A man wearing a mask reads a newspaper in Kochi, Kerala state, India. File/AP

The southern Indian state of Kerala is quickly ramping up efforts to stop a potential outbreak of the deadly Nipah virus as the Centre on Monday recommended various measures to curb the virus outbreak.

Based on the first report submitted by a central team the state of Kerala continues to battle the highest number of coronavirus cases in the country.

Union Health Secretary Rajesh Bhushan said in a letter to state Chief Secretary V.P. Joy that an active search for cases needs to be undertaken in the containment area as per the micro plan provided by the central team.

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"Both the hospital-based and community-based surveillance needs to be strengthened. Awareness needs to be created among the field formations for early detection of cases of Acute Encephalitis Syndrome/Respiratory Distress and risk communicated to the public," he said.

All district administrations will have to comply with the accepted norms of home quarantine and there should be an intensive follow-up on such cases, he stressed.

On Tuesday, the state health minister told reporters that the samples of eight primary contacts have come back negative.

A health worker (right) checks the body temperature of a woman (centre) in Chennai. File/AFP

"That these eight immediate contacts tested negative is a great relief,” Veena George said.

Nipah, which was first identified during a late 1990s outbreak in Malaysia, can be spread by fruit bats, pigs and through human-to-human contact. There is no vaccine for the virus, which can cause raging fevers, convulsions and vomiting. The only treatment is supportive care to control complications and keep patients comfortable.

The virus has an estimated fatality rate of between 40% and 75%, according to the WHO, making it far more deadly than the coronavirus.

George said that more samples will be tested on Tuesday and that a total of 48 contacts, including the eight that have tested negative, are being monitored at a hospital. Officials will also be carrying out door-to-door surveillance and identifying secondary contacts.

A Covid-19 patient with breathing problems waits in an ambulance to be admitted in a hospital in Chennai. File/AFP

The state health department had given guidelines to district collectors and district health officers in districts bordering Kerala to ensure strict vigil at all the check posts. The state has also constituted full-fledged medical teams at the borders with a heavy police posse guarding the check posts.

On Monday, Kerala registered nearly 20,000 COVID-19 infections out of India's daily total of 31,222. While cases across the country have declined after a devastating surge earlier this year, the situation in Kerala remains concerning, with experts warning that the state cannot let its guard down.