NCDC guidelines

"Currently NCDC's definition of suspected Nipah cases is very narrow," says Randeep. As per NCDC's guidelines, as of now, a suspected Nipah case is only a person from the affected community in Kozhikode who develops symptoms such as fever with headache, cough or shortness of breath, altered mental status or seizure. Nipah cases tend to occur in a cluster or as an outbreak, says the NCDC document. 

Case fatality rate is estimated to be 40-75 per cent, but can go even up to 100 per cent. Drinking contaminated raw date palm sap and close physical contact with an infected person or animal are the two routes of transmission identified. 

"The transmission rate is high in the primary spread from bats to humans. But it's low in the secondary transmission from humans to humans," Randeep said. 

Since Nipah virus is classified as a biosecurity level-4 (BSL-4) agent, all samples should be sent to the National Institute of Virology, Pune, which is the designated testing lab, the guidelines say.

The guidelines specify how health staff should collect samples, take the person's medical history, etc.

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