# Nipah: The looming post-covid pandemic

## TL;DR

Nipah virus, a deadly pathogen first identified in 1999, is emerging as a potential post-COVID pandemic threat due to its severe symptoms and lack of treatment.

## Contribution

The paper highlights the growing global threat of Nipah virus and its potential to cause a pandemic.

## Key findings

- Nipah virus has caused hundreds of human fatalities and significant animal deaths since its discovery.
- Current public health measures are insufficient to control Nipah virus transmission.
- There are currently no antiviral medications or vaccines available for Nipah virus.

## Abstract

First identified as a pathogen in Malaysia and Singapore in 1999, Nipah virus (NiV) caused nearly 300 human cases and over 100
fatalities. It also killed about 1 million pigs. Three years later (2002), it was reported in Pteropus bats in Malaysia, in Cambodia &
Thailand, (2005), and as far as Madagascar (2007) and Ghana (2008). India (Kerala) reported its first human NiV-caused fatalities in
September 2023. Taken together, these trends emphasize its public health threat. In humans, NiV infection initially leads to fever,
headache, body aches and muscle pain, nausea and vomiting. The symptoms rapidly evolve into sore throat, cough and atypical pneumonia
leading to severe respiratory distress. The cadre of NiV-induced pathology (Nipah disease, NiD) then includes severe dizziness and
drowsiness, progressive alteration in cognition and consciousness, acute encephalitis and seizures. Public health protocols (e.g.,
mask-wearing, quarantine), essential to contain and control CoViD-19, seem insufficient to contain NiD spread because NiV transmission
occurs primarily via direct contacts with body fluids of infected carriers, but presumably not by airborne transmission. As in the case
of SARS-C0V2, health care providers (i.e., physicians, dentists, nurses, dental assistants) are greatest risks not only of contracting
but of spreading NiV infection. NiV is a high-pathogenicity pathogen, against which, at present, we have no anti-viral medications or
preventive vaccine. Taken together, the evidence to date heightens the threat of an upcoming NiD pandemic.