Reducing the Risk of Foodborne Transmission of Nipah Virus

  • Stephen P. LubyEmail author
  • Nazmun Nahar
  • Emily S. Gurley
Part of the Food Microbiology and Food Safety book series (FMFS)


Nipah virus is a paramyxovirus whose wildlife host is large fruit bats in the genus Pteropus. Antibodies against Nipah virus and closely related Henipaviruses are common among old world fruit bats that live in Australia, across South and Southeast Asia and sub-Saharan Africa, but human infections with Nipah virus are uncommon. When humans are infected with Nipah virus 40 – 70 % die. People who are infected with Nipah virus can transmit the infection to other people. In the first recognized and largest Nipah outbreak, Nipah virus was transmitted from bats to pigs in Malaysia. A widespread outbreak among pigs led to infections among people who had close contact with infected pigs. The outbreak was arrested by culling over 900,000 pigs. Human Nipah virus infections have been identified in Bangladesh nearly every year from 2001 through 2014. The most common pathway of human Nipah infection is from drinking raw date palm sap. Pteropus bats frequently visit trees at night where sap is being collected and lick the sap stream as it flows into the collection pot. Drinking fresh date palm sap is a widely enjoyed seasonal delicacy in Bangladesh. Focused intensive interventions in limited areas discouraging people from drinking raw date palm sap or encouraging sap harvesters to use skirts to prevent bats access to the sap stream have reduced but not eliminated high risk practices.


Behavior change Environmental health Epidemiology PCR Source tracking Wildlife 


  1. Anthony SJ, Epstein JH, Murray KA et al (2013) A strategy to estimate unknown viral diversity in mammals. mBio 4:e00598–e00513. doi: 10.1128/mBio.00598-13 CrossRefPubMedPubMedCentralGoogle Scholar
  2. Arankalle VA, Bandyopadhyay BT, Ramdasi AY et al (2011) Genomic characterization of Nipah virus, West Bengal, India. Emerg Infect Dis 17:907–909. doi: 10.3201/eid1705.100968 CrossRefPubMedPubMedCentralGoogle Scholar
  3. Bennett LA, Campillo C, Chandrashekar CR et al (1998) Alcoholic beverage consumption in India, Mexico, and Nigeria: a cross-cultural comparison. Alcohol Health Res World 22:243–252PubMedGoogle Scholar
  4. Bossart KN, Geisbert TW, Feldmann H et al (2011) A neutralizing human monoclonal antibody protects African green monkeys from Hendra virus challenge. Sci Transl Med 3:105ra103. doi: 10.1126/scitranslmed.3002901 CrossRefPubMedPubMedCentralGoogle Scholar
  5. Bossart KN, Rockx B, Feldmann F et al (2012) A Hendra virus G glycoprotein subunit vaccine protects African green monkeys from Nipah virus challenge. Sci Transl Med 4:146ra107. doi: 10.1126/scitranslmed.3004241 CrossRefPubMedPubMedCentralGoogle Scholar
  6. Chadha MS, Comer JA, Lowe L et al (2006) Nipah virus-associated encephalitis outbreak, Siliguri, India. Emerg Infect Dis 12:235–240CrossRefPubMedPubMedCentralGoogle Scholar
  7. Chakraborty A (2011) Nipah outbreak in Lalmonirhat district, 2011. Health Sci Bull 9:13–19Google Scholar
  8. Chakraborty A, Khan SU, Hasnat MA et al (2012) Anthrax outbreaks in Bangladesh, 2009-2010. Am J Trop Med Hyg 86:703–710. doi: 10.4269/ajtmh.2012.11-0234 CrossRefPubMedPubMedCentralGoogle Scholar
  9. Ching PKG, de los Reyes CV, Sucaldito MN et al (2015) Outbreak of henipavirus infection, Philippines, 2014. Emerg Infect Dis 21:328–331CrossRefPubMedPubMedCentralGoogle Scholar
  10. Chua KB (2003) Nipah virus outbreak in Malaysia. J Clin Virol 26:265–275CrossRefPubMedGoogle Scholar
  11. Chua KB, Bellini WJ, Rota PA et al (2000) Nipah virus: a recently emergent deadly paramyxovirus. Science 288:1432–1435CrossRefPubMedGoogle Scholar
  12. Chua KB, Lam SK, Goh KJ et al (2001) The presence of Nipah virus in respiratory secretions and urine of patients during an outbreak of Nipah virus encephalitis in Malaysia. J Infect 42:40–43CrossRefPubMedGoogle Scholar
  13. de Wit E, Prescott J, Falzarano D et al (2014) Foodborne transmission of Nipah virus in Syrian hamsters. PLoS Pathog 10:e1004001. doi: 10.1371/journal.ppat.1004001 CrossRefPubMedPubMedCentralGoogle Scholar
  14. Drexler JF, Corman VM, Gloza-Rausch F et al (2009) Henipavirus RNA in African bats. PLoS One 4:e6367. doi: 10.1371/journal.pone.0006367 CrossRefPubMedPubMedCentralGoogle Scholar
  15. Drexler JF, Corman VM, Muller MA et al (2012) Bats host major mammalian paramyxoviruses. Nat Commun 3:796. doi: 10.1038/ncomms1796 CrossRefPubMedPubMedCentralGoogle Scholar
  16. Field H, de Jong C, Melville D et al (2011) Hendra virus infection dynamics in Australian fruit bats. PLoS One 6:e28678. doi: 10.1371/journal.pone.0028678, PONE-D-11-11577 [pii]CrossRefPubMedPubMedCentralGoogle Scholar
  17. Field HE, Mackenzie JS, Daszak P (2007) Henipaviruses: emerging paramyxoviruses associated with fruit bats. Curr Top Microbiol Immunol 315:133–159PubMedGoogle Scholar
  18. Fogarty R, Halpin K, Hyatt AD et al (2008) Henipavirus susceptibility to environmental variables. Virus Res 132:140–144CrossRefPubMedGoogle Scholar
  19. Furuse Y, Suzuki A, Oshitani H (2010) Origin of measles virus: divergence from rinderpest virus between the 11th and 12th centuries. Virol J 7:52. doi: 10.1186/1743-422X-7-52 CrossRefPubMedPubMedCentralGoogle Scholar
  20. Goh KJ, Tan CT, Chew NK et al (2000) Clinical features of Nipah virus encephalitis among pig farmers in Malaysia. N Engl J Med 342:1229–1235CrossRefPubMedGoogle Scholar
  21. Gurley ES, Montgomery JM, Hossain MJ et al (2007) Person-to-person transmission of Nipah virus in a Bangladeshi community. Emerg Infect Dis 13:1031–1037CrossRefPubMedPubMedCentralGoogle Scholar
  22. Halim MA, Chowdhury MSH, Muhamed N et al (2008) Sap production from khejur palm (phoenix sylvestris roxb) husbandry: a substantial means of seasonal livelihood in rural Bangladesh. For Trees Livelihoods 18:305–318CrossRefGoogle Scholar
  23. Harcourt BH, Lowe L, Tamin A et al (2005) Genetic characterization of Nipah virus, Bangladesh, 2004. Emerg Infect Dis 11:1594–1597CrossRefPubMedPubMedCentralGoogle Scholar
  24. Hegde ST, Sazzad HM, Hossain MJ et al (2013) Rick factor analysis for Nipah infection in Bangladesh 2004 to 2012. Am J Trop Med Hyg 89:1Google Scholar
  25. Hess IM, Massey PD, Walker B et al (2011) Hendra virus: what do we know? N S W Public Health Bull 22:118–122. doi: 10.1071/NB10077, NB10077 [pii]CrossRefPubMedGoogle Scholar
  26. Hossain MJ, Gurley ES, Montgomery JM et al (2008) Clinical presentation of nipah virus infection in Bangladesh. Clin Infect Dis 46:977–984CrossRefPubMedGoogle Scholar
  27. Hsu VP, Hossain MJ, Parashar UD et al (2004) Nipah virus encephalitis reemergence, Bangladesh. Emerg Infect Dis 10:2082–2087CrossRefPubMedPubMedCentralGoogle Scholar
  28. Islam MS (2012) Nipah transmission from bats to humans associated with drinking traditional liquor (tari) in northern Bangladesh, 2011. Health Sci Bull 10:16–20Google Scholar
  29. Khan MS, Hossain J, Gurley ES et al (2010) Use of infrared camera to understand bats' access to date palm sap: implications for preventing Nipah virus transmission. Ecohealth 7:517–525. doi: 10.1007/s10393-010-0366-2 CrossRefPubMedGoogle Scholar
  30. Khan SU, Gurley ES, Hossain MJ et al (2012) A randomized controlled trial of interventions to impede date palm sap contamination by bats to prevent nipah virus transmission in Bangladesh. PLoS One 7:e42689. doi: 10.1371/journal.pone.0042689 CrossRefPubMedPubMedCentralGoogle Scholar
  31. Lebbie AR, Guries RP (2002) The palm wine trade in Freetown, Sierra Leone: production, income, and social construction. Econ Bot 56:246–254. doi: 10.1663/0013-0001(2002)056[0246:TPWTIF]2.0.CO;2 CrossRefGoogle Scholar
  32. Lloyd-Smith JO, George D, Pepin KM et al (2009) Epidemic dynamics at the human-animal interface. Science 326:1362–1367. doi: 10.1126/science.1177345 CrossRefPubMedPubMedCentralGoogle Scholar
  33. Luby S (2014) Nipah virus. In: Motarjemi Y (ed) Encyclopedia of food safety. Elsevier, Waltham, MA, pp 214–217CrossRefGoogle Scholar
  34. Luby S, Hossain J, Gurley E et al (2009a) Recurrent zoonotic transmission of Nipah virus into humans, Bangladesh, 2001–2007. Emerg Infect Dis 15:1229–1235CrossRefPubMedPubMedCentralGoogle Scholar
  35. Luby SP (2013) The pandemic potential of Nipah virus. Antiviral Res 100:38–43. doi: 10.1016/j.antiviral.2013.07.011 CrossRefPubMedGoogle Scholar
  36. Luby SP, Gurley ES (2012) Epidemiology of henipavirus disease in humans. Curr Top Microbiol Immunol 359:25–40. doi: 10.1007/82_2012_207 PubMedGoogle Scholar
  37. Luby SP, Gurley ES, Hossain MJ (2009b) Transmission of human infection with Nipah virus. Clin Infect Dis 49:1743–1748. doi: 10.1086/647951 CrossRefPubMedPubMedCentralGoogle Scholar
  38. Luby SP, Rahman M, Hossain MJ et al (2006) Foodborne transmission of Nipah virus, Bangladesh. Emerg Infect Dis 12:1888–1894CrossRefPubMedPubMedCentralGoogle Scholar
  39. Middleton D, Pallister J, Klein R et al (2014) Hendra virus vaccine, a one health approach to protecting horse, human, and environmental health. Emerg Infect Dis 20:372–379. doi: 10.3201/eid2003.131159 CrossRefPubMedPubMedCentralGoogle Scholar
  40. Middleton DJ, Morrissy CJ, van der Heide BM et al (2007) Experimental Nipah virus infection in pteropid bats (Pteropus poliocephalus). J Comp Pathol 136:266–272CrossRefPubMedGoogle Scholar
  41. Middleton DJ, Westbury HA, Morrissy CJ et al (2002) Experimental Nipah virus infection in pigs and cats. J Comp Pathol 126:124–136CrossRefPubMedGoogle Scholar
  42. Mohd Nor MN, Gan CH, Ong BL (2000) Nipah virus infection of pigs in peninsular Malaysia. Rev Sci Tech 19:160–165PubMedGoogle Scholar
  43. Nahar N, Mondal UK, Hossain MJ et al (2014a) Piloting the promotion of bamboo skirt barriers to prevent Nipah virus transmission through date palm sap in Bangladesh. Glob Health Promot. doi: 10.1177/1757975914528249 PubMedPubMedCentralGoogle Scholar
  44. Nahar N, Mondal UK, Sultana R et al (2013) Piloting the use of indigenous methods to prevent Nipah virus infection by interrupting bats' access to date palm sap in Bangladesh. Health Promot Int 28:378–386. doi: 10.1093/heapro/das020 CrossRefPubMedGoogle Scholar
  45. Nahar N, Sultana R, Gurley ES et al (2010) Date palm sap collection: exploring opportunities to prevent Nipah transmission. Ecohealth 7:196–203. doi: 10.1007/s10393-010-0320-3 CrossRefPubMedGoogle Scholar
  46. Nahar N, R Sultana, R Paul et al (2014) A community intervention trial utilizing behavior change to reduce the risk of Nipah spillover through date palm sap in Bangladesh. Project report. icddr,b, DhakaGoogle Scholar
  47. NIPORT (2013) Bangladesh demographic and health survey 2011. NIPORT, Dhaka, Bangladesh/Calverton, MDGoogle Scholar
  48. Nowak R (1994) Walker’s bats of the world. Johns Hopkins University Press, BaltimoreGoogle Scholar
  49. Okereke O (1982) The traditional system of oil palm wine production in Igbo Eze local government area of Anambra state of Nigeria. Agric Syst 9:239–253, doi: Scholar
  50. Pallister J, Middleton D, Wang LF et al (2011) A recombinant Hendra virus G glycoprotein-based subunit vaccine protects ferrets from lethal Hendra virus challenge. Vaccine 29:5623–5630. doi: 10.1016/j.vaccine.2011.06.015, S0264-410X(11)00879-6 [pii]CrossRefPubMedPubMedCentralGoogle Scholar
  51. Paton NI, Leo YS, Zaki SR et al (1999) Outbreak of Nipah-virus infection among abattoir workers in Singapore. Lancet 354:1253–1256CrossRefPubMedGoogle Scholar
  52. Pernet O, Schneider BS, Beaty SM et al (2014) Evidence for henipavirus spillover into human populations in Africa. Nat Comm 5:5342. doi: 10.1038/ncomms6342 CrossRefGoogle Scholar
  53. Rahman MA, Hossain MJ, Sultana S et al (2012) Date palm sap linked to Nipah virus outbreak in Bangladesh, 2008. Vector Borne Zoonotic Dis 12:65–72. doi: 10.1089/vbz.2011.0656 CrossRefPubMedGoogle Scholar
  54. Sazzad HM, Hossain MJ, Gurley ES et al (2013) Nipah virus infection outbreak with nosocomial and corpse-to-human transmission, Bangladesh. Emerg Infect Dis 19:210–217. doi: 10.3201/eid1902.120971 CrossRefPubMedPubMedCentralGoogle Scholar
  55. Sultana R, Mondal UK, Abedin J et al (2013) Evaluating long-term behavior change resulting from an intervention to prevent Nipah virus transmission from bats to humans in Bangladesh International Meeting on Emerging Diseases and Surveillance. International Society for Infectious Diseases, Vienna, Austria, p 41Google Scholar
  56. Sultana R, Rimi NA, Azad S et al (2012) Bangladeshi backyard poultry raisers' perceptions and practices related to zoonotic transmission of avian influenza. J Infect Dev Ctries 6:156–165CrossRefPubMedGoogle Scholar
  57. Uppal PK (2000) Emergence of Nipah virus in Malaysia. Ann N Y Acad Sci 916:354–357CrossRefPubMedGoogle Scholar
  58. Wacharapluesadee S, Boongird K, Wanghongsa S et al (2010) A longitudinal study of the prevalence of Nipah virus in Pteropus lylei bats in Thailand: evidence for seasonal preference in disease transmission. Vector Borne Zoonotic Dis 10:183–190. doi: 10.1089/vbz.2008.0105 CrossRefPubMedGoogle Scholar
  59. Wacharapluesadee S, Lumlertdacha B, Boongird K et al (2005) Bat Nipah virus, Thailand. Emerg Infect Dis 11:1949–1951CrossRefPubMedPubMedCentralGoogle Scholar
  60. Wolfe ND, Dunavan CP, Diamond J (2007) Origins of major human infectious diseases. Nature 447:279–283. doi: 10.1038/nature05775 CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Stephen P. Luby
    • 1
    Email author
  • Nazmun Nahar
    • 2
  • Emily S. Gurley
    • 3
  1. 1.Center for Innovation in Global HealthStanford UniversityStanfordUSA
  2. 2.Swiss Tropical Public Health InstituteBaselSwitzerland
  3. 3.Centre for Communicable DiseasesICDDR, BDhakaBangladesh

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