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A One Health approach to understanding and managing Nipah virus outbreaks

Nature Microbiology volume 10, pages 1272–1281 (2025)Cite this article

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Abstract

Nipah virus (NiV) is a zoonotic paramyxovirus belonging to the genus Henipavirus, which infects Pteropus bat species in Southeast and South Asia. Since its discovery in the late 1990s in Malaysia, NiV has caused outbreaks in humans in Singapore, Bangladesh, India and the Philippines. The spillover pathway for the most recent NiV outbreak in 2023 in Kerala, India, remains speculative. NiV causes serious disease in infected humans, with a mean case-fatality rate of 70%, and no approved treatment or vaccines exist. Humans have been infected directly from bats through shared food or through infected bridging hosts, including pigs and horses, although other spillover pathways may exist. Here, we review the pathways of NiV spillover and transmission, highlighting areas needing further research. We emphasize the importance of collaborative and multidisciplinary efforts both in the laboratory and in the field, and the implementation of a One Health strategy to prevent future epidemics.

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Fig. 1: Routes of NiV transmission.
Fig. 2: In vitro and in vivo models of NiV–cell and NiV–bat interactions for understanding drivers of virus replication and shedding.
Fig. 3: An integrated One Health surveillance strategy for the identification of NiV spread among humans and animals.

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Acknowledgements

A.B. acknowledges support from the Canadian Institutes of Health Research–Centre for Research on Pandemic Preparedness and Health Emergencies, Early Career Investigator Grant (grant number PEE-183995), Canadian Institutes of Health Research–Institute for Infection and Immunity, Early Career Research Support (grant number PTT-192089), Canadian Institutes of Health Research–Institute for Infection and Immunity (project grant number PJT-195787) and Natural Sciences and Engineering Research Council of Canada (grant number RGPIN-2022-03010). VIDO receives operational funding from the Canada Foundation for Innovation through the Major Science Initiatives, the Government of Saskatchewan through Innovation Saskatchewan and the Ministry of Agriculture. R.K.P. was supported by the US National Science Foundation (grant numbers EF-2133763 and EF-2231624). H.S. and E.S.G. are supported by National Institutes of Health (NIH) and National Institute of Allergy and Infectious Diseases (NIAID) funding (grant number U01AI168287). J.H.E. was supported by NIH/NIAID (grant number U01AI153420). The content of this Perspective is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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Author notes

  1. These authors contributed equally: Pragya D. Yadav, Kaushal Baid.

Authors and Affiliations

  1. Indian Council of Medical Research–National Institute of Virology (ICMR-NIV), Pune, India

    Pragya D. Yadav & Deepak Y. Patil

  2. Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, Saskatchewan, Canada

    Kaushal Baid & Arinjay Banerjee

  3. Institute of Epidemiology Disease Control and Research, Dhaka, Bangladesh

    Tahmina Shirin

  4. Infectious Diseases Division, icddr,b, Dhaka, Bangladesh

    Mohammed Ziaur Rahman & Syed M. Satter

  5. Centre for Planetary Health and Food Security, School of Environment and Science, Griffith University, Nathan, Queensland, Australia

    Alison J. Peel

  6. EcoHealth Alliance, New York, NY, USA

    Jonathan H. Epstein

  7. Viral Special Pathogens Branch, US Centers for Disease Control and Prevention, Atlanta, GA, USA

    Joel M. Montgomery

  8. Department of Public and Ecosystem Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA

    Raina K. Plowright

  9. Department of Genetics, University of Cambridge, Cambridge, UK

    Henrik Salje

  10. Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA

    Emily S. Gurley

  11. Department of Veterinary Microbiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada

    Arinjay Banerjee

  12. Department of Biology, University of Waterloo, Waterloo, Ontario, Canada

    Arinjay Banerjee

  13. Department of Laboratory Medicine and Pathobiology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada

    Arinjay Banerjee

  14. Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada

    Arinjay Banerjee

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Contributions

P.D.Y., K.B., R.K.P., H.S., E.S.G. and A.B. synthesized the idea for the Perspective and generated the outline for the article. P.D.Y., K.B., D.Y.P., T.S., M.Z.R., A.J.P., J.H.E., J.M.M., R.K.P., H.S., E.S.G., S.M.S. and A.B. wrote the first draft, provided feedback and assisted with revisions. K.B. and D.Y.P. generated the figures. R.K.P. and A.B. assisted in refining the figures. A.B. supervised K.B. P.D.Y., E.S.G., S.M.S. and A.B. are co-senior authors.

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Correspondence to Arinjay Banerjee.

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A.B. is a co-inventor of the Efk3B bat cell line, which is sold through Kerafast, USA. The other authors declare no competing interests.

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Yadav, P.D., Baid, K., Patil, D.Y. et al. A One Health approach to understanding and managing Nipah virus outbreaks. Nat Microbiol 10, 1272–1281 (2025). https://doi.org/10.1038/s41564-025-02020-9

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