Rapidly deployable mobile BSL-3 laboratory: a response to the Nipah virus outbreak in Kozhikode, Kerala, India, 2023

Nipah virus (NiV) outbreak was declared in Kozhikode district, Kerala state, India, on 12 September 2023. The local, state, and national authorities worked in an integrated way to tackle and control the outbreak. Indian Council of Medical Research (ICMR) deployed a team from the ICMR-National Institute of Virology (NIV), Pune, India, along with an indigenously developed and validated Mobile BSL-3 (MBSL-3) laboratory for providing onsite NiV diagnosis. The Kozhikode district of Kerala state was the epicenter of three NiV outbreaks on May 2018, August 2021, and most recently in September 2023. The Ernakulam district of Kerala also reported a NiV outbreak in June 2019. In the 2023 outbreak, six confirmed NiV cases were detected, with two deaths. During previous outbreaks in 2019 and 2021, the team from ICMR-NIV, Pune, had successfully established a field laboratory utilizing the BSL-2 facility for NiV onsite diagnosis. BSL-3 personnel protective equipment and standard operative procedures were used to handle clinical specimens. Post COVID-19 pandemic, under the pioneering initiative of the Government of India, ICMR, and Klenzaids Contamination Control Pvt. Ltd, Mumbai developed a rapidly deployable, pragmatic, access control, and containment laboratory on bus chassis. The MBSL-3 laboratory was utilized for the NiV onsite diagnosis for early containment of outbreaks, reducing the turnaround time for diagnosis to just 4 hrs. The MBSL-3 laboratory plays a significant role in NiV outbreak response and could be utilized in the future also reaching the remotest areas of the country.