A laboratory for testing Nipah virus samples has been set up at the Kozhikode Medical College in Kerala, one day after the state reported a Nipah virus infection case. Health Minister Veena George announced the opening of the lab on Sunday, September 7 after a 12-year old boy in Kozhikode died of Nipah virus infection. The facility was set up by Monday evening. While the state has a unit of the National Institute of Virology, Pune in Alappuzha district and the Institute of Advanced Virology (IAV) in Thiruvananthapuram, it does not have a lab to test Nipah samples.
Five samples have been sent to Kozhikode Medical College lab to test for the Nipah virus. It was set up in consultation and coordination with NIV Pune and its Alappuzha centre. The testing is done jointly by the staff of NIV Pune, NIV Alappuzha and Kozhikode Medical College. The lab will conduct RT-PCR tests and point of care testing (testing done in close proximity to patients) for the Nipah virus, Health Minister Veena George said. However, while the medical college lab can test the samples, they will have to be sent to the NIV in Pune for confirmation. This process can take up to 12 hours, the Health Minister added.
Testing kits, reagents (a substance used in chemical analysis or other reactions) were sent from NIV Pune and its Alappuzha centre on an emergency basis to the Kozhikode lab.
“The information (of a sample being negative or positive) is required for immediate action. At the same time the virus is highly lethal. We need confirmation from a reference lab, we can’t avoid it. The advantage of having a local lab is that we can start treatment and public health measures” AP Sugunan, scientist and officer-in-charge of the NIV’s Alappuzha centre, told TNM. The 12 hours’ time for confirmation, he added, is an international requirement as Nipah is classified as an extremely dangerous pathogen.
The technology for Nipah testing is the same as that for COVID-19 testing, due to which the Kozhikode lab could be set up in 24 hours. “The format is the same but requires specific reagents and training from people who have experience in handling highly dangerous pathogens. Though the general condition for testing Nipah is to have a Biosafety Level 3 Lab (BSL-3), the one at Kozhikode has facilities of BSL-2 only. COVID-19 tests are done in BSL-2 labs,” AP Sugunan said.
“At the Kozhikode lab we aren’t doing any virus culturing (in which samples of a virus are placed in different cell lines, which the virus being tested for is able to infect), but we are doing molecular testing. The sample is deactivated and tested. This is allowed by a BSL-2 lab with some additional precautions. We aren’t doing virus isolation. There may be a live virus while the test is being done but it’s deactivated and tested,” he added.
Kerala reported a Nipah virus outbreak in 2018, which claimed 17 lives in Kozhikode, and in 2019 the virus infected a young man in Kochi. He survived, and the virus was contained effectively so that the infection was confined to the index patient.