Nipah Virus in Maryland

• Initial symptoms typically include fever, headache, myalgia, vomiting, and sore throat. This can progress rapidly to respiratory distress, including acute respiratory syndrome, or severe neurological symptoms. Common neurological manifestations include acute encephalitis, seizures, disorientation, and drowsiness. In critical cases, patients can develop severe brain swelling leading to coma and death.

Nipah virus is a zoonotic virus, with Pteropus fruit bats (flying foxes) being the natural reservoir. Transmission to humans primarily occurs through direct contact with infected bats or their bodily fluids, or through consumption of contaminated food products like raw date palm sap. Spillover events have also occurred from bats to domestic animals, particularly pigs, which can then transmit the virus to humans through close contact. Human-to-human transmission is possible, especially among close contacts or healthcare workers caring for infected patients, often facilitated by exposure to bodily fluids.

• Prevention strategies focus on reducing the risk of exposure to the virus from bats, sick pigs, and other infected animals. This includes avoiding consumption of raw date palm sap and unwashed fruits, and limiting contact with sick animals. Healthcare workers must utilize standard infection control precautions and appropriate personal protective equipment (PPE) when caring for suspected or confirmed cases. Currently, there is no approved vaccine available for humans or animals.