Nipah Virus

What is nipah virus?

Nipah virus (NiV) is a virus that spreads between animals and people (a zoonotic virus). It spreads mainly through fruit bats (also called flying foxes) but can also spread through pigs and other animals like goats, horses, dogs or cats. The virus spreads when:

• People or animals have contact with the bodily fluids (blood, poop, pee or saliva) of an infected animal.
• People eat foods that have been contaminated by an infected animal.
• People are in close contact with a person that has nipah virus, usually while caring for them.

The best way to avoid nipah virus is to avoid exposure to sick animals (especially bats and pigs) in areas with known transmission. This includes avoiding food products that an infected animal can contaminate like raw date palm sap or fruit. Since the virus can spread from person to person through bodily fluids, you should avoid or take precaution when going near anyone with nipah virus.

Nipah virus can cause mild to severe symptoms including encephalitis (brain infection) and death. There’s no medication or vaccine to treat it. Managing symptoms is the only way to treat nipah virus.

Preventing nipah virus involves infection control measures like protective equipment and disinfecting surfaces, as well as avoiding sick animals or areas with known nipah virus outbreaks.

Where is nipah virus found?

Nipah virus outbreaks happen almost every year in parts of Asia, primarily Bangladesh and India.

The virus was first discovered in 1999 when it led to 100 deaths in Malaysia and Singapore. Over 1 million pigs were killed because of the virus, which had a major economic impact on the countries. Since 1999, there have been about 20 additional outbreaks.

You should take extra precautions when traveling to countries that are susceptible to outbreaks like Bangladesh, Malaysia, Singapore or India. Other areas like Cambodia, Indonesia, Madagascar, the Philippines and Thailand may also be susceptible to the virus since the bat species that spreads nipah virus can be found in these areas.

What are the symptoms of nipah virus?

Initial symptoms of nipah virus may include:

• Fever.
• Headache.
• Breathing difficulties.
• Cough and sore throat.
• Diarrhea.
• Vomiting.
• Muscle pain and severe weakness.

Symptoms typically begin within four to 14 days after exposure to the virus. It’s common to have a fever or headache first and develop respiratory problems like cough and difficulty breathing later.

In severe cases, a person can develop brain infection (encephalitis), which is life-threatening. Other severe symptoms include:

• Confusion and disorientation.
• Slurring speech.
• Seizures.
• Coma.
• Respiratory distress.

Researchers aren’t entirely sure why some people have severe symptoms and others have mild symptoms. Some people with the virus have no symptoms at all.

What does nipah virus do to humans?

Nipah virus can be deadly to humans. According to the Centers for Disease Control and Prevention (U.S.), death may occur in 40% to 75% of all cases. This depends on how well health officials can manage the outbreak.

What causes nipah virus?

The first case of nipah virus happened when people who were in contact with infected pigs began getting very sick. Researchers then determined bats were the original source, having passed the virus to pigs.

If an infected bat or pig spreads its bodily fluid to another animal, they infect that animal. The same happens if people are in contact with the bodily fluid of the animal. This could be from pee, poop, blood or saliva. Once a person has the virus, they can spread it to other people through their own bodily fluids.

Transmission also occurs when food products are contaminated by fluids of infected animals. This includes fruit and raw date palm sap. People who regularly climb trees where bats sleep and rest have also been infected by nipah virus.

How contagious is Nipah virus?

Nipah virus is contagious. It can spread through bodily fluids like saliva, poop, pee and blood. This means if you’re caring for a person with nipah virus, you could get it when the person coughs or sneezes.

How does it spread?

The virus mainly spreads from animals to humans. But it can also spread from person to person. That’s why it’s important for caregivers to wear protective equipment when treating a person with nipah virus.

Is Nipah virus airborne?

Yes, the virus spreads through respiratory droplets. This means it can spread through the air when a person coughs or sneezes.

What are the risk factors for nipah virus?

The main risk factor for the virus is interacting with bats, pigs and humans with a known infection, especially in areas with nipah virus outbreaks. You should take extra care to avoid sick animals. Consuming raw date palm sap or fruit is also a risk factor since bats can leave pee, poop and other fluids on them.

What are the complications of nipah virus?

Some of the known long-term complications include convulsions and personality changes. A small number of people develop symptoms months or years after exposure to the virus because the virus is dormant (you have the virus, but it’s not giving you symptoms). People who recover from encephalitis may relapse (get encephalitis again).

How is nipah virus diagnosed?

A healthcare provider can diagnose nipah virus by reviewing your symptoms and discussing any recent travel to areas where nipah virus is common. During the first stages of infection, a healthcare provider can perform a real-time polymerase chain reaction (RT-PCR) test to confirm nipah virus. This test uses the following bodily fluids to diagnose the condition:

• Nasal or throat swabs.
• Cerebrospinal fluid (CSF).
• Urine samples.
• Blood samples.

Providers can diagnose the infection in its later stages or after recovery by testing your blood for certain antibodies. This is called enzyme-linked immunosorbent assay (ELISA).

How is nipah virus treated?

There are no antiviral medications to treat the virus. This means treatment consists of managing your symptoms. This may consist of:

• Drinking lots of water.
• Getting plenty of rest.
• Taking acetaminophen or ibuprofen.
• Using medications to control nausea or vomiting.
• Using inhalers or nebulizers to improve breathing difficulties.
• Taking antiseizure medications if you experience a seizure.

Researchers are studying using monoclonal antibody treatment for nipah virus.

Is there a cure for nipah virus?

There’s no vaccine or medications to cure nipah virus.

Can I prevent nipah virus?

If you live in or travel to an area where nipah virus occurs, you should take the following precautions to avoid getting the virus:

• Wash your hands frequently.
• Avoid any contact with sick pigs or bats.
• Clean and disinfect pig farms. Animals with the virus should go into quarantine right away.
• Avoid trees or bushes where bats are known to rest or sleep.
• Avoid eating or drinking things that may be contaminated, such as palm sap or fruit. If you collect palm sap, boil it first. Wash and peel all fruits before consuming them.
• Throw away any fruit with bat bites or fruit that’s touched the ground.
• Avoid contact with the saliva, blood or other bodily fluids of a person with the virus.

Infection control measures can also help prevent spread of nipah virus. For example, if you’re caring for a person that has or is suspected of having nipah virus, you should always use personal protective equipment (PPE). Examples of PPE include:

• Isolation or full coverage gowns that protect against bodily fluids.
• Medical gloves.
• Eye protection like safety glasses or goggles.
• Medical or surgical masks. The style of mask may vary depending on the severity of the outbreak.

In hospitals and other healthcare centers, healthcare providers should practice standard infection control protocols. The EPA (Environmental Protection Agency) recommends using Q-list disinfectants to disinfect and sanitize all clinical surfaces.

Do people survive nipah virus?

Yes, people survive nipah virus. But, about 40% to 75% of people who get the infection die from it. This rate varies depending on the countries’ abilities to detect and manage the virus. Symptoms can range from a mild fever and headache to brain infection or death.

When should I see my healthcare provider?

Contact a healthcare provider immediately if you have symptoms of nipah virus, especially if you’ve visited a country with known outbreaks or have recently cared for a person or animal with the virus. While there’s no treatment, knowing you have the virus can prevent it from spreading to others.

A note from Cleveland Clinic

Nipah virus is a potentially life-threatening virus that spreads mainly through bats and pigs. The best way to prevent it is to avoid sick animals, especially in areas where outbreaks are common. Since it spreads from person to person, you should also avoid people who have the virus unless you’re taking proper precautions and using infection control practices. You should let a healthcare provider know if you’ve recently visited areas with known nipah virus outbreaks and come down with symptoms like fever, headache or difficulty breathing.