Nipah Virus in Focus: A Comprehensive Review of the Pathogenesis, Epidemiological Patterns, Diagnostic Advances, and Future Public Health Strategies

Nipah virus (NiV) remains one of the most concerning emerging pathogens due to its repeated spillover events, high mortality, and the absence of licensed vaccines or treatments. Its recurrence demonstrates that the ecological factors facilitating such outbreaks, including those linked to bat hosts, are still present. These patterns highlight the continued need for a coordinated One Health approach that connects human, animal, and environmental health. This review has four aims: (1) to summarize current understanding of NiV biology and pathogenesis, (2) to describe the epidemiological trends that shape how outbreaks unfold, (3) to assess recent advances in diagnostics, and (4) to highlight emerging strategies for prevention and control. Our narrative synthesis shows that NiV’s ability to infect both the respiratory and nervous systems, combined with strong immune‑evasion mechanisms, contributes to rapid deterioration in many patients. Epidemiological evidence from South and Southeast Asia consistently links outbreaks to bat reservoirs, occasional intermediate hosts, and increasingly recognized person‑to‑person transmission. In diagnostics, improvements in rapid molecular tests, point‑of‑care tools, and serological platforms have expanded the ability to detect cases quickly in field settings. Promising progress is also being made in surveillance systems, ecological risk assessment, and the development of antiviral agents and vaccine candidates. By synthesizing current scientific and public health insights, this review underscores the need for sustained multidisciplinary strategies to mitigate future NiV threats.