Figure 1
Interdisciplinary Coordination at National, State and District level.
Abbreviations: GoI- Government of India, GoK- Government of Kerala, MoHFW- Ministry of Health & Family Welfare, DGHS- Directorate General Health Services, NCDC- National Centre for Disease Control, RoHFW- Regional office & Health Family welfare, EMR- Emergency Medical Relief, IDSP- Integrated Disease Surveillance Programme, DHS- Directorate Health Services, SNO- State Nodal Officer, DMO- District Medical Officer, SDH-Sub-district Hospital, CHC- Community Healthcare Centre, PHC- Primary Healthcare Centre, INI- Institutes of National importance, AIIMS- All india institute of medical science, NIMHANS- National Institute Of Mental Health And Neurosciences, DME- Directorate Medical Education, GMC-Government Medical College, DC- District Commissioner ICAR-Indian Council Agricultural Research, KAHD- Kerala Animal Husbandry Department, LSGD- Local Self Development Government.
Table 1
Role of various stakeholders and coordinated multidisciplinary response mechanism l during Nipah virus disease outbreaks (2018 and 2019) at National, State, District, and Subdistrict levels.
| CENTRAL AUTHORITIES | ||
|---|---|---|
| PARTNER INSTITUTES | EXPERTISE | ROLES & RESPONSIBILITIES |
| 1. NCDC Delhi & NCDC Kozhikode 2. ROHFW Thiruvananthapuram 3. EMR, 4. AIIMS Delhi 5. NIMHANS Bangalore 6. NIV Pune |
| 1. Providing technical guidance on Case Definitions for Suspect, Probable, Confirmed cases and Contacts, advisory for healthcare personnel, Information for general public, Treatment guidelines, Sample collection and transport guidelines 2. Establishing the timelines of events, undertaking epidemiological linkage and risk assessment 3. Verify the outbreak and confirm the diagnosis 4. Suggest measures for containment 5. Training for ICP, including Dead body disposal 6. Establishing point of care test (PoCT) during the second outbreak 7. Activation of Emergency Operations Centre (EoC) 8. Undertake reporting of event to International Agencies, as prescribed under IHR |
| 1. NIHSAD Bhopal | Veterinary expert | 1. Source identification collection of bats and testing for NiVD |
| STATE, DISTRICT AND SUBDISTRICT AUTHORITIES | ||
| 1. Health and Family Welfare Department, Government of Kerala including Govt Medical Colleges Kozhikode, Ernakulam, Thrissur and District Hospitals of Thrissur and Idukki 2. Private hospitals 3. Municipal Corporation |
| 1. Strengthening Infection control practices and Biomedical waste management practices 2. Early suspicion of cases 3. Establishing Control rooms and providing resources for response 4. Treatment of cases and Isolation of suspects 6. Cremation and last rites of the deceased as per the guidelines 7. Contact tracing and establishing epidemiological linkages 8. Undertake Media briefings |
| 2. Kerala Animal Husbandry Department |
| 1. Source identification and collection of bats 2. Establishing and attending helpline for livestock farmers 3. Vigil on reports of livestock for unusual symptoms |
| 4. Nipah cell (District Rapid Response Team) |
| 1. Initiating the first response to the outbreak 2. Attending helpline, screening calls, follow up of symptomatic cases through call back 3. Cyber space monitoring 4. Social media awareness through IEC, posters and videos |
| 5. District Administrative authorities |
| 1. Cyber Investigation for online fake content related to NiVD 2. Maintain law and order |
| 6. Local Self Government Department(LSGD) (refr) comprising Panchayat Directorate, Directorate of Urban Affairs, Commissionerate of Rural Development and Town and Country Planning Department |
| 1. Co-ordinate the above activities and provide resource assistance 2. Help in alleviating the fears of community 3. Provide support to affected families and food kits to home quarantine cases 4. Facilitating implementation of surveillance and response |