09 Feb Nipah Virus: UAB Infectious Disease Specialist Discusses OUTBREAK & GLOBAL HEALTH CONCERNS

MedicalResearch.com Interview with:

Dr. Freedman M.D.

David O. Freedman, M.D.
Professor Emeritus of Infectious Diseases
Editor of the Textbook of Travel Medicine
World Health Organization—Member,  Emergency Committee on Zika Virus
University of Alabama, Birmingham USA

MedicalResearch.com: What is the background for this outbreak?

Response: India has reported 2 confirmed (PCR and ELISA) Nipah virus (NiV) cases in West Bengal State where the Kolkata megalopolis is located; the state borders Bangladesh. Symptom onset in both cases was late December 2025 in 2 health care workers. One patient has improved while the other remains in the ICU. All samples from 200 contact persons tested negative for NiV.  No further confirmed cases have been detected in West Bengal

Bangladesh has reported 1 confirmed NiV case in Rajshahi Division which neighbors India. Symptom onset was January 21, 2026, and the patient expired on January 28. The patient reported no travel history but reported repeated consumption of raw date palm sap between 5 and 20 January.  All 35 contact-persons are being monitored and have tested negative for NiV and no further cases have been detected to date.

MedicalResearch.com: How is the virus transmitted?

NiV infection is a zoonotic disease transmitted to humans through infected animals (such as bats), or food contaminated with saliva, urine, and excreta of infected animals especially pigs. Fruit bats, also known as flying foxes, (Pteropus species) are the natural hosts for the virus.  Fruit bats also consume the sap and contaminate the trees. It can also be transmitted directly from person to person through close contact with an infected person.

MedicalResearch.com: Where is the infection endemic?

Cases of Nipah virus infection were first reported in 1998 and since then have been reported in Bangladesh, India, Malaysia, Philippines and Singapore.  Regular outbreaks tend to occur between December and April corresponding with the harvesting and consumption of date palm sap.

CDC image of a man collecting the tree’s sap for consumption. The raw sap from palm trees may contain the Nipah virus, leading to a potentially deadly infection in humans.

In India his event represents the third NiV infection outbreak reported in West Bengal. Previous outbreaks were reported in Siliguri in 2001 and Nadia in 2007.

Bangladesh reported its first case of NiV infection in 2001. Since then, some human infections have been reported almost every year. In 2025, four laboratory-confirmed fatal cases were reported from Bangladesh.  Clusters of cases are mainly reported in the country’s central and northwest districts.

MedicalResearch.com: What are the symptoms of infection? 

Human infections range from asymptomatic infection to acute respiratory infection (mild, severe), and fatal encephalitis (brain swelling). Infected people initially develop symptoms including fever, headaches, myalgia (muscle pain), vomiting and sore throat. This can be followed by dizziness, drowsiness, altered consciousness, and neurological signs that indicate 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.

CDC/ Brian Mahy, PhD
Nipah Virus CNS Infection

The case fatality ratio (CFR) in outbreaks across Bangladesh, India, Malaysia, and Singapore range from 40% to 75%, depending on local capabilities for early detection and clinical management. infection.

MedicalResearch.com: Is there a test for the virus?

Both PCR for the virus itself and ELISA for antibodies can rapidly detect infection from human blood samples.  However, the testing can only be performed at national reference labs under Biosafety Level 3 precautions due to the highly infectious nature of blood samples.  Some countries have mobile BSL-3 labs that can be deployed to outbreak areas.

MedicalResearch.com: What should readers take away from your report?

Response: The risk of exported cases or subsequent outbreaks outside the currently affected local areas of India and Bangladesh at the global level is extremely low.  There have never been previous confirmed cases outside very localized areas of Bangladesh, India, Malaysia, Philippines and Singapore.

MedicalResearch.com: Is there anything else you would like to add? Any disclosures?

Response: There are currently no licensed medicines or vaccines for NiV.  Reducing the risk of human-to-human transmission. People experiencing Nipah-like symptoms with a history of possible exposures should be referred to a health facility, as early supportive care is key in the absence of licensed treatment. Close unprotected physical contact with sick people should be avoided.

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Last Updated on February 9, 2026 by Marie Benz MD FAAD