Kerala Gains Approval to Use Truenat Tests for Nipah Virus Surveillance

Truenat tests, now accessible locally, eliminate the need to send Nipah-positive samples to Thiruvananthapuram, Thonnakkal, or Kozhikode labs for reconfirmation. This streamlined process accelerates testing, outbreak identification, and preventive measures.

In a recent development to bolster Kerala's healthcare efforts in battling the Nipah virus outbreak in the Kozhikode district, the Indian Council for Medical Research (ICMR) has granted permission for the state to conduct Truenat tests. These tests utilise portable, smart chip-based, battery-operated Reverse Transcription Polymerase Chain Reaction (RT-PCR) kits in select hospitals.

Kerala Health Minister Veena George announced that the state's request for Truenat testing was strongly advocated during discussions with ICMR. Only hospitals equipped with level 2 biosafety facilities, which adhere to strict protocols to prevent sample contamination, will be authorised to utilise Truenat testing facilities.

With Truenat tests available locally, samples that initially test positive for Nipah will no longer need to be sent to labs in Thiruvananthapuram, Thonnakkal, or Kozhikode for reconfirmation. This streamlined approach aims to expedite testing, outbreak detection, and the implementation of preventive measures.

The Health Minister stated that a Standard Operating Procedure (SOP) for Truenat tests would be developed shortly. She also provided an update on the Nipah outbreak in Kozhikode, indicating that no new positive cases had been reported in the past four days, and the health condition of all patients undergoing treatment remained stable. "The condition of the nine-year-old boy who was earlier on ventilator support is improving clinically. He is responding, which is a positive sign," the Minister said.

She highlighted the critical role played by healthcare workers in identifying potential cases and initiating the testing process. When two individuals from the same family were admitted to a private hospital, health workers promptly collected their details and sent samples for testing. Following a negative result in an influenza viral panel test, the samples were tested for Nipah, leading to a swift response by the state health department.

Regarding the recurrence of the Nipah virus in Kozhikode, the Minister noted that even ICMR could not definitively explain why it reappeared exclusively in this region. "ICMR studies said that many states, including Kerala, are prone to this infection," George said.

In response, the Kerala Health Department plans to conduct a zero-surveillance study to investigate further. The study will assess the presence of Nipah antibodies among individuals with high-risk exposure to Nipah patients.

ICMR's findings revealed that the virus responsible for the 2018 and 2023 outbreaks is nearly identical, with no mutations observed. However, symptoms appear to have evolved. For instance, the first patient in the recent outbreak was initially diagnosed with pneumonia, while a nine-year-old boy was initially diagnosed with community-acquired pneumonia.

The Health Minister expressed the need for further discussions to finalise diagnosis and testing protocols for Nipah. Patients exhibiting symptoms such as acute respiratory distress syndrome and encephalitis will also be screened for Nipah. This evolving understanding of Nipah's symptoms represents a valuable learning experience for healthcare professionals.