Resurgence of Nipah Virus: A Threat to Public Health in India

Mahendra Pal^1, , Priyanka Thakur², Ravindra Zende³ and Aishwarya Nair³

¹Narayan Consultancy on Veterinary Public Health and Microbiology, Bharuch, Gujarat, India

²Food And Agriculture Organization of The United Nation, UN House, Pulchowk. Kathmandu. Nepal

³Department of Veterinary Public Health and Epidemiology, Mumbai Veterinary College, Parel, Mumbai, India

Cite this paper:
Mahendra Pal, Priyanka Thakur, Ravindra Zende and Aishwarya Nair. Resurgence of Nipah Virus: A Threat to Public Health in India. American Journal of Biomedical Research. 2026; 14(1):1-7. doi: 10.12691/ajbr-14-1-1

Abstract

Emerging and re-emerging viral zoonoses pose a serious threat to public health globally. The Nipah virus (NiV), a member of the genus Henipavirus within the family Paramyxoviridae, is a highly pathogenic zoonotic virus with case fatality rates ranging from 40% to 75%, depending on outbreak conditions and healthcare capacity. Considering case fatality rates ranging from 40% to over 75%, the Nipah virus is a highly pathogenic zoonotic virus that occasionally causes epidemics of severe encephalitis and respiratory sickness in humans. Ever since it first appeared in Malaysia in 1998–1999, in South and Southeast Asia, the Nipah virus has frequently caused epidemics, especially in Bangladesh and India. The principal natural reservoir hosts have been identified as fruit bats of the genus Pteropus through extensive epidemiological, ecological, and molecular investigations. Transmission occurs through direct bat-to-human spillover, exposure to infected intermediate animal hosts, consumption of contaminated food products, and human-to-human transmission. This article synthesizes current evidence on the virology, transmission dynamics, epidemiology, clinical manifestations, diagnosis, treatment, and prevention of Nipah virus infection, with emphasis on recent Indian outbreaks. Recent advances in rapid molecular diagnostics, monoclonal antibody–based therapeutics, antiviral candidates, and vaccine development platforms are also critically discussed. Given its epidemic potential, high mortality, and absence of licensed vaccines or specific antiviral therapies, continued surveillance, strengthened outbreak preparedness, and accelerated research into effective medical countermeasures remains public health priority.

Keywords:
Emerging infections Encephalitis Nipah virus One Health Public health Zoonotic disease

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]	Pal, M., “Public health concern due to emerging and re-emerging zoonoses", International Journal of Livestock Research, 3 (1), 56-62, 2013.
[2]	WHO, "Nipah virus infection – Bangladesh (Disease Outbreak News)", World Health Organization, 17 February 2023. [Online]. Available: https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON442. [Accessed 14 June 2026].
[3]	Chua, K.B., Bellini, W.J., Rota, P.A., Harcourt, B.H., Tamin, A., Lam, S.K., and Mahy, B.W.J., "Nipah virus: a recently emergent deadly paramyxovirus", Science, 288 (5470), 1432-1435, 2000.
[4]	Leopardi, S., Priori, P., Zecchin, B., Zamperin, G., Milani, A., Tonon, F., Giorgiutti, M., Beato, M.S. and De Benedictis, P., "Interface between bats and pigs in heavy pig production", Viruses, 13(1), 4, 2020.
[5]	Luby, S.P., Rahman, M., Hossain, M.J., Blum, L.S., Husain, M.M., Gurley, E., and Ksiazek, T.G., "Foodborne transmission of Nipah virus, Bangladesh", Emerging Infectious Diseases, 12(12), 1888-1894, 2006.
[6]	Luby, S.P., Hossain, M.J., Gurley, E.S., Ahmed, B.N., Banu, S., Khan, S.U., and Rahman, M., "Recurrent zoonotic transmission of Nipah virus into humans, Bangladesh, 2001–2007", Emerging Infectious Diseases, 15 (8), 1229-1235, 2009.
[7]	Arunkumar, G., Chandni, R., Mourya, D.T., Singh, S.K., Sadanandan, R., Sudan, P. and Bhargava, B., "Outbreak investigation of Nipah virus disease in Kerala, India, 2018", The Journal of Infectious Diseases, 219(12), 1867-1878, 2019.
[8]	WHO, "Nipah virus", World Health Organization, 29 January 2026. [Online]. Available: https://www.who.int/news-room/fact-sheets/detail/nipah-virus. [Accessed 14 June 2026].
[9]	Faus-Cotino, J., Reina, G. and Pueyo, J., "Nipah virus: A multidimensional update", Viruses, 16 (2), 179, 2024.
[10]	Tan, F.H., Sukri, A. and Idris, N., "A systematic review on Nipah virus: Global molecular epidemiology and medical countermeasures development", Virus Evolution, 10(1), veae048, 2024.
[11]	Nidom, R.V., et al., "Comprehensive surveillance and molecular detection of the Nipah virus in fruit bats (Pteropus vampyrus) across Indonesia: insights from 2023 to 2024", International Journal of One Health, 171-177, 2025.
[12]	Epstein, J.H., Anthony, S.J., Islam, A., Kilpatrick, A.M., Khan, S.A., Balkey, M.D., Ross, N., Smith, I., Zambrana-Torrelio, C., Tao, Y., Islam, A., Quan, P.L., Olival, K.J., Khan, M.S.U., Gurley, E.S., Hossein, M.J., Field, H.E., Fielder, M.D., Briese, T., and Daszak, P., "Nipah virus dynamics in bats and implications for spillover to humans", Proceedings of the National Academy of Sciences, 117 (46), 29190-29201, 2020.
[13]	Wang, L., Lu, D., Yang, M., Chai, S., Du, H. and Jiang, H., "Nipah virus: Epidemiology, pathogenesis, treatment, and prevention", Frontiers of Medicine, 18 (6), 969-987, 2024.
[14]	Joshi, J., Shah, Y., Pandey, K., Ojha, R.P., Joshi, C.R. and Bhatt, L.R., "Possible high risk of transmission of the Nipah virus in South and South East Asia: A review", Tropical Medicine and Health, 51, 44, 2023.
[15]	Gurley, E.S., Montgomery, J.M., Hossain, M.J., Bell, M., Azad, A.K., Islam, M.R., and Breiman, R.F., "Person-to-person transmission of Nipah virus in a Bangladeshi community", Emerging Infectious Diseases, 13 (7), 1031-1037, 2007.
[16]	Bruno, L., Nappo, M.A., Ferrari, L., Di Lecce, R., Guarnieri, C., Cantoni, A.M. and Corradi, A., "Nipah virus disease: Epidemiological, clinical, diagnostic and legislative aspects of this unpredictable emerging zoonosis", Animals, 13 (1), 159, 2023.
[17]	Plowright, R.K., Peel, A.J., Streicker, D.G., Gilbert, A.T., McCallum, H., Wood, J., and Restif, O., "Transmission or within-host dynamics driving pulses of zoonotic viruses in reservoir–host populations", PLoS Neglected Tropical Diseases, 10 (8), e0004796, 2016.
[18]	Islam, M.S., Sazzad, H.M., Satter, S.M., Sultana, S., Hossain, M.J., Hasan, M., and Gurley, E.S., "Nipah virus transmission from bats to humans associated with drinking traditional liquor made from date palm sap, Bangladesh, 2011–2014", Emerging Infectious Diseases, 22 (4), 664-670, 2016.
[19]	Chadha, M.S., Comer, J.A., Lowe, L., Rota, P.A., Rollin, P.E., Bellini, W.J., and Mishra, A.C., "Nipah virus-associated encephalitis outbreak, Siliguri, India", Emerging Infectious Diseases, 12(2), 235-240, 2006.
[20]	Scotto, G., Fazio, V., Moula Ali, A.M., Bavisetty, S.C.B., Franza, A. and Massa, S., "Nipah Virus Encephalitis: Pathogenetic aspects and current therapeutic strategies", Pathogens, 15 (4), 443, A2026.
[21]	Hassan, D., Ravindran, R. and Hossain, A., "Nipah Virus Mystery: Insight into transmission and mechanism of disease progression", Journal of Pure and Applied Microbiology, 16 (1), 26-34, 2022.
[22]	Tan, C.T., Goh, K.J., Wong, K.T., Sarji, S.A., Chua, K.B., Chew, N.K., Murugasu, P., Loh, Y.L., Chong, H.T., Tan, K.S. and Thayaparan, T., "Relapsed and late-onset Nipah encephalitis", Annals of Neurology, 51(6), 703-708, 2002.
[23]	Wong, K.T., Shieh, W.J., Zaki, S.R. and Tan, C.T., "Nipah virus infection, an emerging paramyxoviral zoonosis", Seminars in Immunopathology, 24 (2), 215-228, 2002.
[24]	Vindel-Zuñiga, C., Salinas-Avalo, I., Valencia-Ochoa, C. and Pérez-Dávila, M., "A systematic review of neurological symptoms, signs, and neuroimaging findings in Nipah virus (NiV) infection", Discover Neuroscience, 21 (1), 12, 2026.
[25]	Xu, K., Broder, C.C. and Nikolov, D.B., "Ephrin-B2 and ephrin-B3 as functional henipavirus receptors", Seminars in Cell and Developmental Biology, 23 (1), 116-123, 2012.
[26]	"Timeline of Nipah virus outbreaks reported in Kerala (2018–2026)", Compiled from published news reports and official health updates, 2026.
[27]	Mohandas, S., Patil, D., Mathapati, B., Rai, V., Sabarinath, K., Belani, S., Balasubramanian, R., Khurana, J., Barde, P. and Yadav, P., "Survey on the prevalence of Nipah virus in Pteropus medius bats from non-outbreak regions of India", Journal of Infection and Public Health, 103273, 2026.
[28]	Pal, M and Abdo, J., “Nipah virus disease: A newly recognized viral zoonosis”, International Journal of Livestock Research, 2, 65-68, 2012.
[29]	Rahman, M.A., Shanjana, Y., Cronmiller, S., Zong, D., Davis, R., Ernest, J., Nguyen, J., Rawa, A., Thomas, M.R. and Islam, M.R., "Risk evaluation and mitigation strategies for potential outbreaks of Nipah virus infection: evidenced by the recent incidences in Southeast Asian countries", Health Science Reports, 7 (12), 7:e70239, 1-9, 2024.
[30]	Chan, X.H.S., Haeusler, I.L., Choy, B.J., Hassan, M.Z., Takata, J., Hurst, T.P., Jones, L.M., Loganathan, S., Harriss, E., Dunning, J. and Tarning, J., "Therapeutics for Nipah virus disease: a systematic review to support prioritization of drug candidates for clinical trials", The Lancet Microbe, 6 (5), 1-12, 2025.
[31]	Posa, M.K., "Comprehensive review of Nipah Virus outbreaks and cases: Epidemiology, clinical manifestations, diagnostic approaches and therapeutic advances in Nipah virus treatment", Clinical Manifestations, Diagnostic Approaches and Therapeutic Advances in Nipah Virus Treatment, 04 March 2026.
[32]	Broder, C.C., "Henipavirus outbreaks to antivirals: the current status of potential therapeutics", Current Opinion in Virology, 2 (2), 176-187, 2012.
[33]	Lo, M.K., Feldmann, F., Gary, J.M., Jordan, R., Bannister, R., Cronin, J., Patel, N.R., Klena, J.D., Nichol, S.T., Cihlar, T. and Zaki, S.R., "Remdesivir (GS-5734) protects African green monkeys from Nipah virus challenge", Science Translational Medicine, 11(494), eaau9242, 2019.
[34]	Geisbert, T.W., Feldmann, H., Broder, C.C. and Mire, C.E., "Remdesivir protects African green monkeys from Nipah virus challenge", Science Translational Medicine, 11 (494), eaau9242, 2019.
[35]	Nahar, N., Mondal, U.K., Hossain, M.J., Khan, M.S.U., Sultana, R., Gurley, E.S. and Luby, S.P., "Piloting the promotion of bamboo skirt barriers to prevent Nipah virus transmission through date palm sap in Bangladesh", Global Health Promotion, 21(4), 7-15, 2014.
[36]	Pal, M., Gebrezabiher, W. and Rahman, M.T., "The roles of veterinary, medical and environmental professionals to achieve One Health", Journal of Advanced Veterinary and Animal Research, 1(4), 148-155, 2014.
[37]	Pal, M. and Gutama, K.P., "Can Nipah virus be considered as a potential pathogen for next pandemic? A Critical Appraisal", American Journal of Infectious Diseases, 9 (4), 122-128, 2021.
[38]	Henríquez, R. and Munoz-Barroso, I., "Viral vector-and virus-like particle-based vaccines against infectious diseases: A minireview", Heliyon, 10 (15), 1-20, 2024.
[39]	Mishra, G., Prajapat, V. and Nayak, D., "Advancements in Nipah virus treatment: Analysis of current progress in vaccines, antivirals, and therapeutics", Immunology, 17 (2), 155-169, 2024.
[40]	CEPI, "Nipah vaccine development program", Coalition for Epidemic Preparedness Innovations, 2025. [Online]. Available: https://cepi.net. [Accessed 14 June 2026].