporary challenges for global health: How do we deal with complex infections at the level of multispecies and its surroundings? By taking this example, I want to focus on the movement of the virus,[1] people and food to show the need for multidisciplinary approaches to understanding what the WHO terms as ‘emerging zoonoses.’ The virus on the move: On 17 May 2018, an architect, in his late 20s, was admitted to a local hospital in Kozhikode with fever and vomiting. The doctors suspected it as encephalitis. This patient’s brother had died 12 days before after showing similar symptoms. The laboratory tests at the Manipal Centre for Virus Research diagnosed it as Nipah infection. It claimed 17 lives in total. In the public discussion about the movement of virus, fruit bats were seen as its natural hosts. People on the move: One of the public health responses was the isolation of cases. However, the movement of people threatened further spread of the virus. The media carried stories about domestic travellers getting admitted to hospitals with symptoms that looked similar to that of Nipah. The UAE Ministry of Health and Prevention issued a warning about travelling to Kerala. The tourism sector in Kerala took a hit as tourists cancelled their bookings. Migrant Keralite labourers from the Gulf region could not visit their families during Ramadan. Weddings were postponed and local shops remained closed in Kozhikode. Food on the move: UAE and Qatar temporarily banned the import of fruits and vegetables from Kerala as a precautionary measure. The rumours about the zoonotic origin of the outbreak badly affected food markets within Kerala. The fruit sellers lost their regular income. Their sales in the state decreased drastically, especially in the district of Kozhikode, where the virus first emerged. The Health Minister of the state warned people against spreading wrong information about the association between Nipah and fresh chicken on social media. In addition, reports about fruit bat culling on Facebook complicated the situation further. When we look at these three movements, it becomes clear that pandemic preparedness and response cannot be limited to scientific and technological expertise. The multilevel interactions manifested in Nipah outbreak demonstrate the need for multidisciplinary approaches to study these crises and intervene upon them. The One Health Approach advocated by the WHO takes ‘food safety, the control of zoonoses… and combating antibiotic resistance’ into account when posed with issues like the Nipah. A place like the Global Academy of Agriculture and Food Security offers exciting opportunities to examine these questions. [1] The scope of this piece is limited. Nipah (and many other viruses) has always existed among bats (or other animals) in Kerala and other places. I acknowledge that a zoonotic transmission from animal to human requires a confluence of factors.
