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Four Stages Of Coronavirus Transmission And Next Phase Of India’s Battle

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As of 19 March, a total of 173 COVID-19 cases (148 Indians and 25 foreign nationals) have been reported in 19 states/union territories. These include 19 who have been discharged/cured, 1 who has migrated and 4 reported deaths. Hospital isolation of all confirmed cases, tracing and home quarantine of the contacts is ongoing.

Government’s Response

The Prime Minister’s Office, Group of Ministers, Ministry of Health & Family Welfare (MoHFW) and Cabinet Secretary are closely monitoring the COVID-19 situation. The government has invoked powers under The Epidemic Diseases Act, 1897 to enhance preparedness and containment of the virus. With COVID-19 being declared a notified disaster, the State Disaster Response Fund, constituted under Section 48 (1) (a) of the Disaster Management Act, 2005, is now available with state governments for response measures.

Central ministries along with states/UTs have taken urgent steps to strengthen community surveillance, quarantine facilities, isolation wards, and ensure availability of adequate personal protective equipment (PPE), trained manpower and rapid response teams for management of COVID-19.

Infection count in India is Steadily Rising

Latest Government data has pegged it at 166. This includes 25 foreign nationals.

Is India going to become the next epicenter for coronavirus? Are the measures taken by the Government enough to protect India?  Experts have been warning that what has worked in other countries may not work for the world’s second-most populous country.

Many experts believe that the reason behind India’s comparatively low numbers is the limited scope of testing in the country.

The World Health Organization urged countries to test as many people as possible to curb the pandemic, but India has only been testing those who have traveled from affected countries or come in contact with a confirmed case and shown symptoms after two weeks of quarantine.

Four Stages

Stage 1: When the disease is just introduced to a population. In India’s case, that is with imported cases – only those with travel history to affected countries tested positive for the infection.

Stage 2: According to the ICMR, India is presently in the second stage. In this stage, local transmission of the disease is reported. In this stage, only those people who are living in close contact with with persons with travel history are affected.

Stage 3: In this stage, there is community transmission i.e. even those who have had no known contact with an affected person, and haven’t travelled to an affected country start contracting the coronavirus disease.

Stage 4: The fourth stage is when there is a widespread outbreak, leading it to become an epidemic within the population and difficult to contain.

Contact Tracing

Persons who have lived in close contact with someone who is infected with the virus are more likely to contract the virus, and they will potentially infect others.

Such people need to be watched closely.

Once someone is confirmed as infected, contacts are identified by asking about the person’s activities and the activities and roles of the people around them since the onset of illness.

Contact identification: Once someone is confirmed as infected, contacts are identified by asking about the person’s activities and the activities and roles of the people around them since the onset of illness.

Contact listing: All persons considered to have contact with the infected person should be listed as contacts.

Contact follow-up: Regular follow-up should be conducted with all contacts to monitor for symptoms and test for signs of infection.

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The Nipah virus is considered one of the deadliest zoonotic infections globally, not because it spreads rapidly like influenza or COVID-19, but because of its extremely high fatality rate, rapid progression, and severe brain involvement. Medical experts warn that once symptoms escalate, the disease can turn fatal within days. According to available data, the case fatality rate of Nipah virus ranges between 50 and 75 per cent, placing it among the most lethal viral infections known to humans. In this explainer, Dr Dip Narayan Mukherjee, Consultant – Microbiology and Infectious Diseases, CK Birla Hospitals, CMRI, sheds light on why the virus is so dangerous and difficult to control. Why Is the Nipah Virus So Deadly? According to Dr Mukherjee, Nipah’s lethality lies in a combination of delayed symptom recognition, aggressive disease progression, and early involvement of the brain. “Nipah virus often begins with very non-specific symptoms, which makes early detection difficult. By the time it is clinically suspected, the virus may have already affected the brain,” he explains. Early Symptoms Often Go Unnoticed One of the biggest challenges in controlling Nipah virus is that its initial symptoms closely resemble common viral illnesses, leading to delays in diagnosis and isolation. Early symptoms include: Fever Headache Cough Muscle pain General weakness “These symptoms are easily mistaken for flu, viral fever, or respiratory infections,” says Dr Mukherjee. “This delay gives the virus time to progress silently.” Severe Brain Infection Drives High Mortality The most dangerous aspect of Nipah virus infection is its neurological involvement. The virus frequently causes encephalitis, or inflammation of the brain, which significantly increases the risk of death. Neurological symptoms may include: Seizures Confusion and altered consciousness Extreme drowsiness Coma “Once the central nervous system is involved, the disease becomes very difficult to manage,” Dr Mukherjee notes. “At this stage, treatment is largely supportive because there is no specific antiviral therapy available.” This lack of targeted treatment options makes early detection critical. Human-to-Human Transmission Raises Risk While Nipah virus is primarily transmitted from fruit bats, it can also spread from person to person, particularly in healthcare settings. Dr Mukherjee points out that: Caregivers and healthcare workers are at higher risk Exposure to high viral loads can worsen outcomes Inadequate infection control increases transmission risk “Strict adherence to infection control practices is essential. Even a small lapse can result in secondary infections,” he says. Zoonotic Nature Makes Exposure Hard to Predict Nipah virus is transmitted from fruit bats, either directly or through intermediate hosts such as pigs. This zoonotic pattern makes outbreaks unpredictable, especially in regions where humans, animals, and wildlife interact closely. Adding to the challenge: There is no approved vaccine Treatment options remain limited Isolation protocols must be strictly enforced What Can Reduce Nipah Fatalities? According to experts, early action remains the most effective defence against Nipah virus. Key measures include: Early isolation of suspected cases Strict use of personal protective equipment (PPE) Rapid escalation and referral to specialised centres Strong hospital infection control protocols “The earlier the virus is identified and contained, the better the chances of preventing severe disease and fatalities,” Dr Mukherjee emphasises. The Bottom Line Nipah virus continues to be a serious public health threat because of its high fatality rate, neurological complications, and lack of targeted treatment. Its ability to masquerade as a mild illness in the early stages makes vigilance crucial. Health experts stress that awareness, early suspicion, and strict infection control are currently the most powerful tools to reduce deaths linked to this deadly virus. As Dr Mukherjee concludes, “With Nipah, time is the most critical factor. Early recognition can save lives.”
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