From monkeypox to Covid-19: Why Kerala often reports the first cases of disease

The sensitivity in state's health surveillance, citizen behaviour and awareness might have played a part

So, why is it Kerala that almost always reports the first cases of such diseases in India? The reasons, experts suggested, could be manifold.

One primary cause is that the state’s population is spread across the globe, with a large number of students studying medicine and many expatriates working as doctors or nurses around the world. These categories face the occupational hazard of viral attacks and may unwittingly spread undiagnosed diseases to others when they travel back to India.

Also Read: How does monkeypox spread? What do experts say?

An article in the journal Nature suggested that the high population density of animals and humans in the state, coupled with the depletion of forests, could be other triggers for viral outbreaks.

Dr T S Anish, Associate Professor of Community Medicine at Thiruvananthapuram Medical College, spoke to Malayalam newspaper Mathrubhumi and explained that human expansion into the Western Ghats and the consequent destruction of habitats left bats, which were common disease vectors, without food. These bats then travelled to human settlements in search of food and might be responsible for the spread of infections.

Anish told The Hindu that civets and monkeys could also be responsible for the spread of diseases. "The loss of habitats of wild animals such as bats, monkeys and civet cats forced them to move closer to human habitations and establish new interfaces with human beings," he said. "The interfaces led to the spread of zoonotic diseases. Civet cats have almost become urban animals as their natural habitats have been wiped out. These animals are believed to be the mediators of the pathogen that caused the Severe Acute Respiratory Syndrome. Bats are now considered as the reservoirs of the Nipah and Ebola virus."

Also Read: Monkeypox emergency could last months, with window closing to stop spread, say experts

The sensitivity in Kerala's health surveillance, citizen behaviour and awareness might have also played a part in helping to detect diseases. Epidemiologist and public policy expert Dr Chandrakant Lahariya told CNBC-TV18 that the first person infected with monkeypox in Kerala volunteered to be tested. He was asymptomatic but he chose to take the test after he heard that one of his UAE contacts had tested positive.

The aforementioned factors have greatly contributed to the detection of many infectious diseases in the state.