The West Bengal health and family welfare department has released guidelines on the transmission of the Nipah virus and the necessary precautions to be taken, days after two nurses tested positive for the virus. A five-member medical team from the state health department prepared the advisory for patients infected with Nipah or showing symptoms, as well as for their caregivers and health workers.
What the guidelines say
Anyone who has come into contact with the blood, fluids, saliva, sneeze or cough droplets, etc. of a patient infected with Nipah or is showing symptoms will be required to undergo a mandatory 21-day home quarantine, as per the guidelines issued on Wednesday.
The state health department has described spending time in a closed, confined space with a patient infected with Nipah or showing symptoms of Nipah as ‘high risk’ in its guidelines. In addition, the person will have to be checked twice a day while in home quarantine.
If symptoms are detected, the person in home quarantine will have to be admitted to the hospital immediately. The person will have to be kept in the isolation ward, as per the guidelines.
Similarly, anyone who comes into contact with the clothes of a patient infected with Nipah or with Nipah symptoms or comes into contact with the patient will be kept under observation for 21 days. Health department officials will call the affected person every day to check on his or her health. If the person shows symptoms, he or she will be taken to the hospital immediately.
In addition, the guidelines state that caregivers of patients infected with Nipah or showing symptoms must use adequate protective measures. The state health department has directed individuals without symptoms to take a specific antiviral medication as a precautionary measure. Those who develop symptoms, however, must be admitted to a hospital. Since no definitive treatment for Nipah infection exists, two alternative antiviral drugs will have to be used experimentally on such patients, the guidelines add.
What guidelines for testing say
The state health department has also directed that suspected samples be sent for an RT-PCR test immediately. The guidelines state that the medication will be stopped only if the test report is negative at least twice in a day; otherwise, treatment will continue. If any health worker comes in contact with such a patient but is asymptomatic, the health worker can continue working with personal protection like masks and PPE kits, and does not need to be under quarantine.
The health department has asked health workers to take a special antiviral drug for two weeks to prevent getting infected with the Nipah virus. The guidelines also state that critical care specialists and neurologists will be responsible for patients infected with Nipah or with Nipah symptoms.
Patients who test positive for Nipah will have their samples tested every five days. If separate reports of the three samples—saliva, urine and blood—return negative twice within a day, the patient will be discharged from the hospital. The state health department has also directed that discharged patients be kept under observation for 90 days.