The 14-year-old boy from Kerala’s Malappuram district, who was infected with the Nipah virus, died in Kozhikode on Sunday.

The boy had developed fever 10 days back and had been on ventilator support since Friday, The Indian Express quoted health department officials as saying.

After confirming that it was a case of Nipah virus infection, National Institute of Virology-Pune on Saturday transferred the boy from a private hospital to the Medical College Hospital in Kozhikode.

Doses of monoclonal antibodies were scheduled to arrive in Kozhikode from Pune on Sunday, but the boy passed away before that. His body will be buried according to protocol for Nipah virus-infected individuals, the newspaper reported.

Four more persons have shown symptoms of Nipah virus, with one of them currently on life support, Kerala’s Health Minister Veena George told reporters. Their samples have been sent for testing. Approximately 240 persons, who were in contact with the boy, are currently under observation, The Indian Express quoted George as saying.

The health department has established a control room in Malappuram, where an alert has been declared. Residents have been advised to wear masks and a lockdown has been enforced in selected areas within the Pandikkad panchayat, which is the boy’s hometown.

District Collector VR Vinod has implemented restrictions in Pandikkad and Anakkayam panchayats and announced that educational institutions in these panchayats will remain closed, reported The Hindu.

People have been advised to refrain from attending gatherings, including previously scheduled events. Weddings and other social gatherings should be limited to a minimal number of guests.

On Sunday, the Union government said that immediate public health measures had been advised to contain the disease. A joint outbreak response central team will be deployed to assist the state with case investigation, identification of epidemiological linkages, and technical support, the Centre said in a statement.

Since 2018, Kerala has experienced five Nipah outbreaks. According to The Indian Express only six patients, who tested positive, have survived till date: one in Kozhikode in 2018, another in Kochi in 2019 and four in Kozhikode in 2023.

In 2018, 17 out of 18 infected individuals had succumbed, with one death reported in 2021. In 2023, two deaths due to Nipah virus were recorded.