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Nipah virus infection: pathology and pathogenesis of an emerging paramyxoviral zoonosis

Kum Thong Wong1, Wun-Ju Shieh, Shalini Kumar

  • 1University of Malaya, Kuala Lumpur, Malaysia.

The American Journal of Pathology
|December 6, 2002
PubMed

Insights

Nipah virus, a novel paramyxovirus, caused a deadly encephalitis outbreak in Malaysia. Autopsy findings revealed systemic vasculitis, necrosis, and viral antigens in endothelial cells and neurons, crucial to Nipah virus disease pathogenesis.

Area of Science:

  • Virology
  • Pathology
  • Epidemiology

Background:

  • An outbreak of acute encephalitis in Malaysia in 1998 led to the identification of Nipah virus, a novel paramyxovirus.
  • The virus caused high mortality rates, particularly among pig handlers, highlighting a new human infection.

Purpose of the Study:

  • To investigate the clinical and pathological features of Nipah virus infection.
  • To understand the pathogenesis of this novel zoonotic disease.

Main Methods:

  • Multidisciplinary investigation including epidemiology, microbiology, molecular biology, and pathology.
  • Examination of autopsy tissues from 32 fatal human cases using routine histology, immunohistochemistry (IHC), and electron microscopy.
  • Diagnosis confirmed by IHC and serology.

Main Results:

  • Histopathological findings included systemic vasculitis, thrombosis, and parenchymal necrosis, predominantly in the central nervous system.
  • Endothelial cell damage, necrosis, and syncytial giant cells were observed in affected blood vessels.
  • Widespread Nipah virus antigens were detected in endothelial cells, smooth muscle cells, and neurons.

Conclusions:

  • Infection of endothelial cells and neurons, along with vasculitis and thrombosis, are critical factors in the pathogenesis of Nipah virus disease.
  • The study elucidated the pathological mechanisms underlying this severe human paramyxovirus infection.

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