Nipah Virus: What Nurses Need to Know About the South Asian Outbreak

As of January 27, 2026, two healthcare workers in West Bengal, India, tested positive for the Nipah virus, raising red flags for public health officials. The virus is considered at an outbreak level in India, according to the Global Virus Network, a status that is not "unprecedented" but still is "concerning."

Of the healthcare workers who became infected, one patient is still on a ventilator, while the other is recovering from severe neurological symptoms. Both patients are 25-year-old healthcare workers who developed symptoms in late December 2025. One patient has shown improvement while the other remains in critical care. Importantly, all 196 traced contacts have tested negative, with no additional cases detected to date.

This rare, high-fatality virus is on the watch by public health officials, especially with the United States recently officially completing its withdrawal from the World Health Organization last month.

What Exactly is Nipah Virus?

The Nipah virus (NiV) is a zoonotic virus, which means it jumps from animals to humans. Fruit bats, specifically those from the Pteropus genus, are the main culprits. According to the World Health Organization (WHO), the virus has a fatality rate of 40-75%, making it one of the deadliest pathogens out there. The virus was first identified in 1998 and has seen only isolated outbreaks and infections since. 

It has no treatment or cure, which makes it especially dangerous. 

The virus spreads through contact with infected bats, their droppings, or even contaminated food (raw date palm sap is a big no-no). It can also spread from person to person through respiratory droplets, bodily fluids, or contaminated surfaces.

What makes Nipah especially tricky is its long incubation period, anywhere from 4 to 21 days, with rare cases stretching to two months. This means an infected person could be spreading the virus without even realizing they’re sick yet. And when symptoms finally appear, the consequences can be devastating.

Unfortunately, surviving the virus doesn't necessarily mean someone is in the clear either. Survivors are often still left with long-term symptoms, including:

• Epilepsy
• Personality changes
• Reinfection from the virus reactivating later

Spotting the Symptoms: When to Suspect Nipah

The early symptoms of Nipah can be misleading because they mimic more common illnesses, like the flu. As nurses, we know that not every fever is a code red, but with Nipah, vigilance is everything. Here’s what to watch for:

Early symptoms include:

• Fever
• Fatigue
• Headache
• Muscle pain

Unfortunately, things can go downhill fast. As the disease progresses, symptoms can escalate to:

• Severe respiratory distress
• Acute encephalitis (inflammation of the brain)
• Confusion, disorientation, or altered mental state
• Seizures
• Coma

Nurses on the Frontlines: Care and Interventions

Without a current treatment for the virus, management is focused on supportive care measures, which can include: 

• Managing respiratory distress with oxygen or ventilators.
• Monitoring vital signs and hemodynamics.
• Controlling seizures with appropriate medications.
• Maintaining a careful fluid balance—overhydration could worsen brain swelling.

There’s ongoing research into treatments like remdesivir and ribavirin, but for now, the best tool we have is early, aggressive supportive care.

Of course, infection control is a priority if the virus is suspected. When caring for a suspected or confirmed Nipah case, PPE should include:

• N95 respirator (not a surgical mask—this is airborne spread, folks).
• Eye protection or face shields.
• Gowns and gloves.

Isolation protocols:

• Use airborne, droplet, and contact precautions. Triple threat!
• Place patients in negative-pressure rooms if possible.
• Restrict visitors to limit exposure.

WHO also recommends a heightened awareness during Nipah’s “season,” which typically runs from December to May in South Asia.

Global Context: Should We Be Worried?

The good news is that Nipah outbreaks tend to be geographically limited to South and Southeast Asia. It’s also not as easily transmissible as, say, the flu or COVID-19. Human-to-human transmission typically occurs in close-contact settings, often in hospitals or homes.

The latest WHO risk assessment rates this outbreak as moderate at the local level and low globally. No travel restrictions have been issued, but anyone headed to affected areas should be cautious. Some airports may also have additional screening measures as a precaution. 

As of February 2, 2026, the Global Virus Network (GVN) also issued the official statement that the virus does not represent a "new or escalating" global threat. 

Prevention Tips for Nurses and Travelers

If you’re working in or traveling to areas affected by Nipah, here are some key steps you can take to stay safe:

• Avoid contact with fruit bats or their habitats. 
• Don’t consume raw date palm sap, as it’s a known transmission route.
• Wash your hands.
• If you suspect a case, isolate the patient immediately and notify your infection control team.

🤔Nurses, what are your thoughts on the Nipah virus? Share your thoughts if nurses should be prepared below.