Manipal Institute of Virology was earlier praised for detecting and containing the outbreak of Nipah virus in Kerala in 2018.

Manipal lab that detected Nipah virus removed from ICMR list contests moveImage for representation : Manipal Centre for Virus Research
news Health Saturday, February 22, 2020 - 20:06

It has been a testing week for Dr. G Arunkumar, who heads the Manipal Institute of Virology (MIV). The Indian government's decision to strike off MIV's laboratory from the list of Indian Council of Medical Research’s (ICMR) Viral Research and Diagnostic Laboratories came as a rude shock to Dr. Arunkumar and his counterparts in Manipal.

MIV was praised for detecting and containing the outbreak of Nipah virus in Kerala in 2018. "This decision has been taken through no fault of ours. We are unsure what has led to this decision," says Dr. Arunkumar speaking in his office in Manipal.  

A news report published earlier this month stated that MIV was accused by ICMR of storing pathogens of Nipah virus, considered a Risk Group (RG) 4 virus, and studying it despite not having the required biological safety level 4 (BSL4) certification. The report also stated that the Indian government also asked the United States Centre for Disease Control and Prevention (CDC) to stop funding any research in India without the government's approval. 

This comes in the wake of a review of research into biological weapons grade pathogens in India amid the coronavirus outbreak. However, the government's actions were strongly contested by MIV. 

In a statement released to the media, Manipal Academy of Higher Education (MAHE) stated, "As per the direction from DG ICMR, all Nipah virus positive clinical samples were handed over to NIV, Pune on 12th July 2018 and receipt obtained.  No biological samples or Nipah virus positive samples were transferred into or out of India, and this study has no connection with vaccine development or research."

MIV, a private laboratory, was started alongside 3 other virus laboratories in 2010 after years of planning following the SARS outbreak. The three others were ICMR's regional centers in Bhubaneswar and Port Blair, and King George Medical University in Lucknow. The Ministry of Health funded the consumables used in the laboratory and covered the expenses of its personnel till 2016. After that, government funds for the laboratory was reduced in a phased manner before it became a fully self sustained facility in March 2019.

It was on May 18 2018 that the first case of Nipah virus in Kerala was detected by MIV after Dr. AS Anoop Kumar, a physician at Baby Memorial Hospital in Kozhikode turned to Dr. G Arunkumar, a virologist in MIV, Manipal to diagnose a cluster of what appeared to be cases of encephalitis. Both Dr. Arunkumar and doctors at Baby Memorial Hospital ruled out encephalitis and zeroed in on the cause of the deaths to be Nipah virus. 

MIV was perfectly placed to detect the virus since in 2017, the team at the virology institute, was trained by the US CDC to test for Nipah virus. The laboratory in Manipal was one of only two facilities in India authorized to test for Nipah virus, the other one being Pune's National Institute of Virology (NIV).

After MIV had identified it to be Nipah virus, the laboratory notified the NIV in Pune for a second round of testing to be doubly sure. "We informed the authorities in Kerala that we were dealing with a deadly virus but we did not reveal its name," Dr Arunkumar recalls. Virologists in NIV isolated the virus and confirmed the case of Nipah on May 20, 2018.

In evidence of the coordination between ICMR and MIV, on May 27 2018, ICMR, in a letter to the Virology institute in Manipal, sanctioned Rs 15.8 lakh for the outbreak investigation of the Nipah virus.


Dr. Arunkumar, MIV

In July that year, the outbreak of Nipah virus was deemed to be over and a team of officials from NIV, Pune travelled to Manipal to collect samples of Nipah virus stored in the laboratory. 

According to communication between MIV and NIV Pune, which TNM has accessed, 18 samples which tested positive and 367 samples which tested negative for Nipah virus were transported to Pune on July 12. A receipt was handed over to MIV and the transport of the samples was further acknowledged by officials in Pune. In November 2018, officials from IMCR arrived in Manipal once again to review "aspects related to the collection of Nipah virus samples". 

Dr. Arunkumar assumed that this was the end of the matter but over the past year, he says, the ICMR's correspondence with MIV changed noticeably. Even though fresh Nipah virus cases emerged in 2019, MIV was not listed as a designated laboratory in this year.

In April 2019, an official in the Ministry of Health and Family Welfare wrote to MIV stating that it was not eligible to store Nipah virus samples. In the letter, the official further accused MIV of collecting samples of Nipah virus despite being directed to transfer all samples to NIV. MIV's foreign collaboration with the US CDC was also questioned at this time. The Acute Febrile Illness programme carried out by MIV along with the US CDC was stopped in May 2019 following the letter. 

However, Dr. Arunkumar states that MIV did not store or collect Nipah virus samples at this time and replied to ICMR's letter stating the same. "We realised something was amiss only In July 2019 when we were no longer able to enter results in the portal on ICMR VRDL," he adds. 

The tussle between ICMR and Manipal's virus research facility has become public knowledge this month at a time India is closely following developments in China after the outbreak of coronavirus. However, the health ministry is yet to clarify if any further action will be taken on MIV after already making serious charges against the laboratory and revoking its inclusion in the list of Viral Research and Diagnostic Laboratories. 

"We will fight these claims and ensure that all the issues are resolved," Dr. Arunkumar adds.

 

Show us some love! Support our journalism by becoming a TNM Member - Click here.