Nipah virus is a zoonotic virus, meaning it can be transmitted from animals to humans. It is carried by fruit bats (flying foxes) of the genus Pteropus which are found throughout south east Asia. Nipah can also be spread through contaminated food or directly between people. The virus can cause a range of illnesses, from asymptomatic infection to acute respiratory illness and fatal encephalitis. It can also cause severe disease in animals such as pigs, resulting in significant economic losses for farmers.
Although Nipah virus has caused only a few known outbreaks in Asia, it has led to severe disease and death in people, making it a public health concern. It is among the World Health Organization’s list of diseases that have pandemic potential.
Nipah virus infection in humans can range from asymptomatic to acute respiratory infection, seizures and fatal encephalitis. The incubation period – from being infected to displaying symptoms – is around four to 14 days but has been as long as 45 days.
Initial symptoms of Nipah virus infection include:
These symptoms can be followed by:
The most important complication of Nipah virus infection is encephalitis, which is associated with a high mortality rate. The case fatality rate is estimated at 40 to 75 per cent. This rate can vary by outbreak depending on the strength of health systems in the affected areas.
Approximately 20 per cent of patients are left with neurological consequences such as seizures and personality changes. Some people who recover may relapse or develop delayed onset encephalitis.
Nipah virus can be transmitted to humans from animals (such as bats or pigs), or contaminated foods. It can also be transmitted directly from people in close contact with infected individuals – for example, family members or health workers. The first outbreak of Nipah in Malaysia was passed from pigs to humans. Person-to-person transmission was responsible for most of the cases in the India outbreak in May-June 2018. There is a potential risk of sexual transmission of Nipah virus.
The virus can spread through:
Currently, there are no licensed treatments or vaccines available for Nipah virus infection for either people or animals. Treatment is limited to supportive care, including rest, hydration, and treatment of other symptoms. Intensive supportive care is recommended to treat severe respiratory and neurologic complications.
Several experimental therapies are in pre-clinical development or phase 1 clinical trials, including monoclonal antibodies and novel antivirals.
There is currently no vaccine against the virus, although i a trial will launch in Bangladesh in January 2026.
In the meantime if you are travelling to an area where there is a risk of infection you should:
The risk to travellers to countries where Nipah outbreaks are likely to occur is low.
The name Nipah comes from the village in Malaysia where the disease emerged in 1998. The virus spilled over from bats to pigs and humans were exposed to the urine and/or respiratory secretions of infected livestock. Three hundred people got sick and more than one hundred of those people died. One million pigs were killed to control the disease. No new outbreaks have been reported in Malaysia since 1999.
Outbreaks have also occurred in India, the Philippines, and Singapore. And in Bangladesh there have been cases nearly every year since 201. Outbreaks are seasonal, taking place between December and April during the harvesting and consumption of date palm sap. In May 2018 an outbreak was reported in Southern India for the first time, in Kozhikode district of Kerala.
Other regions may be at risk for infection, as the Pteropus bat species is widespread across Asia and Australia.
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