India to procure 20 more doses of monoclonal antibody from Australia for Nipah treatment: ICMR DG

India has reached out to Australia for procuring 20 more doses of monoclonal antibody for the treatment of Nipah virus infection amid cases being reported from Kerala, ICMR DG Rajeev Bahl said on Friday.

With repeated instances of Nipah outbreaks being reported from the southern state and the mortality rate very high compared to Covid, Bahl said that ICMR is also planning to start work on developing a vaccine against the viral disease.

He said mortality among the infected is very high in Nipah (between 40 and 70 per cent) compared to the mortality in Covid, which was 2-3 per cent.

A fresh case of Nipah virus was confirmed in Kozhikode, taking the total number of people infected in the state to six, two of had died earlier.

'We got some doses of monoclonal antibody from Australia in 2018. Currently the doses are available for only 10 patients,' Bahl said, adding globally monoclonal antibody has been given to 14 patients infected with Nipah virus outside India and all of them have survived.

'Only phase 1 trial to establish the safety of the medicine has been done outside. Efficacy trials have not been done. It can only given as compassionate use medicine,' he said.

According to him, no one so far has been administered the medicine in India.  'Twenty more doses are being procured. But the medicine needs to be given during the early stage of the infection,' he said, adding it can only given as compassionate use medicine.

He asserted that all efforts are on to contain the spread of the virus in Kerala.

All patients are contact of an index patient, he said.

On ICMR planning to start work on new vaccines such as a vaccine for Nipah, Bahl said the procedure involves looking for partners - who can make it, and on which platform.  'Our biggest asset at the moment is that we have developed vaccines on diverse platforms during Covid such as DNA vaccine, mRNA vaccine, adenoviral vector vaccine, protein subunit vaccine, and nasal vaccine, and we can use these diverse platforms to develop the new vaccine against disease such as Nipah infection,' he said.

On why cases keep surfacing in Kerala, Bahl said, 'We do not know. In 2018, we found the outbreak in Kerala was related to bats. We are not sure how the infection passed from bats to humans. The link couldn't be established. Again we are trying to find out this time. It always happens in the rainy season.'

Globally monoclonal antibody have been given to 14 patients infected with Nipah virus outside India and all of them have survived.

The decision to use the antibody, however, has to be of the Kerala government's, besides that of doctors and also families of patients.  ICMR's National Institute of Virology in Pune is conducting whole genome sequencing of the virus to know which exact variant is in circulation in Kerala.  Meanwhile he said the Mobile BSL 3 Laboratory which has been sent to Kozikodhe to enable testing at the district itself there testing of samples have already begun.

In view of high mortality, Bahl said taking precautions is the best option. He advised people to follow social distancing, wear masks and stay away from raw food that could be exposed to bats. 

Developed in America, the antibody was shared with a university in Australia as part of a tech-transfer initiative.