A deadly virus that causes fever, vomiting and convulsions – and for which there is no vaccine – has sparked a health alert in India.
Nipah is mainly carried by fruit bats and has a mortality rate of around 75%.
It can also be passed on by pigs and from human-to-human contact and can lead to coma or swelling of the brain.
At least three people from the same family have died from the virus in Kerala, said state health minister K K Shailaja.
Eight other deaths are also being linked to the virus, including a nurse who is said to have treated the victims.
Neighbours told local media that two of the people who died had eaten fruit from land where they were building a home.
A bat was reportedly found in a well on the property, according to the Press Trust of India.
The only treatment for Nipah is care to contol the symptoms and keep patients comfortable.
“The health department is doing everything possible to save the lives of the infected & prevent the advance of virus,” said the office of Kerala’s chief minister Pinarayi Vijayan.
The victims who tested positive for the virus all died in Calicut district, and India’s health minister has rushed experts to the area amid reports of panic.
Nipah was first identified in Malaysia in 1998, before spreading to Singapore and killing more than 100 people.
Fifty people were also killed in India’s West Bengal state during outbreaks in 2001 and 2007.
The virus has killed more than 100 in Bangladesh – with a 2004 outbreak blamed on people eating date palm sap that had been contaminated by infected bats.