An Overview of Nipah Virus Infection: Epidemiology, Pathogenesis, Diagnostic Challenges, and Global Research Priorities

Nipah virus (NiV) is a highly pathogenic zoonotic henipavirus that causes severe respiratory and neurological disease with case-fatality rates of 40–75%. Despite its epidemic potential, no licensed vaccines or specific antiviral therapies are currently available. Consequently, the World Health Organization (WHO) has prioritized NiV and established a research and development roadmap to accelerate the development of diagnostics, therapeutics, and vaccines. Since its emergence during outbreaks in Malaysia and Singapore in 1998–1999, NiV has caused recurrent outbreaks in South and Southeast Asia, including multiple events in West Bengal, India, with the most recent cases reported in January 2026. NiV transmission occurs through direct contact with infected animals, consumption of contaminated food products, or human-to-human transmission, with fruit bats (Pteropus spp.) serving as natural reservoirs. Clinical manifestations range from mild illness to severe acute respiratory disease and fatal encephalitis, with rapid neurological deterioration. Laboratory diagnosis relies primarily on molecular detection by RT–PCR and serological assays, such as ELISA. However, diagnostic development is limited by the scarcity of well-characterized clinical specimens, gaps in external quality assessment, and insufficient surveillance data. This article reviews current laboratory diagnostic strategies and outlines WHO research priorities for 2024–2029, emphasizing rapid point-of-care diagnostics, strengthened laboratory capacity, particularly in low- and middle-income countries, and integration within One Health surveillance frameworks to improve outbreak preparedness and response.