India has reached out to Australia seeking to restock monoclonal antibody doses to combat the Nipah virus and is expecting 20 more doses soon, Indian Council of Medical Research (ICMR) head Dr. Rajiv Bahl said on Friday. He added that the monoclonal antibody has passed the phase-one trial and has been administered to 14 persons globally till now.
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Stating that the aim as of now is to ensure that the Nipah virus is contained as fast as possible, he added that aggressive contact tracking is underway.
“The mortality among the infected is very high in Nipah — between 40% and 70% — compared to the mortality in COVID, which was 2% to 3%,” Dr. Bahl said, addressing a press conference. He asserted that all efforts are on to contain the spread of the virus in Kerala and noted that all patients, so far, are contacts of an index patient.
Deadly outbreak
Kerala is currently battling its fourth outbreak of the deadly virus. Two persons have died due to the virus while it has infected at least five others in the Kozhikode district. Several villages have been declared containment zones, and close to 1,000 contacts have been identified, of which over 200 are considered “high risk”.
Speaking about administering the antibody to patients, Dr. Bahl said that the final decision to use this antibody lay with the State government, the patient and the doctor administering treatment.
“ICMR is only making the antibody available for a virus that is known to have a high mortality rate,” he said, adding that none of the 14 people who have used the monoclonal antibody so far had died due to the virus.
Developed in the United States, the antibody was shared with an Australian university as part of a tech-transfer initiative. India got some doses of monoclonal antibodies from Australia in 2018. Currently, doses are available for only 10 patients, explained Dr. Bahl.
‘No authorised treatment’
Confirming that no one in India has so far administered the antibody, he said that it has to be administered in the early stage of the infection.
“Made available to India for compassionate use, the antibody is not a treatment. There is no authorised treatment for Nipah. The phase-1 of the trial for this antibody was completed and thereafter no opportunity presented itself to take the research forward. So far the information available with us is that it is safe but we can’t say that this is effective. Having said that, what is also true is the fact that if it helps the citizens in any way we will make it available for use,” said Dr. Bahl.
The monoclonal antibody is used in Australia for the Hendra virus, which is a bat-borne virus that is associated with a highly fatal infection in horses and humans. Numerous disease outbreaks in Australia among horses have been caused by Hendra Virus. Two doses of the antibody have to be given per person, the ICMR head explained.
‘Follow COVID precautions’
Asked why Kerala is facing a repeated outbreak of Nipah, he said that the exact reason was still being worked out. “In 2018, we found the outbreak in Kerala was related to bats, but we were not able to understand the exact pathway on how it got transferred from bats to humans. What we know is that it happens during a particular season. Again we are trying to find the pathway this time,” he said.
ICMR also said that while the standard operating protocols for treatment and handling of patients are in place, adequate precautions have to be followed to contain the spread of the virus. “Most of the COVID precautions like wearing a mask, washing hands and maintaining proper hygiene, avoiding contact with an infected person should be followed,” Dr. Bahl said.
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