1 September 2021 KOZHIKODE DISTRICT 2 NIPAH VIRUS CORE COMMITTEE Sl No Action point Name Designation phone 1 Surveillance team Dr Sarala Nair DSO 8848057426 2 Sample Test and result Mana ID: 961482
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1 ACTION PLAN FOR NIPAH OUTBREAK 2021 September 2021 KOZHIKODE DISTRICT 2 NIPAH VIRUS –
CORE COMMITTEE Sl. No. Action point Name Designation phone 1. Surveillance team Dr Sarala Nair DSO 8848057426 2. Sample T
est and result Management Dr Beena Microbiology HOD 9446161949 3. Linkage of Suspected New Patients to Index Case Dr Asma Community
medicine 9846120001 4. Contact List Management Dr Seethu Ponnuthambi MO 8547036100 5. Patient Transportation Management Dr Lat
hika JAMO 9847858421 6. Material & Logistics Management Mr Baiju KMSCL 9446252658 7. Case treatment Dr Chandni HOD Emergency
dept Medical college 9447202748 8. Expert Visit coordination Dr Anuradha JAMO 7356522250 9. IEC and media management Mr Baby
Mass media 9495257810 10. Infrastructure management Dr Sreejayan Superintendent MCH 9745636707 11. Call center management Dr Akhi
lesh Aardram assistant nodal officer 9895550777 12. Dead body management Dr Nilu Corporation health officer 8547553444 13. Data
analysis Dr Arjun C M MO 9496344681 14. Psychological support team Dr Issudheen NMHP coordinator 9895292298 15. Intersectoral
coordination Dr Naveen A DPM 9946105492 3 Daily core committee meeting under leadership of Ministers, District collector, DMO and Principal
at 4 PM, Government guest house Kozhikode followed by media briefing. New email id - nipahcell kkd2021@gmail.com Nipah virus Se
ptember 2021 - Kozhikode action plan : 1. 24 *7 control room Guest house Calicut a. Control room access is authorized only to those engaged
in control room activities b. Identity proof is mandatory c. In and out movement is written on log book d. Team members of different gro
ups has to work in their assigned areas e. Review meetings will be held in mornings and evenings f. Documentation team will record minutes
of all meetings g. Decisions taken will be communicated to the respective groups h. Implementation status of the decisions taken will be monitor
ed i. Emergency meetings will be informed by phone to the respective teams by the documentation team j Communication to the media will be
done only through the media management team k. Health bulletin release at 4 pm by freezing the data as at 5 pm and shared with the State Cell and
Press briefing at 5 pm 2. 24*7 call center a. Establishing call centre with 10 landline connections. b. Linkage with DISHA system t o an
swer medical queries ,logistics and administrative issues regarding Nipah and related health problems with proper documentation and report. Ca
lls today Cumulative calls Queries Self reporting Follow up remarks 4 3. Surveillance team Will be un
der DSO and epidemiologist and active surveillance in defined area will be done with medical teams . Overall coordination of active case finding , diagn
osis and reporting of cases will be under this team. Hospital surveillance and field surveill ance. Scrutiny off all encephalitis deaths in past one
month and route map of the cases for establishing any association. Dat e Suspected Cases Probable Cases Confirmed case Dat e of rep or
t Till date …… Toda y …..(d ate) (last 24hrs) Cumul ative Till date …… Toda y …..(d ate) (last 24hrs) Cumul ative Till
date …… Toda y …..(d ate) (last 24hrs) Cumul ative Confirmed Deaths Probable Deaths Till date Toda
y …..(date) (last 24hrs) Cumulative Till date Today …..(date) (last 24hrs) Cumulative a. Suspect Nipah Case Per
son from an area/ locality affected by a Nipah virus disease outbreak who has: ➢ Acute Fever with new onset of altered mental status or seizure and
/or ➢ Acute Fever with severe headache and/or ➢ Acute Fever with Cough or shortness of breath b. Probable Nipah case 5 Suspect case
- patient/s who resided in the same village where suspect/confirmed case of NIPAH were living during the outbreak period and who died before complete
diagnostic specimens could be collected OR Suspect case - patients who came in direct contact with confirmed case - patients in a hospital settin
g during the outbreak period and who died before complete diagnostic specimens could be collected. c. Confirmed Nipah Case Suspected case who has
laboratory confirmation of Nipah virus infection either by: ➢ Nipah virus RNA identified by PCR from throat swab, urine, serum or cerebrospinal
fluid (optional). ➢ Isolation of Nipah virus from throat swab, urine, serum or cerebrospinal fluid. 4. Contact tracing Will be under com
munity medicine department and DMO team. a. By central contact tracing team b. By field workers. 6 5. Patient transportation. Three
108 ambulances can be kept exclusive ly for Nipah cases transportation. 7 6. Triage and Isolation facility Pay ward vertical bloc
k in Medical college. All covid cases in pay wards and geriatric ward will be shifted to PMSSY and other institutions. 7. Treatment A
s per the Treatment Protocol – ANNEXURE 3 8 8. Testing and sample management. Planning for establishing a point of care (POC )
lab. Till then we can send the sample to NIV PUNE. Sample Sent Result Published Positive Till yesterday Today Cumulative Till yesterda
y Today Cumulative Till yesterday Today Cumulative 9. Material management As of now sufficient materials are in stock
. KMSCL will mobilize necessary consumables asper need. 9 Sl. No Item Available Stock (DMO) Receipt on (DMO) Issue on (DMO)
Balance (DMO) MCH Stock Requirement (MCH+ DMO) Remarks 1 PPE kit 2 3 layer mask 3 Gloves
4 Mask N95 5 Hand rub 10. Psychological support. DMHP team will take the lead for giving psychological su
pport for the people. 11. IEC /BCC 1. Daily press release 2. Single media spokesperson - health minister 3. Social media 4. Media sc
an for false news. 12. Training and awareness of all health workers in both government and private sector. 13. Expert visit management Only t
he teams with state permission will be allowed to do field activities in the district. Team Members Institution Activity Details Team A
Team B Team C 10 14. Source identification. Animal husbandry has a pivot role in identifying the source . Inter dep
artmental coordination is inevitable in this process. 15. HR management Medical college should be supported with more HR and funds to tackle the
crisis. NHM will support as per SMD ‘s directions. 16. Funeral guidelines. As per guidelines body will be buried in corporation itself. 17.
Concept of one health shoul d be promoted . ANNEXURE – 3 TREATMENT ALGORITHM Test Negative
Repeat test after 48 hours If symptomatic Suspect Case h/o Definite Contact+Symptoms Intensive Suppo
rt Care General Measures Treatment of Encephalitis Treatment of ARDS Treatment of Myocarditis Test for NIPAH Throat Swab, Blood, Uri
ne (CSF if available) F AVIPIRAVIR 1800 mg twice a day for one day followed by 800 mg BD for nex t 13 days may be used. Continue Intense Supporti
ve Care Consider MAB / Remdisivir/favipiravir/ Ribavirin After discussion with patient/LAR Treatment plan to be formulated by Institutional Medical
Board bOARBoard A dminister only on compassionate grounds 20mg/kg infusion – 2 doses in 48 hours Patients for MAB Yes D isch
arge plan - as per the guideline Test positive Confirmed case REMDESIVIR 200 mg iv followed by 100 mg iv once a day may be used for upto 12 d
ays. Ribavirin 2 g stat 1 g 6 hourly for1 to 4 days 500 mg 6 hourly for 5 - 10 days OR OR Followed by POST EXPOSURE PROPHYLAXIS 1.
Inj Remdesivir 200 mg loading and 100 mg iv OD for 12 days OR 2. Favipiravir 1800 mg BD for 1 day followed by 800 mg BD for nex
t 13 days. ANNEXURE 4 - GUIDELINES FOR DISCHARGE OF PATIENTS Contact + / Case Definition / NIPAH Suspect Isolation Ward Test RTPCR / PO
C Lab Negative Positive Observe the Patient for 3 days Treatment as per Guidelines Discharge when 1. clinically stable 2. RT PCR from all 3 s
amples negative on two occasions at least 5 days apart To be decided by treating physician and confirmed by Medical board NB: Any amendment to thi
s Guidelines be done only with the concurrence of Medical Board Asymptomatic Discharge & observe at home for 21 days Symptomatic or Develops new
symptoms Repeat t est RTPC / POC Lab after 2 day s Positive Negative Asymptomatic Symptoms Present Investigate for alternate diagnosis S
hift out of Isolation Unit Case based decision Under full infection control practice Observe the Patient for 3 days from last test Asymptomati