Nepal has not reported any confirmed cases of Nipah virus so far. However, recent infections in India’s West Bengal, including among doctors and nurses, show that the risk is close. Nepal has already started screening travellers at airports and land border points, but the real question is whether the country is fully prepared if a case does appear.
Nipah virus is rare but extremely deadly. Between 40 and 75 per cent of people who become infected do not survive, and there is no approved vaccine or specific treatment. For a country like Nepal, closely connected to India and facing rapid environmental and population changes, this is a public health threat that should not be ignored.
Why Nipah matters for Nepal?
The World Health Organization lists Nipah virus among its top priority diseases because of its potential to trigger outbreaks with devastating consequences. Unlike many viruses that capture headlines, Nipah does not need large numbers to cause large damage. Even small outbreaks have overwhelmed health systems and left lasting social and economic scars.
Nepal shares an open and porous border with India, with millions crossing annually for work, healthcare, trade, and family ties. West Bengal, where recent Nipah cases have emerged, is directly connected to Nepal through multiple land routes. Human mobility is essential for livelihoods, but it also enables pathogens to move silently across borders.
Airport and border screening are important first steps. However, Nipah’s incubation period can range from 4 to 21 days, and in some cases even longer. This means infected individuals may show no symptoms at the time of travel, making detection at entry points inherently limited.
A virus that crosses species and people
Nipah virus is zoonotic, meaning it spreads from animals to humans. Its natural reservoirs are fruit bats, particularly those of the Pteropus genus, commonly known as flying foxes. These bats are widely distributed across South and Southeast Asia, including many parts of Nepal.
Transmission can occur through direct contact with infected animals, consumption of food contaminated by bat saliva or urine, or close contact with infected people and their bodily fluids. In Bangladesh, repeated outbreaks have been linked to the consumption of raw or fermented date palm sap contaminated by bats. While this specific practice is uncommon in Nepal, the broader risk, food and drink exposed to wildlife, is very real.
Crucially, the strain of Nipah circulating in India and Bangladesh can spread from person to person, particularly in households and healthcare settings. This has been documented repeatedly, often affecting caregivers and health workers. In recent Indian outbreaks, doctors and nurses were among those infected, an alarming reminder of how quickly health facilities can become amplification points.
Bats, forests, and human expansion
Nepal’s vulnerability to zoonotic diseases like Nipah is shaped not only by geography, but also by rapid environmental and social change. Over recent decades, forest cover has expanded in many regions due to conservation success. At the same time, human settlements have pushed closer to forest edges.
In districts such as Chitwan, Pokhara, Gulmi, and Mustang, community members report seeing more wild animals near homes and farms—monkeys, deer, wild boar, porcupines, and bats. Bats are frequently observed roosting near cattle sheds, sometimes biting calves. These everyday interactions, often considered normal, are precisely where spillover events can occur.
Cultural practices also matter. In some communities, wild animals are still hunted or consumed despite legal restrictions. Bats have been used in traditional medicine, while wildlife meat consumption, though declining, has not disappeared entirely. These practices do not imply blame; rather, they highlight the need for culturally sensitive public health communication that respects tradition while reducing risk.
As one health practitioner noted, Nepal’s increasing population, habitat encroachment, and open border with India together create “very favourable conditions” for the emergence or re-emergence of zoonotic diseases. Nipah is a textbook example of such a threat.
What Nipah looks like in the body
Nipah infection often begins with non-specific symptoms: fever, headache, muscle pain, vomiting, or sore throat. This makes early detection difficult, especially in Nepal, where febrile illnesses are common, and healthcare access varies widely.
In severe cases, the virus attacks the brain, causing encephalitis. Patients may develop confusion, drowsiness, seizures, and coma within days. Pneumonia and severe respiratory distress can also occur. Even among survivors, long-term neurological complications, such as persistent seizures or personality changes, have been reported. In rare cases, the virus can reactivate months or years later.
Treatment is limited to intensive supportive care. There is no proven antiviral therapy and no licensed vaccine. This reality makes prevention, early detection, and infection control far more important than clinical treatment alone.
What Nepal should do now
Nepal still has a critical window to prepare before a crisis emerges. Several steps are essential:
- Strengthen hospital preparedness, especially infection prevention and control training for health workers.
- Improve surveillance for encephalitis and severe respiratory illness, particularly in border districts and forest-edge communities.
- Enhance laboratory capacity to rapidly identify high-risk pathogens.
- Adopt a One Health approach, coordinating human, animal, and environmental health sectors.
- Communicate risk clearly and calmly, avoiding panic while promoting practical prevention.
For the general public, simple measures matter: avoiding consumption of fruits that may be contaminated by bats, minimising contact with wild animals, practising hand hygiene, and seeking prompt medical care for severe illness—especially after travel to affected regions.
Preparedness is the best protection
Nipah virus is not new. It has been known for more than two decades, and its patterns are well documented. What remains uncertain is whether countries act decisively before outbreaks occur or only after lives are lost.
Nepal has no Nipah cases today. That is precisely why this moment matters. Vigilance now quiet, informed, and sustained offers the best chance to ensure that Nipah remains a warning from across the border, not a headline at home.
