That evening of May 19 is still etched in the memory of K.P. Sooraj, professor, Institute of Chest Diseases (ICD) in Kozhikode. Their first Nipah patient, a nurse who attended to an early victim, was taken to the hospital on that day.
“She was admitted around 5 p.m. Two more with similar symptoms followed her in the next seven hours,” he said. For the staff of the ICD, the Nipah outbreak was a medical emergency they had not expected. All the patients needing intensive care were treated there. A fortnight later, the last of their patients is on the way to recovery.
Refurbishment works were going on at the ICD, attached to the Government Medical College Hospital, Kozhikode, when the inflow of patients with Nipah symptoms began. There was only one patient at the Intensive Care Unit (ICU) and he could easily be shifted to another ward. “Fast deterioration in condition of patients was the most discernible aspect of the viral infection. At the time of admission, they would have only fever and altered behaviour. Within hours, they would develop respiratory problems and cardiac complications,” T.P. Rajagopal, Head of the Department, says.
“We were told to be ready to face any eventuality by the higher authorities. Though the cause of the infection was yet to be proved in the initial days, we could assume what it was and provided the best available supportive treatment,” Dr. Rajagopal, says. Only those who needed intensive care were admitted to the ICD, which worked like a centralised ICU.
All the staff were immediately trained in the use of personal protection equipment (PPE) and in observing treatment protocol. It was followed by two more rounds of training by teams from the National Centre for Disease Control (NCDC) and the All-India Institute of Medical Sciences (AIIMS).
“The only time something similar had happened was during the H1N1 outbreak. All of us almost worked round-the-clock,” Dr. Sooraj says. Once the outbreak was confirmed, staff were told that they would not be granted leave till it subsided. Family members were discouraged from visiting patients. The practice of caregivers remaining in proximity of the patients too was discouraged and the hospital staff themselves assumed that role.
A few were allowed to enter the ward only after ensuring that they wore the PPE and followed the guidelines. Eight people were admitted to the ICD, of which five tested positive for Nipah infection. One survived. “It was really tough spending time in the ward wearing those equipment. Looking back, our collective effort has paid off. One patient is on the path of recovery and has been shifted to the Medical College Hospital,” says Dr. Rajagopal.