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Nipah Virus Encephalitis: Pathogenetic Aspects and Current Therapeutic Strategies
Gaetano Scotto1, Vincenzina Fazio1, Ali Muhammed Moula2
1Department of Biomedical Sciences, University of Foggia, 71121 Foggia, Italy.
Pathogens (Basel, Switzerland)
|May 4, 2026
Summary
Nipah virus (NiV) causes severe disease outbreaks in Asia. Current research focuses on developing antiviral therapies and vaccines, alongside integrated public health strategies for outbreak containment.
Area of Science:
- Virology
- Immunology
- Public Health
Background:
- Nipah virus (NiV) is a highly pathogenic zoonotic paramyxovirus causing severe disease and high mortality in South and Southeast Asia.
- Human infections result from bat spillover or human-to-human transmission, presenting a wide clinical spectrum from asymptomatic cases to fatal encephalitis.
- NiV targets endothelial and neuronal cells, leading to vasculitis, blood-brain barrier disruption, and central nervous system infection.
Purpose of the Study:
- To review current knowledge on Nipah virus pathogenesis, immune evasion, and clinical manifestations.
- To synthesize emerging therapeutic and vaccine strategies against NiV.
- To highlight critical gaps and future directions for preparedness and response to NiV outbreaks.
Main Methods:
- Literature review of Nipah virus research.
- Synthesis of data on viral replication, host immune responses, and clinical outcomes.
- Analysis of preclinical and clinical trial data for therapeutics and vaccines.
- Evaluation of public health strategies for outbreak containment.
Main Results:
- NiV employs strategies to counteract innate immunity, inhibiting interferon signaling and inducing detrimental inflammatory responses.
- Neurological involvement is a severe manifestation, leading to encephalitis with potential long-term sequelae.
- Promising preclinical results exist for monoclonal antibodies and small-molecule antivirals, but face translational challenges.
- Several vaccine platforms show encouraging immunogenicity in early-phase clinical trials.
Conclusions:
- No licensed NiV therapies or vaccines are currently available, necessitating continued research and development.
- Integrated public health strategies, including rapid identification, isolation, and contact tracing, are crucial for outbreak containment.
- A One Health approach is vital for mitigating NiV transmission and reducing mortality, emphasizing the need for improved global preparedness.
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