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Among the dead in the Kerala outbreak was nursing assistant and mother-of-two Named, Lini puthussery who had helped to treat one of the original family suffering from Nipah earlier this monthPuthussery died on Monday and was cremated before her family members could bid her a final Goodbye, because of fears the virus could spread. Officers of the health, animal husbandry and forest departments have taken samples of the dead bats for further investigation. Fruit bats are the natural host of the virus belonging to Pteropodidae family. Although "They are not confirmed Nipah Cases yet, so there is no need to panic", he added via telephone.

Symptoms of Nipah virus are trouble in breathing, brain swelling, headache, fever, drowsiness, disorientation and delirium.

The report said that this was the fourth death in the family with Moosa's two sons and sister-in-law dying from the disease. Due to the migratory habit of the locally abundant fruit bats in South Asia, Nipah outbreaks occur more in this region.

But on Wednesday, this correspondent met a group of Accredited Social Health Activists or ASHA workers as they conducted a door-to-door awareness campaign in Soopikkada village - the ground zero of the Nipah outbreak - where four persons have succumbed to the virus so far. "It is hard to know if the symptoms are of Nipah virus or ordinary influenza", says Kurup, adding that unless the situation clears, he will not visit the state.

An emergency meeting of health officials was chaired by District Collector Mir Mohammed Ali to review preparedness of hospitals in case the infection is reported in the district.

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"I am not very anxious about my family back there as the state medical department is working very efficiently and we hope that the virus will be contained soon", he adds. "All the doctors and nurses who treat suspected patients are using it", he said.

Kerala is on high alert over the infection and two control rooms have been opened in Kozhikode. It said that a detailed advisory, with preventive measures and common signs, would be issued soon. The disease has been confined to Kozhikode and Malappuram districts.

Human-to-human transmission of the virus has been recorded in previous outbreaks in India that killed as many as 50 people.

Although state health officials in Kerala - a popular travel destination for Gulf tourists - have declared the state safe, they have cautioned travellers against visiting the districts of Kozhikode, Malappura, Waynad and Kannur.