Nipah virus infection - Bangladesh
6 February 2026
Situation at a glance
On 3 February 2026, the International Health Regulations National Focal Point (IHR NFP) for Bangladesh notified WHO of one confirmed case of Nipah virus (NiV) infection in Rajshahi Division. The patient developed fever and neurological symptoms on 21 January. Nipah virus infection was laboratory-confirmed on 29 January. The patient reported no travel history but had a history of consuming raw date palm sap. All 35 contact-persons are being monitored and have tested negative for NiV and no further cases have been detected to date. Bangladesh regularly has small NiV outbreaks, with cases reported at different times of the year, though outbreaks tend to occur between December and April corresponding with the harvesting and consumption of date palm sap. The Ministry of Health and Family Welfare in Bangladesh has implemented several public health measures. WHO assesses the overall public health risk posed by NiV to be low at the national, the regional and global level. The risk of international disease spread is considered low.
Description of the situation
On 3 February 2026, the Bangladesh IHR NFP notified WHO of one confirmed case of NiV infection that occurred in Rajshahi Division, northwestern Bangladesh. The case was confirmed by Polymerase Chain Reaction (PCR) and Enzyme-Linked Immunosorbent Assay (ELISA) testing on 29 January 2026.
The patient is female, aged between 40-50 years, residing in Naogaon District, Rajshahi Division. She developed symptoms consistent with NiV infection on 21 January, including fever, headache, muscle cramps, loss of appetite (anorexia), weakness, and vomiting, followed by hypersalivation, disorientation, and convulsion. On 27 January, she became unconscious and was referred by a local physician to a tertiary hospital. She was admitted on 28 January, and the Nipah surveillance team collected throat swabs and blood samples. The patient died the same day.
The patient reported repeated consumption of raw date palm sap between 5 and 20 January 2026. Following the confirmed diagnosis, an outbreak investigation team, including One Health stakeholders, started investigations on 30 January.
A total of 35 contact persons has been identified, including three household contact persons 14 community contact persons and 18 hospital contact persons. Samples were collected from six symptomatic contact persons, including three from household, two from communities and one from hospital. All six samples tested negative for NiV infection by PCR and anti-Nipah IgM antibody detection by ELISA. As of 3 February, no additional cases have been identified. Contact persons are under monitoring.
Bangladesh reported its first case of NiV infection in 2001. Since then, human infections have been reported almost every year. In 2025, four laboratory-confirmed fatal cases were reported from Bangladesh.
Epidemiology
NiV infection is a zoonotic disease transmitted to humans through infected animals (such as bats), or food contaminated with saliva, urine, and excreta of infected animals. It can also be transmitted directly from person to person through close contact with an infected person. Fruit bats, also known as flying foxes, (
Pteropus species) are the natural hosts for the virus.
The incubation period ranges from 3 to 14 days. In some rare cases, incubation of up to 45 days has been reported. Laboratory diagnosis of a patient with a clinical history of NiV infection can be made during the acute and convalescent phases of the disease by using a combination of tests. The main tests used are RT-PCR from bodily fluids and antibody detection via ELISA.
Human infections range from asymptomatic infection to acute respiratory infection (mild, severe), and fatal encephalitis (brain swelling).
Infected people initially develop symptoms including fever, headaches, myalgia (muscle pain), vomiting and sore throat. This can be followed by dizziness, drowsiness, altered consciousness, and neurological signs that indicate acute encephalitis. Some people can experience atypical pneumonia and severe respiratory problems, including acute respiratory distress. Encephalitis and seizures occur in severe cases, progressing to coma within 24 to 48 hours.
Further information about NiV infection can be found
here.
The CFR in previous outbreaks across Bangladesh, India, Malaysia, Philippines and Singapore ranged from 40% to 75%, depending on local capabilities for early detection and clinical management. There are currently no licensed medicines or vaccines specific for NiV infection. Early intensive supportive care is recommended to treat severe respiratory and neurologic complications.
Henipavirus nipahense (or Nipah virus) is considered a priority pathogen for the acceleration of medical countermeasures to respond to epidemics and pandemics as part of the WHO R&D Blueprint for Epidemics.
Public health response
Several public health measures have been implemented by local authorities, including:
- On 30 January 2026, the Ministry of Health and Family Welfare (MoHFW), in collaboration with relevant sectors, initiated an outbreak investigation using a coordinated One Health approach.
- Active contact tracing was implemented to identify and monitor exposed individuals.
- Preparations were undertaken to conduct an advocacy meeting involving Civil Surgeons, Upazila Health Officers, Hospital Directors, and Superintendents from Nipah-endemic districts.
- Community awareness programmes are being planned with the involvement of field-level health workers.
- Audio-visual health education materials on NiV infection are being developed for point-of-entry staff and travellers.
The support provided by WHO includes:
- WHO is monitoring the situation closely, in coordination with the national and sub-national health authorities.
- WHO facilitated IHR event communication to notify the case.
WHO risk assessment
Nipah virus is a zoonotic pathogen with a high death rate and no licensed vaccine or treatment, though early supportive treatment can save lives. Its reservoirs are fruit bats or flying foxes (bats of the
Pteropus genus), which are distributed in the coastal regions and on several islands in the Indian ocean, India, south-east Asia and Oceania. The virus can be transmitted to humans from wild and domestic animals. Secondary human-to-human transmissions are also possible. Cases of Nipah virus infection were first reported in 1998 and since then have been reported in Bangladesh, India, Malaysia, Philippines and Singapore. The virus is present in Bangladesh, while NiV cases are reported throughout the year, outbreaks tend to occur between December and April corresponding with the harvesting and consumption of date palm sap. Clusters of cases are mainly reported in the country’s central and northwest districts.
To date, since 2001 Bangladesh has documented 348 NiV disease cases, including 250 deaths, corresponding to an overall case fatality rate of 72%. Nearly half of these cases (n=162) were primary cases with a confirmed history of consuming raw date palm sap or tari (fermented date palm sap), while 29% resulted from direct person-to-person transmission. Most cases detected in Bangladesh were reported through December to April, suggesting a seasonal pattern. Based on the current available information, WHO assesses the overall public health risk posed by NiV at the national level to be low due to the following reasons:
- The case fatality rate from NiV infection is high. There are currently no specific drugs or vaccines available for NiV infection, although WHO has identified Nipah as a priority disease for research under WHO Research and Development Blueprint. Intensive supportive care is recommended for the treatment of severe respiratory and neurologic complications.
- The initial signs and symptoms of NiV infection are non-specific, and the diagnosis is often not suspected at the time of presentation. This can delay timely diagnosis and create challenges in outbreak detection, effective and timely infection control measures, and outbreak response activities.
- Fruit bats (Pteropus spp.), as a natural reservoir of the Nipah virus, are present in Bangladesh and repeated spillover of the virus from its reservoir to the human population has been demonstrated.
- Despite ongoing efforts at risk communication and community engagement to address awareness, there is continued consumption of raw date palm sap by the community.
- However, the yearly number of NiV cases reported in Bangladesh remains under 10 since 2016, with exception in 2023 when 14 cases were reported. Although human-to-human transmission has been reported in previous outbreaks, it has been less frequent in recent years.
- In addition, strong public health measures are in place to detect and control outbreaks, including a hospital-based systematic human NiV infection surveillance system which has been established since 2006, the utilization of the National Rapid Response Team (NRRT) at the central level and the Rapid Response Team (RRT) at the district level and the capacity to rapidly test samples.
Bangladesh borders India and Myanmar, and WHO assesses the risk at the regional level to be low. While there have not been any instances of cross-border transmission by humans previously, the risk remains, given shared ecological corridor for the virus's natural host
Pteropus bats and occurrence among domestic animals and humans previously in both countries. However, India has strong capacities and experience of controlling previous NiV outbreaks.
WHO assesses the risk at the global level to be low, as there have been no previous confirmed cases outside Bangladesh, India, Malaysia, Philippines and Singapore.
WHO advice
In the absence of a licensed vaccine or specific therapeutic treatment for Nipah virus disease, reducing or preventing infection in people relies on raising awareness of the risk factors. This includes providing guidance on and reinforcing risk communication messages about the measures that people can take to reduce exposure to the Nipah virus. Case management should focus on delivering timely supportive care, supported by an effective laboratory system and adequate infection prevention and control measures in health facilities. Intensive supportive care is recommended for treatment of severe respiratory and neurologic complications.
Public health educational messages should focus on:
Reducing the risk of bat-to-human transmission
- Efforts to prevent transmission should first focus on decreasing bat access to date palm sap and other fresh food products. Freshly collected date palm juice should be boiled, and fruits should be thoroughly washed and peeled before consumption. Fruits with signs of bat bites should be discarded. Areas where bats are known to roost should be avoided.
Reducing the risk of human-to-human transmission
- Close unprotected physical contact with NiV-infected people should be avoided. Regular hand washing should be carried out after caring for or visiting sick people along other preventive measures.
- People experiencing Nipah-like symptoms should be referred to a health facility, as early supportive care is key in the absence of treatment. Contact tracing and monitoring are also key to mitigate human-to-human transmission.
Controlling infection in health care settings
- Health and care workers caring for patients with suspected or confirmed infection, or handling specimens from them, should always implement standard precautions for infection prevention and control at all times, for all patients.
- When caring for patients with suspected or confirmed NiV, WHO advises the use of contact and droplet precautions including a well-fitting medical mask, eye protection, a fluid-resistant gown, and examination gloves. Airborne precautions should be implemented during aerosol-generating procedures, including placing the patient in an airborne-infection isolation room and the use of a fit-tested filtering facepiece respirator instead of a medical mask. Suspected or confirmed cases of NiV should be placed in a single-patient room. For family members and caregivers visiting patients with suspected or confirmed Nipah virus, similar precautions should be applied.
- Samples taken from people and animals with suspected NiV infection should be handled by trained staff working in suitably equipped laboratories.
Based on the currently available information, WHO does not recommend any travel and/or trade restrictions.
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https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON594
