Nipah Virus: An emerging zoonotic threat at the human–animal–environment interface

Abstract

Nipah Virus (NiV) is a highly virulent zoonotic pathogen that poses significant global public health concerns. Since its first recognition in the late 1990s, the virus has triggered numerous outbreaks with significant fatality rates, particularly in South and Southeast Asia. Fruit bats of the genus Pteropus serve as the natural reservoir of the virus, while transmission to humans can occur through direct contact with the reservoir, through an intermediary animal, or through human-to-human transmission in certain situations. In humans, NiV infection generally begins with nonspecific initial symptoms, such as fever and malaise, which can then rapidly progress to serious neurological disorders and acute respiratory failure. The rapid and progressive clinical course, coupled with limited diagnostic facilities in many endemic areas, often hinders early detection and effective outbreak control efforts. Currently, there is no specific antiviral drug or vaccine widely used for the prevention of this disease, so case management still focuses on supportive therapy and strict implementation of infection control measures. In addition to its impact on human health, the NiV outbreak also has widespread social and economic consequences, including disruption to the livestock industry, increased pressure on the healthcare system, and reduced productivity. This demonstrates that the NiV is not merely a clinical problem but also a multidisciplinary challenge involving various sectors. Therefore, this review article presents a comprehensive discussion of the NiV, covering aspects of etiology, epidemiology, clinical manifestations, and its implications for public health. The One Health approach is emphasized as a crucial strategy in NiV prevention and control efforts through the integration of surveillance activities, health system strengthening, and the development of sustainable preventive interventions.