Nipah Virus Infection: Diagnostic, Clinical, and Preventive Considerations for Clinicians

Nipah Virus (NiV) is a highly virulent zoonotic henipavirus responsible for recurrent outbreaks across South and Southeast Asia and remains a priority global health threat. Fruit bats of the genus Pteropus serve as the natural reservoir, with transmission to humans occurring through contaminated food products, infected intermediate hosts, or person-to-person spread. Clinical illness ranges from nonspecific febrile disease to rapidly progressive encephalitis and severe respiratory failure, with reported case fatality rates often exceeding 40 percent. This narrative synthesis reviews the evolving epidemiology, phylogenetic diversity, transmission pathways, clinical spectrum, diagnostic approaches, and current management strategies of NiV infection. Persistent seasonal spillovers, limited therapeutic options, the absence of licensed human vaccines, and challenges in early detection continue to hinder containment efforts. Strengthening One Health surveillance, expanding laboratory capacity, and accelerating vaccine and antiviral development remain critical priorities to mitigate future outbreaks and reduce associated morbidity and mortality.