In Singapore, 11 cases, including one death, occurred in abattoir workers exposed to pigs imported from the affected Malaysian farms.
[21] Although these observations were recorded in the first month of the outbreak, the Ministry of Health failed to take them into account, and launched a nationwide campaign to educate people on the dangers of Japanese encephalitis and its vector, Culex mosquitoes.
Later outbreaks have caused respiratory illness in humans, increasing the likelihood of human-to-human transmission and indicating the existence of more dangerous strains of the virus.
[22] The transmission of Nipah virus from flying foxes to pigs is thought to be due to an increasing overlap between bat habitats and piggeries in peninsular Malaysia.
[27] A major future challenge is to develop and maintain a supply of reliable, targeted, and affordable testing tools to enable rapid diagnostics in labs located in regions where the virus is likely to be found in wildlife reservoirs.
Active collaboration between institutions and coordination among human and animal virologists are crucial for early outbreak detection and prompt implementation of preventive measures.
[28] The presence of fruit bats in various tropical countries, including Cambodia, Indonesia, Madagascar, the Philippines, and Thailand, is also recognized as a potential risk factor for future Nipah virus outbreaks.
[30] The clinical impact of Nipah virus highlights ongoing global public health risks due to the lack of effective treatments and vaccines.
A strong international focus on developing vaccines and treatments is essential to reduce the health effects and future risks of Nipah virus.
In cases of severe respiratory and neurological complications resulting from Nipah virus infection, healthcare professionals advise intensive supportive care as the primary treatment approach.
[15] In 2019, the World Health Organization (WHO) released an advanced draft of a research and development roadmap aimed at accelerating the creation of medical countermeasures, including diagnostics, treatments, and vaccines, to support effective and timely responses to Nipah virus outbreaks.
[32] In the 1998–99 Nipah virus outbreak in Malaysia, 140 patients received ribavirin, with their outcomes assessed against 54 historical controls who either lacked access to the drug or declined treatment.
[33] No further clinical studies with ribavirin have been conducted, and research in animal models has not demonstrated its effectiveness against Nipah or Hendra virus infections.
[37][38] In 2016, a phase 1 clinical trial for m102.4 was conducted in Australia with 40 participants, demonstrating that the treatment was safe and well-tolerated, with no signs of an immunogenic response.
[38] Further research requirements for mAb therapy involve conducting clinical trials in endemic regions to evaluate its safety, tolerability, effectiveness, and pharmacokinetic properties in more detail.
[27] Deforestation in the Southeast Asia region is occurring at an alarming pace, driven by factors such as grazing, agricultural expansion, industrialization, and urban development.
[56] Widespread deforestation and habitat fragmentation drive wildlife, especially fruit bats, the natural reservoirs of the Nipah virus, into closer proximity with human communities and livestock.
As bats lose their natural habitats, they increasingly venture into agricultural areas to find food, which raises the likelihood of spillover events.
[57] Climate change, and extreme weather events negatively impact biodiversity, animal distribution, and microflora, all of which may raise the likelihood of zoonotic agents emerging and infectious disease outbreaks occurring.