Six districts in Kerala have been put on alert after a 58-year-old man from Palakkad tested positive for the Nipah virus after he died on Saturday, ANI reported. This is the second case reported in the district.

The man from Kumaramputhur near Mannarkkad in Palakkad tested positive for the virus after he died at a private hospital in Malappuram district’s Perinthalmanna, The Hindu reported. He was being treated at the hospital for a fever.

The virus was detected through tests conducted at the Manjeri Medical College in Malappuram, The New Indian Express reported. The samples have been sent to the Pune’s National Institute of Virology in keeping with the standard protocol for confirmation.

This was the second Nipah-related death in Kerala in recent weeks. An 18-year-old woman from Malappuram died from the infection on July 1, while another patient from Palakkad was hospitalised.

On Sunday, state Health Minister Veena George said that an alert had been issued to hospitals in Palakkad, Malappuram, Kozhikode, Kannur, Wayanad and Thrissur districts, ANI reported.

George said that a contact list had been prepared of the 46 persons who had interacted with the man over the past three weeks, along with a route map, The Hindu reported. She added that both were awaiting release pending confirmation from the National Institute of Virology.

The minister said that fieldwork, including fever surveillance and door-to-door visits by health workers to provide guidance on precautions against the virus, were being conducted in Kumaramputhur.

“We will bolster our fight against Nipah by strengthening the health teams involved in it and intensifying preventive measures as soon as we get the final confirmation from NIV, Pune,” The Hindu quoted George as saying.

With the 46 contacts of the latest case, 543 persons across the state were currently under observation for the virus, the newspaper reported. At least 208 of them are in Malappuram, 219 are in Palakkad, 114 in Kozhikode and two in Ernakulam.

The Nipah virus is a “zoonotic illness” transferred from animals such as pigs and fruit bats to humans. The virus can also be caught through human-to-human transmission.

It causes fever and cold-like symptoms in patients. The infection can also cause encephalitis, which is the inflammation of the brain, and myocarditis, or the inflammation of the heart, in some cases.

Since 2018, Kerala has experienced five Nipah outbreaks.