Why Do Global Diseases Like Covid-19 and MPox First Appear in Kerala?

Recently, the second case of Monkeypox (MPox) in Kerala was reported, making it the third case of this disease in India. A 29-year-old man returned from the UAE and was residing in Ernakulam, Kerala, when he developed a high fever. Tests confirmed the presence of Monkeypox (Clade-1B strain). Prior to this, another case of Monkeypox was found in Malappuram on September 18, where the patient had also returned from a Gulf country. Not just Monkeypox, Kerala has also witnessed outbreaks of the Nipah virus. Recently, a person died due to Nipah, signaling a new wave of this virus. In the years 2018, 2021, and 2023, Nipah wreaked havoc in Kozhikode, while in 2019, Ernakulam was affected.

As for Covid-19, the first case in India also emerged from Kerala. In 2020, a student returning from China tested positive for the virus. Since then, Kerala has repeatedly reported early cases of global diseases. This raises the question: why are these diseases first detected in Kerala? One primary reason for the early detection of global diseases in Kerala is the state’s large NRI (Non-Resident Indian) population. About 2.2 million people from Kerala live abroad, with the majority working in Gulf countries. According to a report by Deccan Herald, the Gulf is a major source of employment for a significant portion of Kerala’s population. Additionally, many students from Kerala travel abroad for higher education.

People working in countries like the UAE, Qatar, Saudi Arabia, and others frequently travel to Kerala. When they return, they may unknowingly bring diseases with them. Therefore, when a global pandemic or infection occurs, Kerala is often one of the first places to detect cases. In 2020, the country’s first Covid-19 patient was also a student returning from China. Kerala’s health department remains highly vigilant, especially when a new disease spreads worldwide. Strict screening measures are implemented at airports to catch infections before they spread. When the World Health Organization (WHO) declared Monkeypox a public health emergency, Kerala quickly began screening at its airports.

However, experts believe that airport screenings have their limitations. At a basic level, the tests are done, but unless a major advisory is issued by the government or WHO, these screenings may not always be fully effective. Moreover, identifying early symptoms can often be challenging, leading to delays in detecting infections. The importance of Kerala’s NRI population is underscored by the fact that during the elections held in April 2024, 22,000 NRI citizens returned home in just two days. The total number of registered NRI voters stood at 89,839. With such a large number of people connected to Gulf countries and their constant movement to and from Kerala, the state becomes a hotspot for the spread of any global disease.