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Member Research & Reports

Member Research & Reports

Johns Hopkins: How Nipah Virus Spreads From Person to Person – Lessons From 14 Years of Investigations

The deadly Nipah virus, which is carried by bats and occasionally infects people, is more likely to be transmitted from person to person when the infected patient is older, male and/or has breathing difficulties, according to a study co-led by scientists at the Johns Hopkins Bloomberg School of Public Health.

The study, published May 9 in the New England Journal of Medicine, is, to date, the most comprehensive evaluation of person-to-person transmission during Nipah virus outbreaks. These outbreaks, all in Asia, have been relatively small to date, but the fatality rates at the outbreak level have been very high, ranging from 40 to 100 percent.

Epidemiologists fear that Nipah virus, a distant cousin of the measles virus, could mutate to become much more infectious among humans and cause a catastrophic pandemic. The findings suggest that reducing exposure to respiratory secretions from infected patients should be a priority in future outbreak responses.

Nipah virus’ principal animal hosts are fruit bats that are found widely throughout much of the globe — from Australia, across tropical Asia and through to the east coast of Africa. Nipah infection in humans causes fever and encephalitis, or brain inflammation, often with seizures and coma. Some patients also develop a pneumonia-like respiratory illness. In Bangladesh, where public health surveillance of Nipah virus outbreaks is more extensive than anywhere else, the case fatality rate is about 75 percent.

Dr. Emily Gurley, scientist in the Bloomberg School’s department of epidemiology, was a lead author.

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