ISLAMABAD: Pakistan on Wednesday decided to enforce “strict and enhanced health surveillance” at all entry points in the country with immediate effect in order to prevent the cross-border transmission of Nipah virus.
Nipah, carried by fruit bats and animals such as pigs, can trigger a deadly brain-swelling fever in humans and can also spread directly from person to person through close contact. Several vaccines are in development but remain in testing.
It is classified as a priority pathogen by the World Health Organisation (WHO) because of its ability to spark fast‑moving outbreaks, its fatality rate of 40 per cent to 75pc, and the fact that there is no approved vaccine or cure.
The measures taken by authorities in Pakistan coincide with those taken multiple other countries — Singapore, Hong Kong, Thailand and Malaysia — after India confirmed earlier today the detection of two cases in December last year.
In this connection, the Border Health Services-Pakistan (BHS), an ancillary department of the Ministry of National Health Services, Regulations and Coordination, issued an advisory which referred to a regional alert reported by international and regional public health surveillance mechanisms, including the WHO South East Asia Region Epidemiological Bulletin.
Citing the alert, the advisory said in view of the “suspected cases of Nipah virus infection in West Bengal, India, and considering the high case fatality rate, zoonotic nature, and potential for human-to-human transmission, it has become imperative to further strengthen preventive and surveillance measures at Pakistan’s borders”.
“In order to prevent the cross-border transmission of Nipah virus in Pakistan and to ensure early detection and prompt response, the competent authority has decided to enforce strict and enhanced health surveillance at all points of entry with immediate effect.
“These instructions shall be applicable to all points of entry, including international airports, seaports, and ground/ land border crossings, without any exception,” the advisory said.
Outlining the instructions, the advisory said all in-charges at entry points should ensure 100pc screening of all arriving passengers, transit passengers, crew members, drivers, helpers, and support staff.
“No individual shall be allowed entry into Pakistan without health clearance by Border Health Services — Pakistan.”
Under the new measures, mandatory verification of the country of origin and complete travel and transit history for the preceding 21 days shall be carried out for each and every traveller, irrespective of their nationality or travel status.
“All in-charges at points of entry shall exercise special vigilance for travellers originating from, or transiting through, Nipah-affected or high-risk regions. Any false declaration, concealment, or misreporting of travel history shall be immediately documented and reported to the competent authorities for further necessary action,” the advisory stated.
Moreover, travellers are also required to undergo thermal screening and clinical assessment at entry points.
“Screening staff shall remain alert for early signs and symptoms of Nipah virus infection, including fever, headache, respiratory symptoms and neurological signs such as confusion, drowsiness or altered consciousness.
“Any individual consistent with suspected Nipah virus case definition shall be immediately isolated at the point of entry, restricted from onward movement, and managed strictly in accordance with Infection Prevention and Control (IPC) protocols,” it was instructed in the advisory.
Such suspected cases should be promptly referred to the designated isolation facility or a tertiary care hospital in coordination with provincial and district health authorities, the advisory said, adding that the “conveyance concerned (aircraft, vessel, vehicle) and surrounding area shall be immediately disinfected as per approved standard operating procedures”.
In-charges at entry points have been further directed to ensure strict compliance with IPC measures, including the mandatory use of personal protective equipment (PPE), hand hygiene, and environmental sanitation.
Any lapse in surveillance or IPC practices should be treated as serious negligence, the advisory said.
Moreover, “daily case/ nil reports from all points of entry shall be recorded in the BHS-P system already in vogue and shared with National Command and Operation Centre and the National International Health Regulation Focal Point”.
Any delay, weak surveillance, under-reporting, or non-compliance with these instructions should be not be tolerated, the advisory stated.
It said: “All in-charges at points of entry are directed to ensure strict compliance with the above instructions in letter and spirit. These measures shall remain in force until further orders are issued by the competent authority.”
What is Nipah virus?
Talking to Dawn, Microbiologist Prof Dr Javaid Usman said that the virus was named after a place in Malaysia.
“The virus is spread through the droppings of fruit bats and pigs. However, both are not present in Pakistan. So the only chance the virus would travel to Pakistan is through carriers. Currently, a few cases have been reported in the Indian state of Bengal due to which neighbouring countries have announced to screen their masses,” he said.
Replying to a question, he said that the major symptoms of the virus included fever and neurological disorders.
“People can have fits. The virus can spread through respiratory droplets, saliva and the blood of a patient who has tested positive. So positive samples are kept in isolation,” Dr Usman said.
Chief of the Centre for Disease Control (CDC) at the National Institutes of Health (NIH), Dr Mumtaz Ali Khan, told Dawn that this was the 51st outbreak since 2001.
“Although we have issued advisories to alert airport authorities, there are very few chances of identifying patients as the incubation period of the virus is 9 to 14 days,” he said.
Additional input from Reuters
