Two new Nipah cases spook India

Telegraph

09-07-2025

Kerala is on edge after a teenager died from Nipah virus, a zoonotic disease that inspired the Hollywood blockbuster 'Contagion' and has a fatality rate as high as 75 per cent.
The outbreak has sparked widespread concern with local media reporting that dozens of potential contacts are in hospital awaiting test results and hundreds are being monitored.
The 18-year-old girl, who died last week, is one of two people known to have contracted the virus in the southern Indian state this month. The second, a 38-year-old woman, is in a critical condition in hospital.
The cases have raised alarm bells as the World Health Organization (WHO) considers the virus a priority pathogen with 'serious potential' to drive mass outbreaks. Earlier this year, the UK Health Security Agency also included Nipah in its list of 24 diseases considered a major threat to public health.
The virus is spread by bats but can spread between people through close contact. However, according to Kerala's health minister, Veena George, there is not yet evidence of human-to-human transmission in the current outbreak.
Ms George said that of those contacts being tested, 46 people have so far been confirmed negative. She did not share how many were still waiting for test results but local media have put the number of potential contacts at 485 – though not all are being tested.
This includes 192 people in Malappuram district, 114 in Kozhikode, 176 in Palakkad, two in Ernakulam, and one in Kannur.
Ms George said that investigation had not found a link between the two known cases and that the women lived roughly 50 miles apart, in neighbouring districts.
'No human to human transmission has been confirmed,' Ms George told The Telegraph on Wednesday. 'It could definitely be two separate spillover events.'
Nipah is carried by bats, and researchers have repeatedly found the virus in Kerala's large bat population. The state is home to more than 40 species of bats, but rapid development and urbanisation is pushing the flying mammals into ever closer contact with humans, escalating the spillover risk.
The virus first infected people in the state in 2018, in a devastating outbreak where 21 of the 23 people infected died. A string of sporadic cases have since been detected, most recently in 2024.
'There could be multiple reasons for regular spillover reports from Kerala. But first and foremost, I think, is the strength of our surveillance system,' said Ms George. 'It should be noted that the presence of the virus has been demonstrated in many parts of the country, but Kerala can identify the human cases.'
The latest 18-year-old victim lived in a house 'near to a very big bat colony', which may explain how she contracted the disease, said Ms George.
'We interviewed the family members extensively, and we are conducting studies to identify the presence of viral RNA and antibodies in bats from the roost,' Ms George said.
The state is also racing to identify more potential cases to cut the threat of another major outbreak.
So far 485 people have been identified as potential contacts, with the police helping health officials by sharing CCTV and mobile phone data to identify and then track down individuals. Those categorised as 'high risk' have been told to quarantine at home for 21 days, while some schools have also closed and switched to online lessons.
Ms George said that although there are so far no signs that the virus – which spreads through contact with the bodily fluids of infected animals or people – is circulating undetected, she remains on edge.
'We haven't crossed the maximum incubation period yet [up to 45 days]. We will be somewhat relieved if no new infections are detected by the middle of July,' she told the Telegraph.
'At the moment, all samples of the contacts tested are negative. But it's a matter of time until all of the contacts cross the maximum incubation period without infection.'
According to the WHO, it usually takes between four and 14 days to show any signs of a Nipah infection after coming into contact with the disease. But in rare instances, this incubation period can stretch to as long as 45 days.
Symptoms can vary, but often cases start with a fever, headache or myalgia before developing into dizziness or confusion – which signals encephalitis, or brain inflammation. In severe cases, people can become comatose within 24 hours, and the case fatality rate ranges from 40 per cent to 75 per cent.
But the virus can also have lifelong impacts for those who survive – roughly 20 per cent of this cohort are left with long-term neurological conditions, including personality changes or seizure disorders.
Still, despite being deemed by the WHO as a priority pathogen with 'serious potential' to drive mass outbreaks, there are still no vaccines or drugs to specifically target the virus.
Researchers are racing to change this – including a team at the University of Oxford, who are developing a vaccine using similar technology to their Covid-19 jab. It is currently in phase 1 clinical trials.
Moderna in the US and Gennova Biopharmaceuticals Limited in India are among other groups working on a Nipah virus shot. Most have some funding from the Coalition of Epidemic Preparedness Innovations, which has committed over $100 million for Nipah research.