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India recently confirmed a new outbreak of the Nipah virus in the eastern state of West Bengal. The country reported two cases this month in healthcare workers and is pushing for heightened health surveillance across parts of Asia.
This outbreak has sparked new concerns worldwide, prompting countries to tighten airport health screening. Health authorities, including the World Health Organisation (WHO), classify Nipah as a priority pathogen because it causes severe illness and death, and it can spread between humans.
As part of its Media and Information Literacy (MIL) function, DUBAWA decided to break down all you need to know about this virus to stay prepared and safe.
What is the Nipah Virus?
Nipah virus (NiV) is a zoonotic virus, meaning it spreads from animals to humans. It was first identified in 1998–1999 during an outbreak among pig farmers in Malaysia. Since then, outbreaks have been reported primarily in South and Southeast Asia, particularly in Bangladesh and India.
The natural hosts of the virus are fruit bats, particularly those of the Pteropus genus. There is evidence that the Nipah virus can infect other animals, including pigs, dogs, cats, goats, horses, and sheep.
The virus is considered highly dangerous because it can cause severe disease and has a high fatality rate, sometimes reaching 40–75%, depending on the outbreak and access to care.
Nigeria has never officially recorded a confirmed human case of Nipah virus infection, but understanding the virus and its spread is important.
Where does the Nipah virus come from?
Fruit bats of the Pteropodidae family, particularly Pteropus species, are the natural hosts of the Nipah virus and show no signs of illness. Humans can become infected through direct contact with infected bats, consumption of food contaminated by bat saliva or urine (such as raw date palm sap), or contact with infected animals, especially pigs.
How does it spread?
Nipah spreads through close contact with bodily fluids, including saliva, blood, urine, or respiratory droplets of an infected person or animal. In some outbreaks, hospital settings have amplified transmission due to poor infection control.
During later outbreaks in Bangladesh and India, the Nipah virus spread directly from person to person through close contact with secretions and excretions.
In Siliguri, India, in 2001, viral transmission was also reported in a health-care setting, with 75% of cases among hospital staff or visitors. From 2001 to 2008, around half of reported cases in Bangladesh were due to human-to-human transmission through providing care to infected patients.
Unlike COVID-19, Nipah is not easily airborne, but its ability to spread between people remains a serious public health concern.
What are the signs and symptoms?
Human infections range from asymptomatic infection to acute respiratory infection (mild or severe) to fatal encephalitis.
Infected people initially develop symptoms including fever, headaches, myalgia (muscle pain), vomiting, and sore throat. This may be followed by dizziness, drowsiness, altered consciousness, and neurological signs indicating acute encephalitis. Some people can also experience atypical pneumonia and severe respiratory problems, including acute respiratory distress. Encephalitis and seizures occur in severe cases, progressing to coma within 24 to 48 hours.
The incubation period (the interval from infection to the onset of symptoms) is estimated to range from 4 to 14 days. However, an incubation period of up to 45 days has been reported.
Most people who survive acute encephalitis make a full recovery, but long-term neurologic conditions have been reported in survivors. Approximately 20% of patients are left with residual neurological consequences such as seizure disorder and personality changes. A small number of people who recover relapse subsequently or develop delayed onset encephalitis.
How can it be prevented or treated?
There are currently no drugs or vaccines specific to Nipah virus infection, although the WHO has identified Nipah as a priority disease for the WHO Research and Development Blueprint. Intensive supportive care is recommended to treat severe respiratory and neurologic complications.
Initial signs and symptoms of Nipah virus infection are nonspecific, and the diagnosis is often not suspected at presentation. This can hinder accurate diagnosis and create challenges for outbreak detection, effective and timely infection control measures, and outbreak response.
In addition, the quality, quantity, type, and timing of clinical sample collection, as well as the time required to transfer samples to the laboratory, can affect the accuracy of laboratory results.
However, based on experience from the 1999 Nipah outbreak involving pig farms, routine, thorough cleaning and disinfection of pig farms with appropriate detergents may be effective in preventing infection.
If an outbreak is suspected, the animal premises should be quarantined immediately. Culling of infected animals with close supervision of burial or incineration of carcasses may be necessary to reduce the risk of transmission to people.
Restricting or banning the movement of animals from infected farms to other areas can reduce the spread of the disease.
Human care is primarily supportive, focusing on managing symptoms and complications.
Several vaccines and antiviral treatments are under development, but none are yet widely available.
What can we do now?
- Avoid consumption of raw palm sap or fruits partially eaten by bats. Fruit bats, which are the natural carriers of the Nipah virus, can contaminate food with their saliva, urine, or faeces.
- Raw palm sap collected overnight is particularly risky because bats often drink from the collection pots. Eating fruits that bats have already bitten into can also expose people to the virus. Properly washing, peeling, or cooking fruits reduces this risk, while avoiding raw or uncovered palm sap altogether is strongly advised.
- Regular handwashing with soap and clean water helps prevent the spread of infections picked up from contaminated surfaces, animals, or people. Hand hygiene is especially important after handling animals, caring for sick individuals, visiting healthcare facilities, or coming into contact with bodily fluids. Where soap and water are unavailable, alcohol-based hand sanitisers can be used.
- People caring for infected or suspected patients, especially healthcare workers and family caregivers, are at risk because the Nipah virus can spread through close contact with bodily fluids.
- Using protective equipment such as gloves, face masks, gowns, and eye protection reduces exposure. Avoiding direct contact with saliva, blood, urine, and respiratory secretions is critical, particularly in home-care and hospital settings.
Conclusion
Nipah virus remains rare, but it is one of the world’s most dangerous infectious diseases due to its high fatality rate and lack of specific treatment or vaccines.
