📰 Citizenship Bill may have to wait for House nod
JPC plans to hold wider consultations
•The Citizenship (Amendment) Bill, 2016, is unlikely to be tabled in the monsoon session of Parliament as the Joint Parliamentary Committee (JPC) that is examining the legislation intends to have wider consultations, its chairperson said.
•JPC chairperson Rajendra Agrawal told The Hindu that the Bill needed further intensive discussions and the JPC would seek the advice of legal and constitutional experts. The Bill proposes citizenship to six persecuted minorities — Hindus, Jains, Sikhs, Parsis, Christians and Buddhists — from Pakistan, Afghanistan and Bangladesh who came to India before 2014.
Resistance in Assam
•There has been strong resistance to the Bill in Assam as it seeks to grant citizenship to non-Muslims from Bangladesh. Several political and civil groups in Assam have said the Bill would pave the way for giving citizenship to illegal Hindu immigrants from Bangladesh in Assam, in violation of the Assam Accord, 1985.
•The JPC that visited Assam on May 7 faced protests as indigenous groups see the Bill as a move to legitimise Hindus who have migrated from Bangladesh after 1971. As per the orders of the Supreme Court, the next draft of the National Register of Citizens (NRC) is to be published on June 30, and this has also created hurdles to the passage of the Bill. A total of 3.29 crore people applied for inclusion in the NRC. In the first list, around 1.9 crore names were included.
•Mr. Agrawal said they would wait for the NRC process to be completed. The NRC is being updated to weed out illegal migrants who came to the State after the 1971 war when Bangladesh liberated itself from Pakistan.
•The cut-off date for NRC is midnight March 24, 1971 and all those who migrated to Assam from Bangladesh before this period would get Indian citizenship as per the Assam Accord .
•“Divergent views have emerged and in some areas there is support for the Bill and in some there is fierce opposition. This is a question of their (Assamese) identity...they are apprehensive,” Mr. Agrawal, who is also a BJP MP from Meerut said. He said the next meeting of the JPC, that comprises 30 MPs, has not been decided yet as they were still studying the old proposals.
•“We will address everyone’s concern, be it Assam or any other State. In Gujarat and Rajasthan there is huge support for the Bill. We have to consider the question: when the NRC is finalised in Assam, what will be done and can be done for those people who become stateless? We have asked people what they want. We will also ask experts. I may belong to one party but as a chairperson (of this committee) I don’t belong to any party. Whoever has expertise, any bureaucrat, locals, legal and foreign relation experts will be consulted,” he said.
•Asked if the JPC could propose striking off Bangladesh from the benefactor countries, Mr. Agrawal said, “The amendment is only for three countries. The committee knows its mandate. If there is a new development, we can discuss it. There is no deadline but the Bill needs intense consultation and it looks difficult that it will be tabled in the monsoon session of Parliament.”
•A Home Ministry official said 12,100 Hindu immigrants from Pakistan were granted long-term visas since 2012. LTVs are precursors to citizenship based on the report given by the State governments.
•Through an executive order in 2015, the Home Ministry relaxed the provisions for persecuted religious minorities from the three neighbouring countries in respect of their entry and stay in India without proper documents or after the expiry of relevant documents. Since 2015, around 150 Bangladeshi Hindus were also granted LTVs.
•There has been no exact numbers of such minority refugees from these countries but officials put the figure at around two lakh Hindu and Sikh refugees from Bangladesh, Pakistan and Afghanistan living in India.
•There are 400 Pakistani Hindu refugee settlements in cities like Jodhpur, Jaisalmer, Bikaner and Jaipur. Hindu refugees from Bangladesh mostly live in West Bengal and North East States.
•Meanwhile in Guwahati, Assam Chief Minister Tarun Gogoi on Friday met representatives of the All Assam Students’ Union and 27 organisations of indigenous communities opposed to the Bill and assured them that his BJP-led government would not take any step against the interest of the State and its people.
•Mr. Gogoi also urged them to ensure an atmosphere suitable for publication of the final draft of the updated NRC by June 30.
📰 Centre notifies Cauvery Water Management Authority
It will decide on water sharing.
•Three days after the Karnataka Assembly election results and three months after the Supreme Court’s order, the Union government on Friday issued a notification for the Cauvery Water Management Authority (CWMA).
•The authority will decide the sharing of the river water among the States of Karnataka, Kerala and Tamil Nadu and the Union Territory of Puducherry.
•MPs of both the AIADMK and the DMK had stalled the winter session of Parliament over the delay in the formation of the authority. They had accused the BJP government of delaying the formation of the authority for electoral gains in Karnataka.
•The authority’s mandate will be to monitor the storage, apportion shares, supervise operation of reservoirs and regulate water releases with the assistance of the Regulation Committee. It will regulate water release by Karnataka at the Biligundulu gauge and discharge station.
•The CWMA will determine the total residual storage in the specified reservoirs on June 1 every year. “The share of each State will be determined on the basis of the flows together with the available carry-over storage in the reservoirs,” the notification says.
•The withdrawals will be allowed on the basis of the share worked out for each State.
•“If the Authority finds that any Government of the party States, namely Tamil Nadu, Kerala, Karnataka and Union territory of Puducherry do not cooperate in implementing the decision or direction of the Tribunal, it can seek the help of the Central Government for implementation of the Award of the Tribunal as modified by the Hon’ble Supreme Court vide Order of 16th February, 2018,” the notification says.
Five-year tenure
•The chairman of the authority will be appointed by the Central government for a tenure of five years. He has to be a senior and eminent engineer with wide experience in water resource management or an IAS office in the rank of secretary or additional secretary. There will be two part-time members — representatives of the Central Government of the rank of Joint Secretary to be nominated by the Ministry of Water Resources, River Development and Ganga Rejuvenation and Ministry of Agriculture and Farmers’ Welfare respectively and four part-time members from party States — administrative secretaries in charge of Water Resource Departments of Kerala, Karnataka, Tamil Nadu and the union territory of Puducherry who shall be nominated by the State governments and Union territory administration respectively.
📰 PM affirms India’s ‘strategic autonomy’
Asks big powers not to return to rivalry
•India’s principle of “strategic autonomy” remains strong, Prime Minister Narendra Modi said, drawing an equivalence in ties with Russia, the U.S. and China and cautioning against a “return to the age of great power rivalries,” at a conference in Singapore on Friday.
•In his keynote address at the ‘Shangri-La Dialogue,’ organised by London-based think-tank IISS and hosted by Singapore, he also called the relationship with China a “multi-layered” one, as he drew out his seven-point vision for the Indo-Pacific region (Indian Ocean and Pacific Ocean).
•The speech by Mr. Modi, the first Indian Prime Minister to have accepted an invitation to address the Shangri-La dialogue, which draws Defence Ministers from the Asia-Pacific region each year, was awaited with much anticipation due to the timing of the conference. In the past year, India has increased its engagement with the ASEAN region, joined a quadrilateral grouping with the U.S., Japan and Australia for the Indo-Pacific, as well as reached out to China and Russia and will join the SCO grouping this month.
•Amid India’s varied strategic moves, as well as the flux in the region, Mr. Modi’s speech was expected to clarify India’s position on the “Indo-Pacific” strategy which is often seen as a platform to contain China’s moves in the South China Sea.
•However, Mr. Modi denied the Indo-Pacific was part of a strategy and called it a “natural” geographical region, placing the 10 countries of South East Asia (ASEAN) at the centre of the forum.
•“India does not see the Indo-Pacific Region as a strategy or as a club of limited members. Nor as a grouping that seeks to dominate. And by no means do we consider it as directed against any country,” Mr. Modi said.
•Referring specifically to relations between India and Russia, U.S., and China separately, Mr. Modi made it clear that he believed India, like Singapore didn’t stand “behind one power or the other.” “No other relationship of India has as many layers as our relations with China…We have displayed maturity and wisdom in managing issues and ensuring a peaceful border,” he said about relations with Beijing.
•Mr. Modi’s words were significant, days before another visit to China’s Qingdao city to attend the SCO summit, a visit which comes a few weeks after he travelled to Wuhan to meet President Xi Jinping.
•“President Putin and I shared our views on the need for a strong multi-polar world order for dealing with the challenges of our times” said Mr. Modi, referring to his meeting with the Russian President in Sochi last month. “At the same time, India’s global strategic partnership with the United States has overcome the hesitations of history and continues to deepen across the extraordinary breadth of our relationship,” he added.
📰 The democracy project in Bangladesh
The Awami League government’s success in turning around the economy and health care must not be overlooked
•Bangladesh, Lebanon, Mozambique, Nicaragua and Uganda are the “new” autocracies, according to Germany’s Bertelsmann Foundation. In its “Transformation Index 2018 (BTI)”, it has rated 58 out of 129 developing nations as autocracies.
•On Bangladesh, the report says, “Due to the worsened quality of elections, the formerly fifth largest democracy is classified as an autocracy again. These developments are worrying for citizens because corruption, social exclusion and barriers to fair economic competition continue to be more prevalent in autocracies.” The BTI has, since 2006, been measuring quality of democracy, market economy and governance in 129 developing and transformation countries. Expectedly, in Bangladesh, while the ruling Awami League Party has rejected the study as baseless and claimed the country to be a “100 percent democracy”, the main opposition Bangladesh Nationalist Party (BNP), has said the report reflects the true nature of Bangladesh’s current political climate.
•A project manager for the BTI at the Bertelsmann Foundation claims the report is balanced as it has flagged “positive developments” in the economic realm in terms of economic output, macroeconomic stability, market-based competition and private enterprise and also “negative developments” in the political realm such as free and fair elections, the separation of powers and the independence of the judiciary.
A long journey
•Since the restoration of democracy after the fall of the H.M. Ershad-led military junta in 1990, Bangladesh has witnessed a change of government every five years. The polls were held under a neutral caretaker administration until the Awami League came to power in December 2008 and scrapped the system using its decisive majority in Parliament.
•This was necessary because the military-backed caretaker administration put in place earlier had overshot its brief and instead of holding an immediate poll, ruled Bangladesh for two years without any mandate. It was a murder of democracy. The military-backed caretaker also tried to finish the political career of Bangladesh’s two top politicians, Sheikh Hasina (picture) and Khaleda Zia, with a ‘minus two agenda’, as if the conflict in Bangladesh was about a personal ego clash between the two women. Not only did the Western media and civil society underplay the element of ideological conflict between two warring visions of Bangladesh (a secular, democratic vision driven by the mantra of economic growth versus a replica of Pakistan’s religion-driven politics) but it also pandered to a military-driven propaganda that Bangladesh had better prospects if led by a cabal of technocrats, micro- and macro-bankers, military generals and intelligence chiefs.
Awami rule
•The last eight years of Awami League rule have proved these self-proclaimed pundits wrong. Bangladesh has achieved phenomenal economic growth and inclusive social and human development in areas such as gender empowerment and public health care. But the West, especially the U.S., has sought to punish Prime Minister Sheikh Hasina for not allowing a free run to the ambitions of Nobel laureate Mohammed Yunus. The BNP leader, Khaleda Zia, had boycotted the 2014 election to protest the absence of a caretaker administration; in any case the campaign of violence unleashed during the BNP’s reign in the early 2000s cannot be forgotten. It is odd that this systematic lethal campaign directed against the Awami League, a party that had led the country to freedom, did not amount to a murder of democracy for the West, but when BNP-Jamaat leaders are jailed for leading and instigating violence, the West has cried ‘murder of democracy’. A top U.S. counter-terrorism expert has been profuse in his praise of Bangladesh’s counter-terrorism effort that has largely contained the spiral of Islamist radicalism post-2014 when a murderous campaign targeting secular bloggers, writers, publishers and even folk singers threatened the very soul of a secular, syncretic Bangladesh.
•India has a huge stake in having a friendly regime in Dhaka for strategic and economic reasons. Our democracies in Asia have many limitations but there is no reason to let the West use that to misrepresent or subvert these national sovereignties.
📰 Populists in Rome
Finally, Italy has a government, and an edgy dialogue with the EU may be on the cards
•The political whirlwind that has swept Italy looks to be dissipating, at least for now. Giuseppe Conte, a little-known academic with an embellished resume, has been sworn in as Prime Minister, after weeks of wrangling between President Sergio Mattarella and a coalition with a slim parliamentary majority. The two-party combine, the anti-establishment Five Star Movement (M5S) led by Luigi Di Maio and the far-right League headed by the rabble-rousing, anti-migrant Matteo Salvini, disbanded plans to form a government after Mr. Mattarella exercised his powers to block the appointment of Eurosceptic Paolo Savona as Finance Minister. The President then decided to order fresh elections and appoint an ex-IMF official as interim Prime Minister, a decision that, if implemented, could have made a bad situation worse. The Eurosceptic coalition partners wasted no time in using the President’s actions as a rallying point for their cause. They charged that France and Germany were running Italy and called for Mr. Mattarella’s impeachment. The prospect of snap polls, which could have resulted in the populists getting a stronger majority, rattled markets early this week. Italian bond yields hit highs unseen in years and share prices dropped not just in Italy but across Europe, the U.S. and Asia. The coalition, which began serious talks in early May, had toned down some of its anti-European Union demands such as leaving the single currency and some €250 billion in debt forgiveness. But it still planned to spend some €170 billion on income support, and lower the pensionable age and taxes. Without plans to raise adequate revenue to fund the spending, the markets and Brussels got jittery. Italy’s government debt is at 132% of GDP, well above the Eurozone average. However, as the week progressed, all sides saw opportunities and a deal was struck, with the President assenting to economics professor Giovanni Tria taking over the finance portfolio. The new government will now have to win a confidence vote next week.
•The road ahead for Italy is far from clear. According to official EU surveys, although 59% of Italians favour the euro, just over half “tend not to trust” the EU. Both Europe and Italy would sustain significant damage if Italy left the Eurozone. Fortunately, that is still an unlikely scenario. The current situation, a coalition of populism and the right, is not ideal. But it provides an opportunity to address some of the underlying Italian disenchantment with the EU, perhaps by striking a balance between austerity and populism. Also, Brussels, along with France and Germany, could work with Italy to address economic and social anxieties. A way can be found that protects both the democratic choices of Italians and the stated values and integrity of the EU.
📰 U.S. will veto UN draft on Palestinians
•The U.S. will “unquestionably veto” a UN draft resolution calling for the protection of Palestinians in Gaza and the West Bank, U.S. Ambassador Nikki Haley said on the eve of a Security Council vote on Friday.
•Ms. Haley described the text put forward by Kuwait on behalf of Arab countries as a “grossly one-sided approach”.
•The United States circulated its own rival draft resolution blaming Hamas for the recent flare-up in Gaza. Kuwait presented its draft two weeks ago, calling for an international protection mission for the Palestinians as protests turned violent on the Gaza border. At least 122 Palestinians have been killed by Israeli fire since March-end.
📰 Farmers’ gaon bandh hits fresh supplies across States
10-day strike to press for loan waivers, higher MSP and assured income
•Farmers in at least seven States began a ten-day strike or ‘gaon bandh’ on Friday, dumping crates of vegetables and thousands of litres of milk on the roads to draw attention to the agrarian crisis and demand an assured minimum income, higher support prices and a complete loan waiver.
•Farmers from 172 organisations have come together for the nationwide strike, under the banner of the Rashtriya Kisan Mazdoor Mahasangh (RKMM) and the Kisan Ekta Manch (KEM).
•The impact of the strike was immediately felt in Punjab, Haryana, Madhya Pradesh, Rajasthan, Maharashtra and parts of Uttar Pradesh and Chattisgarh, according to strike leaders.
Local sales in Punjab
•“Some farmers are dumping their produce. Many are also selling them within the villages,” said Balbir Singh Rajewal, president of the Bhartiya Kisan Union (BKU). “Today is only the first day, so urban markets are still able to sell what was supplied earlier. Wait and see; by day after tomorrow, prices will shoot up in cities.”
•Ramandeep Sangh Mann, a farmer leader associated with the KEM — an umbrella body of 62 farmer groups — said, “According to local reports, 40% of milk supply in Punjab is affected.”
•Extending support to the farmers’ campaign, Punjab Minister Navjot Singh Sidhu visited Patto village in Fatehgarh Sahib and purchased milk and vegetables directly from a farmer.
•“In Haryana, arrival of farm produce at urban centres was down by 70 to 80%,” BKU leader Rakesh Bains told The Hindu .
•Mr. Bains said implementing the Swaminathan Commission’s recommendation on Minimum Support Price (MSP) for crops, complete farm loan waiver and fixation of minimum income for farmers are the key demands that the government should address immediately.
•“We also want the government to fix MSP for milk and vegetables,” he added.
Supplies hit in Rajasthan
•Although the agitation did not affect normal life in Rajasthan, supply of milk, vegetables and other farm produce was hit in Sriganganagar, Hanumangarh and Jhunjhunu districts.
•“We will continue this for the next 10 days and the protest will intensify,” said Santveer Singh, a member of the core committee of RKMM in Rajasthan. He said protests were held in Bikaner, Sikar and Nagaur.
•As the strike began, police in Mandsaur in Madhya Pradesh have kept a close vigil as the anniversary of the June 6 farmers’ agitation approaches. Six farmers were killed in police firing during protests last year.
•In adjacent Neemuch, again there has been not shortage of vegetables and milk although the markets were shut there. Farmers also stayed away from the grain market in Neemuch.
Nashik shuts down
•Police detained three protesters in Saikheda in Nashik, the nerve centre of the farmers’ agitations earlier this year. At Khamkheda village in Deola tehsil, tomato farmers threw their produce on the roads.
•The strike had a strong impact on business at Nashik’s main Lasalgaon Agricultural Produce Market Committee (APMC) — the country’s largest onion market, with sources stating that the price of onions was likely to rise sharply.
•In Khed Shivapur, farmers condemned the apathy of the Devendra Fadnavis-led BJP government by spilling thousands of litres of milk along the Pune-Bengaluru highway.
•However, business was largely unaffected in most of the major wholesale markets in Mumbai and Pune.
📰 Mixed growth signals
Q4 GDP growth is up, but with inflation risks. RBI will have to take a call on raising rates
•Official data showing the GDP expanding at the fastest pace in seven quarters in the three months ended March 31, a brisk 7.7% at that, is reason for cheer. Given that this has been propelled largely by increases in manufacturing and construction activity is a basis for optimism given that the former contributes almost a fifth of quarterly gross value added (GVA) and the latter about 8%. The rebound in construction is all the more heartening since it is both a creator of direct and indirect jobs and a multiplier of overall output. In the fourth quarter, construction is estimated to have posted a robust 11.5% growth, almost a doubling in pace from the 6.6% in the third quarter, and compares favourably with the contraction of 3.9% seen in the demonetisation-hit year-earlier period. Two key groupings of services that together contributed more than 38% of fourth-quarter GVA — the first comprising trade, hotels, transport, communication and broadcasting; and the second, financial, real estate and professional services — accelerated year-on-year, helping lift full-year sectoral GVA growth. Agriculture, forestry and fishing continued an accelerating trend over the four quarters of the last fiscal, with growth of 4.5% boosting the annual expansion to 3.4%. While the fiscal year’s pace for this vital sector is still appreciably lower than the 6.3% in 2016-17, if the quarterly momentum is sustained and the monsoon pans out as forecast, we could see a more broad-based revival in rural demand.
•There are, however, pressure points in the estimates of national expenditure. Private final consumption expenditure continues to languish, with the share of its contribution to GDP sliding to 54.6% in the January-March period, from 59.3% in the preceding quarter and 55.2% a year earlier. Government spending too eased in the fourth quarter, as a proportion, to the lowest quarterly level of the last fiscal at 9.5%. Only gross fixed capital formation, which reflects investment demand, provided cause for some comfort as it contributed 32.2%, which was the most in percentage terms since the 32.5% posted in April-June 2016. A sobering thought here is that the very same growth momentum is likely to spur price pressures across the economy that, combined with the bullish trend in global oil, could fan faster inflation. This may leave the RBI with little option but to raise interest rates, possibly as early as next week. Separately, the latest survey-based Nikkei India Manufacturing Purchasing Manager’s Index shows manufacturing activity expanded at a weaker pace in May from the previous month amid tepid domestic demand. With borrowing costs set to rise and global trade tensions adding to uncertainties for India’s exporters who are yet to capitalise on the rupee weakness, policymakers will need to eschew populism and stick to policy prudence if the tenuous momentum is to be sustained.
📰 Nipah virus: Anatomy of an outbreak
The way Kerala has handled the Nipah virus outbreak holds crucial lessons for the rest of India. Priyanka Pulla reports on how a deadly virus is being tackled by an alert administration
•At around 2 a.m. on May 17 morning, a grievously sick Mohammed Salih, a 28-year-old architect from Kerala’s Perambra town, was rushed by his family to Kozhikode’s Baby Memorial Hospital. Salih was vomiting, had a high fever, and was in a mentally agitated state. The doctor on call, critical care physician A.S. Anoop Kumar, knew these symptoms meant encephalitis, an inflammation of brain tissue that kills hundreds in India every year. Kumar tried to stabilise Salih, but by around 9 a.m., when the hospital’s neurologists came to examine him, it was obvious that something was very wrong.
•Even though Salih was receiving top-end care, his condition was worsening rapidly. He had some very peculiar symptoms, recalls Chellenton Jayakrishnan, one of the neurologists who treated him. His heart was racing at over 180 beats per minute and his blood pressure had shot up. His limbs were limp, displaying no reflexes. These symptoms were unlike any encephalitis cases that the team had ever seen. Jayakrishnan and his colleagues ruled out, one by one, dozens of common causes of encephalitis. Salih couldn’t have Japanese encephalitis. The mosquito-borne infection typically doesn’t affect more than one person in a household, and his younger brother, Sabith, had died about 12 days ago after showing similar symptoms. His father and aunt, too, had contracted the infection.
•Rabies, another possible cause of encephalitis, was ruled out too. “If the family had been exposed through a common pet, they would have fallen sick at the same time,” says Jayakrishnan. Salih had fallen sick days after Sabith did. So, was this a case of poisoning? The team ruled this out, too. Toxins could trigger encephalitis-like symptoms but were usually not accompanied by fever.
•The neurologists knew by then that they were looking at an exotic virus, possibly never seen in Kerala before. Anoop Kumar decided to call for help. He turned to virologist Govindakarnavar Arunkumar at Karnataka’s Manipal Centre for Virus Research (MCVR), about 300 km from Kozhikode. Salih’s samples were dispatched to MCVR.
•Forty-seven-year-old Arunkumar has investigated several mystery outbreaks of encephalitis in the past. In 2015, his team found a recurrent epidemic in Uttar Pradesh’s Gorakhpur to be Scrub Typhus, a diagnosis that was later confirmed by other researchers. A year later, he joined hands with virologist T. Jacob John to uncover the etiology of an encephalitis-like syndrome in Odisha’s Malkangiri district. For four years now, Arunkumar has been heading a surveillance project which tests patients with fever in 10 States for over 40 pathogens. As part of this project, MCVR upgraded one of its labs to Biosafety Level 3 two years ago, so they could work with highly lethal pathogens like the Kyasanur Forest Disease virus. This upgrade gave Arunkumar the chance to expand his testing repertoire. And the pathogen he was eyeing was the deadly Nipah virus.
A serendipitous diagnosis
•The Nipah virus made its first documented appearance in Malaysia in 1998. There, the virus is believed to have jumped from fruit bats of the Pteropus species to domestic pigs paddocked under the trees where such bats roost. From the pigs, the virus travelled to pig breeders, infecting and killing about 105 of them in an outbreak. Nipah next appeared in Bangladesh, triggering nearly 15 outbreaks in the 2000s. The pathogen had a different modus operandi in that country. It mainly infected people who had a taste for raw palm sap, which is frequently contaminated by bat urine and saliva. Once the virus spread to humans, it was transmitted from one person to another through respiratory droplets, a feature that wasn’t seen in Malaysia.
•Nipah killed nearly 70% of those it infected in Bangladesh, compared to 40% in Malaysia. During the epidemic years in Bangladesh, the virus also crossed the border to enter West Bengal — twice. The outbreaks occurred in 2001 and 2007 in the districts of Siliguri and Nadia, killing 70 people.
•Arunkumar was interested in testing for Nipah for two reasons. First, among the States covered by his surveillance project were Tripura and Assam, both across the border from Bangladesh and potential geographies for Nipah. Second, the virus is thought to be a probable bioterrorism agent. So, in August 2017, the MCVR team was trained by the United States’ Centers for Disease Control and Prevention to test for the Nipah virus. This made the Manipal laboratory only the second facility in India capable of doing so, apart from Pune’s National Institute of Virology (NIV). It was a serendipitous move.
•When Arunkumar received Salih’s samples on May 18, he also ruled out common causes of encephalitis such as the Japanese encephalitis virus, the Herpes Simplex virus and Leptospira bacteria. Only one pathogen seemed capable of causing Salih’s symptoms and leading to sickness among several family members at the same time. “It was Nipah,” says Arunkumar.
•Meanwhile, doctors at Baby Memorial had also come to the same conclusion. Nipah had crossed Jayakrishnan’s mind on the first day. By the second day, the team had browsed through medical journals and found that Salih’s symptoms closely matched those of the patients affected in the 1998 Malaysian outbreak. Arunkumar ran the samples through a diagnostic test called Real Time Polymerase Chain Reaction (RT-PCR), which detects viral genetic material. Salih, his father V.K. Moosa, and his maternal aunt Mariyam Kandoth all tested positive for Nipah.
•As this story went to print, Nipah had claimed the lives of 17 of the 19 people it had infected in Kozhikode, a mortality rate of 89%. The outbreak triggered widespread panic, with families in Perambra deserting their homes en masse. As speculation grew about how the virus was transmitted, N-95 masks appeared all over Kozhikode. When officials announced that the virus could spread through fruits that were half-eaten by bats, people cut down on their fruit purchases.
•But without the prompt diagnosis, it could have been worse. In Bangladesh, the first few outbreaks killed dozens in the districts of Meherpur and Naogaon, but were not recognised as Nipah until after they ended. In the 2001 Siliguri outbreak, investigators figured out that it was the Nipah virus that was infecting people only six months later. By then, 60 people had been infected and 45 had died.
•India has a poor record of outbreak investigations. About 10,000 people develop encephalitis-like symptoms each year but never get a diagnosis. Some regions, such as Uttar Pradesh’s Gorakhpur and Bihar’s Muzaffarpur, saw thousands of deaths in repeated annual outbreaks before the causes were established. Against this background, the discovery of an exotic pathogen in the very second patient hit by an outbreak, as was the case in Kozhikode, has few precedents.
A brisk State response
•Once MCVR had pinpointed the Nipah virus, they had to move quickly. Under the 2005 International Health Regulations, India is obligated to report outbreaks of emerging infectious diseases to the World Health Organisation. The MCVR team had to therefore be doubly sure of its findings. The only way to be so was to ask NIV, Pune, to run Nipah diagnostic tests on a second set of the Perambra family’s samples. As they waited for NIV’s confirmation, Arunkumar told the Baby Memorial doctors that they were dealing with a deadly new virus, and that suspected patients should be isolated immediately. “But we didn’t release the name,” says Arunkumar. Revealing the name publicly would require NIV’s verification, which only came on May 20.
•But the State health-care machinery did not wait for confirmation. Within hours of Salih’s arrival at Baby Memorial, Kozhikode’s district medical officer, V. Jayashree, had learnt of it. She put together a team of entomologists and visited Salih’s Perambra home on the morning of May 18. They collected mosquito samples and fogged the area, just in case the mosquitoes were the disease vectors.
•By the time Arunkumar shared the final results on May 20, State medical associations and government doctors were already on high alert. The State’s Health Minister, K.K. Shylaja, was in the city to oversee the outbreak response. It was easy to move ahead at this point. On May 20 morning, an officer trained in Ebola outbreak protocols instructed the State’s doctors in infection-control measures — isolating patients, using surgical masks and decontaminating surfaces. It was an extraordinarily swift response by any measure. Yet, according to the State’s Director of Health Services, R.L. Saritha, this was routine procedure. “There were two cases of encephalitis. We wanted to prevent the third. This is the usual response in Kerala to all outbreaks,” she says.
Two waves slip through
•For all of the Kerala government’s agility in tackling Nipah, the virus proved to be a formidable adversary. When Salih contracted the infection from his younger brother, so did several others. This was the first wave of infection, and Sabith was patient zero — the first to fall sick.
•By all accounts, Sabith was a well liked 26-year-old. A plumber by profession, he loved children and animals, says his cousin Jabir. Today, a colony of rabbits sit in a cage in the family’s abandoned Perambra home. They are fed by the neighbours.
•Some time on May 3, Sabith grew feverish. His family took him to the Perambra Taluk Hospital, where his condition worsened quickly. On May 5, when he began to lose consciousness, the family shifted him to the Kozhikode Medical College. Later in the night, Sabith died. But during his stay in Perambra Taluk Hospital and the medical college, nurses attended to him, and dozens of neighbours came to look him up.
•Such close contact with patient zero led to seven new cases in Perambra Taluk Hospital and 10 in Kozhikode Medical College. Meanwhile, one of the patients infected in the first wave at Perambra went on to get admitted at the Balussery Taluk Hospital on May 17. He infected yet another person, raising the possibility of a second wave of infection at the Balussery hospital. Nipah spreads mainly through respiratory droplets, and sicker patients secrete more virus. It was only in Baby Memorial, which had stricter infection-control protocols, that transmission seems to have stopped.
•While State authorities prepare for a second wave of infection, with the Balussery transmission coming to light only on May 31, Arunkumar believes that this wave may not be a large one. For one, infection-control measures were put in place by the 20th, and over 1,400 people who came in contact with the 19 confirmed cases are being closely watched. For another, unlike other viruses like measles in the Paramyxovirus family to which Nipah belongs, Nipah does not spread efficiently and moves only to people within a metre of very sick patients.
•This pattern of transmission is typical of how Nipah spread in Bangladesh and West Bengal. In the 2001 Siliguri outbreak, the first wave occurred in the Siliguri District Hospital, where patient zero infected nine others, including five staff members. Two of the patients then joined two other nursing homes, where they spread the illness to 34 others. In contrast to Siliguri, where hospital attendants formed the bulk of the patients, Bangladeshi Nipah cases were mostly related to other patients. A 2009 study in Clinical Infectious Diseasesnoted that Bangladeshi nurses had less physical contact with patients, as compared to western hospitals. Instead, family members provided hands-on care. Cultural practices like sharing of beds and utensils with patients exacerbated the risk to families, the researchers noted.
•In Kerala, the number of confirmed new cases emerging each day has slowed after the first wave from patient zero. But as the Nipah virus can incubate in the body for up to 21 days, health officials cannot take it easy for a while. Only when 42 days, or two incubation periods, pass after the last confirmed case will the State be declared Nipah-free.
•The Kerala government’s extraordinary response is, unfortunately, no solace for Salih’s family. Within a span of three weeks, they have lost four members. In the verandah of a neat two-storied house in Perambra, Salih’s uncle, Haji Moidu, sits staring ahead. His family and friends have gathered around him to mourn the loss of his wife Mariyam, brother Moosa, and nephews. Soon after Salih’s death, his aunt and father also succumbed to Nipah.
•But even before the family could come to terms with the deaths, several media outlets had published false information about the victims. A local daily wrote that Sabith had travelled to Malaysia, acquiring the Nipah virus there. The family is furious. “They have attempted to isolate us,” they say, showing Sabith’s passport. The only foreign nation Sabith visited was the United Arab Emirates, in search for a job.
Trapping the suspects
•The question of how Sabith contracted the virus remains a mystery, given that the only other Indian outbreaks have happened in West Bengal. But the strongest suspects now are Kozhikode’s large fruit bat populations. The species were found to be carriers of the Nipah virus in both Malaysia and Bangladesh.
•This is also why two teams of researchers from NIV are currently camping in Kozhikode to collect samples from fruit bats. It’s going to be an uphill task. For one, experiments have shown that the Nipah virus circulates within bats for brief periods of time, during which the likelihood of transmission to humans, or a “spillover” event, increases. In a 2011 study published in the American Journal of Tropical Hygiene and Medicine, virologists experimentally infected fruit bats from Malaysia and Australia with the Nipah virus, and the closely related Hendra virus. When they tried to isolate the pathogen from the bats only a few days later, they were unable to do so in most cases.
•“It’s very challenging to find the virus in bats, even when you are looking in a known reservoir, and that’s because of the nature of the infection,” says Jonathan Epstein, an epidemiologist with the U.S.-based EcoHealth Alliance and an author of the study. According to Epstein, the Nipah infection doesn’t last for very long in bats. “Unless your timing is good, and you are collecting samples close to when the first case was exposed, your chances diminish,” he explains.
•Sabith fell sick on May 3, and it is possible that the virus is undetectable in Perambra’s fruit bats now. However, the mammals may still be carrying antibodies to the Nipah virus, which remain for longer. But it isn’t clear if NIV will test for antibodies, in addition to the viral genes. In an email to The Hindu, NIV director D.T. Mourya said the group’s front line test would be RT-PCR, which only detects viral genes. Unless the NIV researchers are able to find a large number of bats, they may not have enough blood and urine samples to look for antibodies.
•To make matters more difficult, trapping bats is a tough job. The Indian flying fox can weigh over a kilogram, with a wingspan of up to five feet. The team’s strategy will be to raise large nets on 60-feet high poles, so that bats unseeingly fly into them. Meanwhile, the district animal husbandry department will collect bat droppings and urine from the ground. This, too, is becoming harder as monsoon hits Kerala. “Collecting bat droppings is not easy when it is raining. The quantity of urine is only 0.5 ml per animal,” says A.C. Mohandas, the district animal husbandry officer at Kozhikode. Without enough samples, we may never know how Nipah travelled to Kerala.
•Even if fruit bats are eventually found to be the source of Nipah, it may not be easy to establish how Sabith came in contact with them. Early interviews with his family had revealed that he and his brother had supervised the cleaning of a bat-infested well near his house. However, when animal husbandry officials checked the well, they were only able to collect a single bat from an insectivorous species. This sample turned out negative for Nipah. Another explanation could be that Sabith unwittingly ate a fruit contaminated with bat saliva. If this was the route of exposure, it’s doubtful it will be confirmed. But exposure through bitten fruits is not unlikely.
•At Sabith’s Perambra home, three neighbours, all undergraduate students, stop by to chat. They had known Sabith’s family and were shocked by the swiftness with which his family succumbed. The conversation drifts to how Sabith may have contracted the virus. One of them says, “We used to consume half-eaten guavas and mangoes all the time. We would just remove the bitten part and eat the rest. Nothing ever happened to us.” I ask them if they continue to do so. “No,” he says. “We are too scared now.”
