[1] The 2018 Kerala outbreak was traced to fruit bats in the area, was generally confined to Kozhikode and Malappuram districts,[2][3] and claimed 17 lives.

Health advisories were issued for northern Kerala and the adjoining districts of Karnataka, with two suspected cases detected in Mangalore on 23 May 2018.

[19] Two days later, the Ministry of Health and Prevention of the United Arab Emirates advised postponing unnecessary travel to Kerala and avoiding its fruits and vegetables until the situation was under control.

[22] Two days later, the Thamarassery diocese in northern Kerala urged churches to stop placing communion on the tongue, postpone religious classes and avoid weddings, family gatherings and unnecessary travel until the viral spread was contained.

[26] Lini Puthussery, a 28-year-old nurse at the Perambra Taluk hospital who died of the virus, was called a hero by doctors and on social media.

[28] The Kerala Government Hospital Development Society (KGHDS) employees' union instituted an award in Puthussery's name to an outstanding person in the sector.

The central government rushed a team from the National Centre for Disease Control to the state to provide technical support.

[44][45][46][47][48] The index case of the outbreak was reported at a private hospital in Kozhikode district on 5 September, when a 12-year-old boy from Chathamangalam died after testing positive for Nipah virus infection.

Kerala Health Minister Veena George reported that tests had confirmed that the virus strain in the outbreak was identical to one previously found in Bangladesh, and teams from the National Institute of Virology in Pune had established a mobile laboratory at Kozhikode Medical College for virus testing and bat surveys.

The state government established a control room in Kozhikode for continuous monitoring, and health workers were instructed to adhere strictly to infection-control protocols.

Kerala Chief Minister Pinarayi Vijayan said that the state government treated the deaths seriously, and urged the public to wear face masks and visit hospitals only for emergencies.

[63][64] Virus, a 2019 Indian Malayalam medical thriller film co-produced and directed by Aashiq Abu and released on 7 June 2019, was based on the 2018 outbreak.