Nipah virus as a pandemic threat: Current knowledge, diagnostic gaps, and future research priorities.

Abstract

Nipah virus (NiV) is a highly virulent zoonotic pathogen capable of triggering severe outbreaks with pandemic potential. This review consolidates current knowledge on its biology, transmission, pathogenesis, and clinical presentation, alongside recent progress in diagnostics, therapeutics, and vaccine development. Human encroachment into wildlife habitats has intensified interactions with fruit bat reservoirs, driving recurrent spillover events in South and Southeast Asia. Advances in structural virology have elucidated the mechanisms of viral entry, particularly the interaction of the G (attachment) glycoprotein with ephrin-B2/B3 receptors and conformational changes in the F (fusion) protein that mediate host cell entry. These insights have guided the design of monoclonal antibodies, subunit vaccines, and replication-targeted antivirals. Despite these developments, gaps persist in genomic surveillance, point-of-care diagnostics, and licensed medical countermeasures. Strengthening One Health surveillance and accelerating translational research remain critical to mitigating future outbreak risks.