Heart-wrenching: How Nipah virus took away life of a chirpy 12-year-old boy

Vahida and Aboobacker are finding it hard to believe that their only son, Hashim, has been snatched literally away from their lap by a little-known, but deadly virus called Nipah.

Just a few days ago, they were heaving a sigh of relief that his two-day fever was not the dreaded COVID. After all, children fall sick all the time and Hashim, 12, was playing with his friends like usual despite his mild fever.

Vahida, who is in quarantine herself at the Kozhikode Medical College hospital, is finding it difficult to come to terms with her son’s death. “How can it be Nipah?” she asks me. “He was conscious and was talking even when we reached the Medical College. Will one be able to talk if he is infected by Nipah?”

The hospital she refers to was the fourth among five healthcare centres, including a private clinic, that the family took Hashim to for treatment, when his mild symptoms of a viral illness did not subside.

“He had a mild fever. We thus took him to Dr Mohammad’s clinic. He gave him some medicines. We were scared of COVID, but he was better the next day,” recalls the mother.

Even the doctors, focused on COVID these days as case numbers surge in Kerala, were initially left baffled by Hashim’s range of symptoms. The state has seen two outbreaks of the Nipah viral illness in 2018 and 2019.

The last few days of Hashim’s life were thus spent shuttling from hospital to hospital after he developed a fever on August 27.

Dr Mohammad of Central Clinic does not even remember the boy clearly because “there was nothing particularly wrong with him”. “I don’t remember very clearly, he had only fever which was not severe. I prescribed paracetamol and advised him to rest at home,” he told The Federal.

Hashim’s route map traced by the health department in a bid to promptly isolate his contacts shows him at Dr Mohammad’s home clinic in Eranjimavu, Kozhikode, on August 29. Two days later, on August 31, he was taken to EMS Memorial hospital at Mukkam in Kozhikode. According to the route map, released by the District Collector of Kozhikode on Sunday, the boy reached the hospital in his uncle’s auto at 9.58 am and spent an hour there.

Hashim was then taken to Santhi Hospital in Omassery, Kozhikode, in the same auto and spent two hours there till 12 pm. Half an hour later, he was sent to the Medical College hospital by ambulance.

There, Hashim remained admitted for a day and was referred to MIMS Hospital the next day, where he fought for life for four days on ventilator, before passing away.

It begs attention why a child with fever had to hop four hospitals in 24 hours in a state known for its robust healthcare and successful containment of epidemics.

Also read: Kerala’s tryst with Nipah: A tale of scare, vigilance and tears

Doctors at EMS Memorial hospital suspected there was something seriously wrong with Hashim, and that it was not COVID.

“The boy had high fever when he was brought here; we isolated him in a room and got an antigen test done. But COVID was ruled out. His oxygen saturation level was unusually low. He had a severe headache and was visibly upset. The RMO on duty consulted a paediatrician and we realised something was seriously wrong,” reveals C. Rajan, the administration manager at the hospital, adding that they referred the case to the Medical College, but Hashim’s parents preferred to go to Santhi hospital.

“Ours is a small hospital having a capacity of 50 beds, and we did not have ventilator facility. Hence, we referred the boy to another hospital,” Rajan explains.

At Santhi Hospital, Hashim’s condition was no better. “The boy had high fever, nausea and severe headache when he was brought in,” says Shiji Paul, manager in the clinical department.

“His oxygen level was only 85. COVID had already been ruled out from the previous hospital; yet the saturation level was very low. Considering the boy’s age, we assumed that it was a case that required expert care. Hence, we sent the boy to the Medical College in our ambulance in half an hour after a preliminary examination,” Shiji told The Federal.

Hashim was admitted to the Medical College in the red area (the wing where critical patients are taken in), and immediately provided critical care support. His condition had deteriorated considerably by this time.

“We ruled out COVID by antigen and true Nat tests and sent the blood sample for detailed evaluation. We administered drugs for viral encephalitis and sent him in a ventilator-equipped ambulance to MIMS Hospital the very next day,” says Dr VK Shemeer adding that the boy was referred to the MIMS facility because ICU beds were not available at the Medical College.

“It was not a COVID case, and the ICU/ventilator facilities that we have are often occupied 100 per cent. What we usually do with critical cases is quickly enquire with the hospitals around and find the availability of ICU and ventilator facility and send the patient,” the good doctor told The Federal.

For Hashim’s family, the days before his passing are a blur, and for his mother especially, it is hard to recollect the hours since August 31, the critical day when her son suddenly took a turn for the worse.

“When we were about to board the ambulance from Santhi Hospital, he had a seizure. I think it happened because he was scared to get into an ambulance,” says Vahida, who along with her husband Aboobacker has since their son’s death shown symptoms of Nipah — headache and fever.

On August 27, the day he had developed a fever, Hashim had played with his friends in the evening. The next day, he got a headache. “He vomited and then he said the headache was gone,” recalls the mother. She remembers not taking his complaint of a sore throat seriously because Hashim had a history of tonsillitis.

Also read: Amid COVID war, how Kerala quickly swung to fight Nipah virus battle

“When the fever remained for the second day, we went to EMS Memorial hospital. We were scared that he had COVID. When the test was negative, I was so relieved,” she says, sadly.

Unable to come to terms with the tragedy, she keeps asking: “He played with his friends, none of those children is sick. How is it possible if it were Nipah?”

State health minister Veena George said the government would examine whether there was any lapse in diagnosis at Medical College, while a team has been formed to look into the origins of his latest outbreak of Nipah in Kerala.