The Nipah Virus

The Nipah Virus: A Serious Zoonotic Threat – What Pharmacists and the Public in Pakistan Need to Know

By Naeem Mustafa, Pharmacist

January 30, 2026

As a pharmacist practicing in 

Rahim Yar Khan, Punjab, I closely monitor emerging infectious diseases that could impact our communities, especially those with cross-border implications. The recent confirmation of Nipah virus (NiV) cases in West Bengal, India, has once again brought this deadly zoonotic pathogen into the spotlight. While the situation remains contained and the risk to Pakistan is assessed as low by health authorities, awareness is crucial for early recognition, prevention, and community education.

The Nipah Virus

What is Nipah Virus?

Nipah virus is a highly pathogenic virus belonging to the Henipavirus genus in the Paramyxoviridae family. It was first identified during a major outbreak among pig farmers in Malaysia and Singapore in 1998–1999. Fruit bats (Pteropus species, commonly known as flying foxes) serve as the natural reservoir, where the virus causes no apparent illness. Spillover events occur when humans come into contact with infected bats, contaminated food, or amplifying hosts like pigs.

In South Asia, particularly Bangladesh and parts of India, outbreaks have been recurrent since the early 2000s, often linked to consumption of raw date palm sap contaminated by bat saliva or urine.

Recent Developments in January 2026

In late January 2026, Indian authorities confirmed two laboratory-positive cases of Nipah virus in West Bengal state. Both patients are 25-year-old nurses (one male and one female) working at the same private hospital in Barasat, near Kolkata. Symptoms began in late December 2025, progressing to neurological complications (encephalitis). The cases were confirmed by RT-PCR testing at the National Institute of Virology in Pune.

These appear to involve human-to-human transmission in a healthcare setting through close contact. Over 196 contacts were traced, all tested negative and remained asymptomatic as of late January. One patient is improving, while the other remains critically ill. The World Health Organization (WHO) classifies the sub-national risk in West Bengal as moderate due to bat reservoirs in border areas with Bangladesh, but national and global risk as low. No evidence of wider community spread exists, and India has demonstrated strong containment capacity.

In response, several Asian countries—including Pakistan—have enhanced airport and border screenings, including thermal checks and travel history reviews for arrivals from affected regions. Pakistan's Border Health Services and National Institutes of Health (NIH) emphasize vigilance, but experts note the overall risk of an outbreak here remains minimal, given no prior human or animal cases and the virus's specific transmission dynamics.

How Nipah Virus Spreads

Nipah transmits through multiple routes:

Zoonotic spillover: Direct contact with infected bats, their urine/saliva on fruits, or raw date palm sap (common in outbreaks).

Intermediate hosts: Contact with infected pigs (as in Malaysia) or other animals.

Human-to-human: Close contact with an infected person's bodily fluids, especially respiratory droplets or saliva—most common in healthcare or household settings.

It is not highly airborne like some respiratory viruses but spreads efficiently in close-proximity scenarios. Incubation period: typically 4–14 days (up to 21 days or rarely longer).

Signs and Symptoms

Early symptoms mimic common illnesses:

Fever

Headache

Muscle pain

Sore throat

Cough

Difficulty breathing

Vomiting

In severe cases (often progressing rapidly):

Dizziness and drowsiness

Confusion

Seizures

Encephalitis (brain inflammation)

Coma

The case fatality rate ranges from 40–75%, higher in some outbreaks, depending on timely supportive care.

Diagnosis, Treatment, and Management

Diagnosis relies on RT-PCR from throat swabs, blood, urine, or cerebrospinal fluid, available at reference labs like NIH in Pakistan.

No specific antiviral or licensed vaccine exists yet (though candidates are in trials). Treatment is supportive:

Hospitalization and intensive care (respiratory support, hydration, seizure management).

Early intervention significantly improves outcomes.

Pharmacists play a key role in advising on symptom management, infection control, and referring suspected cases promptly.

Prevention Strategies – Key Advice for Pakistan

Given our proximity to India and Bangladesh, and travel links:

Avoid consuming raw date palm sap or unwashed fruits in high-risk seasons/areas.

Do not handle bats or sick animals; avoid bat-roosting sites.

In healthcare settings: Use standard precautions (PPE, hand hygiene) for patients with unexplained fever + neurological/respiratory symptoms.

Practice good hygiene: Wash fruits thoroughly, peel before eating.

Travelers from affected regions: Monitor for symptoms for 21 days; seek immediate care if fever develops.

Public education: Raise awareness without causing panic—focus on hygiene and avoiding risky foods.

Pakistan's health authorities have adequate diagnostic capacity and rapid response mechanisms. The current regional alerts are precautionary, and the virus does not spread easily like influenza or COVID-19.

Final Thoughts

Nipah virus serves as a reminder of the importance of One Health approaches—integrating human, animal, and environmental surveillance. As pharmacists, we are on the front lines of community health education and early detection. Stay informed through reliable sources like WHO, Pakistan's NIH, and provincial health departments.

If you experience flu-like symptoms with neurological signs after potential exposure, consult a healthcare provider immediately. Vigilance, not fear, is the best defense.

Stay safe and informed.

Naeem Mustafa

Pharmacist

PharmaServePK

(References: WHO updates January 2026, ECDC, Reuters, Pakistan NIH statements, and CDC/WHO fact sheets on Nipah virus.)