Beyond zoonosis: a one health exploration of nipah virus clinical spectrum

Abstract

Zoonotic diseases, exemplified by the recent COVID-19 pandemic, have posed significant threats to global public health. Among these, Nipah virus (NiV) stands out as a lethal pathogen responsible for outbreaks with high morbidity and mortality rates. This comprehensive review explores the clinical spectrum of NiV, focusing on epidemiology, transmission dynamics, clinical manifestations, diagnosis, treatment options, recent advancements in vaccine development, and mitigation strategies.
The epidemiology of NiV is characterized by its zoonotic nature, with fruit bats serving as natural reservoirs and various intermediate hosts facilitating transmission to humans and animals. Distinct outbreaks have occurred in different regions, with variations in transmission patterns and clinical outcomes. Clinical manifestations of NiV infection vary across species. In pigs, it leads to swine respiratory and neurological syndrome, while dogs and cats exhibit respiratory distress and renal dysfunction. In humans, NiV infection often manifests as acute encephalitis with diverse neurological symptoms, including sensory disturbances, myoclonus, and late-onset complications.
Diagnosis relies on a combination of assays, including RT-PCR, virus isolation, and antibody detection. Despite the absence of specific treatments, ribavirin and experimental therapies show promise in reducing mortality. Several NiV vaccine candidates are in development, with some showing efficacy in animal models. Prevention and mitigation strategies include livestock infection control, public awareness campaigns, infection prevention in healthcare settings, biosafety measures, and active surveillance. Climate change and human activities contribute to viral spillover, emphasizing the need for a One Health approach to manage NiV and other emerging infectious diseases.