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Fulltext Nipah virus dynamics in bats and implications for spillover to humans

Epstein JH, Anthony SJ, Islam A, Kilpatrick AM, Ali Khan S, Balkey MD, et al.

Proc Natl Acad Sci U S A, 2020 11 17;117(46):29190-29201.
PMID: 33139552 DOI: 10.1073/pnas.2000429117

Nipah virus (NiV) is an emerging bat-borne zoonotic virus that causes near-annual outbreaks of fatal encephalitis in South Asia-one of the most populous regions on Earth. In Bangladesh, infection occurs when people drink date-palm sap contaminated with bat excreta. Outbreaks are sporadic, and the influence of viral dynamics in bats on their temporal and spatial distribution is poorly understood. We analyzed data on host ecology, molecular epidemiology, serological dynamics, and viral genetics to characterize spatiotemporal patterns of NiV dynamics in its wildlife reservoir, Pteropus medius bats, in Bangladesh. We found that NiV transmission occurred throughout the country and throughout the year. Model results indicated that local transmission dynamics were modulated by density-dependent transmission, acquired immunity that is lost over time, and recrudescence. Increased transmission followed multiyear periods of declining seroprevalence due to bat-population turnover and individual loss of humoral immunity. Individual bats had smaller host ranges than other Pteropus species (spp.), although movement data and the discovery of a Malaysia-clade NiV strain in eastern Bangladesh suggest connectivity with bats east of Bangladesh. These data suggest that discrete multiannual local epizootics in bat populations contribute to the sporadic nature of NiV outbreaks in South Asia. At the same time, the broad spatial and temporal extent of NiV transmission, including the recent outbreak in Kerala, India, highlights the continued risk of spillover to humans wherever they may interact with pteropid bats and the importance of limiting opportunities for spillover throughout Pteropus's range.

Matched MeSH terms: Henipavirus Infections/epidemiology*
Henipaviruses: a new family of emerging Paramyxoviruses

Wild TF

Pathol. Biol., 2009 Mar;57(2):188-96.
PMID: 18511217 DOI: 10.1016/j.patbio.2008.04.006

Paramyxoviruses have been implicated in both animal and human infections. Some viruses, such as Morbilliviruses are responsible for large-scale epidemics. However, there are limited observations of these viruses crossing the host species barrier in nature. In 1994, in Australia a fatal infection in horses and humans was identified to be caused by a new Paramyxovirus, Hendra virus (HeV), and in 1998 in Malaysia, a closely related virus, Nipah virus (NiV) was responsible for fatal infections in pigs and humans. These two viruses were sufficiently different from previously described Paramyxoviruses to create a new genus, Henipaviruses. The natural reservoir of these viruses was the fruit bat (Pteropus), which is found in regions extending from the western Pacific to the eastern coast of Africa. Serological studies have established that as many as half the fruit bats in colonies throughout these regions may have antibodies against this family of viruses. The availability of diagnostic reagents for Nipah virus in humans have identified infections in several countries including, Bangladesh, India and Indonesia. In some of these epidemics, mortality in humans exceeds 75%. Deforestation is probably responsible for fruit bats leaving their ecological niches and approaching farms and villages. The infection of humans and animals may occur via contaminated foods or in certain cases by animals to man. At present, only within close families has human-to-human transmission been proposed. Henipavirus infections are probably more widespread than it is at presently known and so it is important to have an intense monitoring for these diseases, especially in countries where large-scale deforestation is happening.

Matched MeSH terms: Henipavirus Infections/epidemiology*
Fulltext Serological evidence of henipavirus exposure in cattle, goats and pigs in Bangladesh

Chowdhury S, Khan SU, Crameri G, Epstein JH, Broder CC, Islam A, et al.

PLoS Negl Trop Dis, 2014 Nov;8(11):e3302.
PMID: 25412358 DOI: 10.1371/journal.pntd.0003302

BACKGROUND: Nipah virus (NiV) is an emerging disease that causes severe encephalitis and respiratory illness in humans. Pigs were identified as an intermediate host for NiV transmission in Malaysia. In Bangladesh, NiV has caused recognized human outbreaks since 2001 and three outbreak investigations identified an epidemiological association between close contact with sick or dead animals and human illness.
METHODOLOGY: We examined cattle and goats reared around Pteropus bat roosts in human NiV outbreak areas. We also tested pig sera collected under another study focused on Japanese encephalitis.
PRINCIPAL FINDINGS: We detected antibodies against NiV glycoprotein in 26 (6.5%) cattle, 17 (4.3%) goats and 138 (44.2%) pigs by a Luminex-based multiplexed microsphere assay; however, these antibodies did not neutralize NiV. Cattle and goats with NiVsG antibodies were more likely to have a history of feeding on fruits partially eaten by bats or birds (PR=3.1, 95% CI 1.6-5.7) and drinking palmyra palm juice (PR=3.9, 95% CI 1.5-10.2).
CONCLUSIONS: This difference in test results may be due to the exposure of animals to one or more novel viruses with antigenic similarity to NiV. Further research may identify a novel organism of public health importance.

Matched MeSH terms: Henipavirus Infections/epidemiology
Fatal fruit bat virus sparks epidemics in southern Asia

Butler D

Nature, 2004 May 6;429(6987):7.
PMID: 15129247
Matched MeSH terms: Henipavirus Infections/epidemiology*
Fulltext Nipah shell disorder, modes of infection, and virulence

Goh GK, Dunker AK, Foster JA, Uversky VN

Microb Pathog, 2020 Apr;141:103976.
PMID: 31940461 DOI: 10.1016/j.micpath.2020.103976

The Nipah Virus (NiV) was first isolated during a 1998-9 outbreak in Malaysia. The outbreak initially infected farm pigs and then moved to humans from pigs with a case-fatality rate (CFR) of about 40%. After 2001, regular outbreaks occurred with higher CFRs (~71%, 2001-5, ~93%, 2008-12). The spread arose from drinking virus-laden palm date sap and human-to-human transmission. Intrinsic disorder analysis revealed strong correlation between the percentage of disorder in the N protein and CFR (Regression: r2 = 0.93, p

Matched MeSH terms: Henipavirus Infections/epidemiology
Advances in diagnostics, vaccines and therapeutics for Nipah virus

Thakur N, Bailey D

Microbes Infect, 2019;21(7):278-286.
PMID: 30817995 DOI: 10.1016/j.micinf.2019.02.002

Nipah virus is an emerging zoonotic paramyxovirus that causes severe and often fatal respiratory and neurological disease in humans. The virus was first discovered after an outbreak of encephalitis in pig farmers in Malaysia and Singapore with subsequent outbreaks in Bangladesh or India occurring almost annually. Due to the highly pathogenic nature of NiV, its pandemic potential, and the lack of licensed vaccines or therapeutics, there is a requirement for research and development into highly sensitive and specific diagnostic tools as well as antivirals and vaccines to help prevent and control future outbreak situations.

Matched MeSH terms: Henipavirus Infections/epidemiology
Nipah virus - the rising epidemic: a review

Ochani RK, Batra S, Shaikh A, Asad A

Infez Med, 2019 Jun 01;27(2):117-127.
PMID: 31205033

The Nipah virus was discovered twenty years ago, and there is considerable information available regarding the specificities surrounding this virus such as transmission, pathogenesis and genome. Belonging to the Henipavirus genus, this virus can cause fever, encephalitis and respiratory disorders. The first cases were reported in Malaysia and Singapore in 1998, when affected individuals presented with severe febrile encephalitis. Since then, much has been identified about this virus. These single-stranded RNA viruses gain entry into target cells via a process known as macropinocytosis. The viral genome is released into the cell cytoplasm via a cascade of processes that involves conformational changes in G and F proteins which allow for attachment of the viral membrane to the cell membrane. In addition to this, the natural reservoirs of this virus have been identified to be fruit bats from the genus Pteropus. Five of the 14 species of bats in Malaysia have been identified as carriers, and this virus affects horses, cats, dogs, pigs and humans. Various mechanisms of transmission have been proposed such as contamination of date palm saps by bat feces and saliva, nosocomial and human-to-human transmissions. Physical contact was identified as the strongest risk factor for developing an infection in the 2004 Faridpur outbreak. Geographically, the virus seems to favor the Indian sub-continent, Indonesia, Southeast Asia, Pakistan, southern China, northern Australia and the Philippines, as demonstrated by the multiple outbreaks in 2001, 2004, 2007, 2012 in Bangladesh, India and Pakistan as well as the initial outbreaks in Malaysia and Singapore. Multiple routes of the viremic spread in the human body have been identified such as the central nervous system (CNS) and respiratory system, while virus levels in the body remain low, detection in the cerebrospinal fluid is comparatively high. The virus follows an incubation period of 4 days to 2 weeks which is followed by the development of symptoms. The primary clinical signs include fever, headache, vomiting and dizziness, while the characteristic symptoms consist of segmental myoclonus, tachycardia, areflexia, hypotonia, abnormal pupillary reflexes and hypertension. The serum neutralization test (SNT) is the gold standard of diagnosis followed by ELISA if SNT cannot be carried out. On the other hand, treatment is supportive since there a lack of effective pharmacological therapy and only one equine vaccine is currently licensed for use. Prevention of outbreaks seems to be a more viable approach until specific therapeutic strategies are devised.

Matched MeSH terms: Henipavirus Infections/epidemiology*
A solid-phase blocking ELISA for detection of antibodies to Nipah virus

Kashiwazaki Y, Na YN, Tanimura N, Imada T

J Virol Methods, 2004 Nov;121(2):259-61.
PMID: 15381364

A monoclonal antibody (MAb) based solid-phase blocking ELISA was developed for detection of antibodies to Nipah virus. The ELISA was designed to detect remaining antigens on the plate with anti-Nipah MAb conjugate after the reaction with sample serum, and enabled simple procedure, detection of neutralizing antibody to Nipah virus, and application of samples from different animal species. Forty of 200 swine reference sera examined were positive by the ELISA, of which thirty seven were found positive by serum neutralization test. Sera from a total of 131 fruit bats captured in Malaysia were also tested and all found negative by the both tests. It is considered that the solid-phase blocking ELISA can be used as a screening test for Nipah virus infection followed by the serum neutralization test as confirmatory test.

Matched MeSH terms: Henipavirus Infections/epidemiology
Production of the matrix protein of Nipah virus in Escherichia coli: virus-like particles and possible application for diagnosis

Subramanian SK, Tey BT, Hamid M, Tan WS

J Virol Methods, 2009 Dec;162(1-2):179-83.
PMID: 19666056 DOI: 10.1016/j.jviromet.2009.07.034

The broad species tropism of Nipah virus (NiV) coupled with its high pathogenicity demand a rapid search for a new biomarker candidate for diagnosis. The matrix (M) protein was expressed in Escherichia coli and purified using a Ni-NTA affinity column chromatography and sucrose density gradient centrifugation. The recombinant M protein with the molecular mass (Mr) of about 43 kDa was detected by anti-NiV serum and anti-myc antibody. About 50% of the M protein was found to be soluble and localized in cytoplasm when the cells were grown at 30 degrees C. Electron microscopic analysis showed that the purified M protein assembled into spherical particles of different sizes with diameters ranging from 20 to 50 nm. The purified M protein showed significant reactivity with the swine sera collected during the NiV outbreak, demonstrating its potential as a diagnostic reagent.

Matched MeSH terms: Henipavirus Infections/epidemiology
Fulltext Agricultural intensification, priming for persistence and the emergence of Nipah virus: a lethal bat-borne zoonosis

Pulliam JR, Epstein JH, Dushoff J, Rahman SA, Bunning M, Jamaluddin AA, et al.

J R Soc Interface, 2012 Jan 7;9(66):89-101.
PMID: 21632614 DOI: 10.1098/rsif.2011.0223

Emerging zoonoses threaten global health, yet the processes by which they emerge are complex and poorly understood. Nipah virus (NiV) is an important threat owing to its broad host and geographical range, high case fatality, potential for human-to-human transmission and lack of effective prevention or therapies. Here, we investigate the origin of the first identified outbreak of NiV encephalitis in Malaysia and Singapore. We analyse data on livestock production from the index site (a commercial pig farm in Malaysia) prior to and during the outbreak, on Malaysian agricultural production, and from surveys of NiV's wildlife reservoir (flying foxes). Our analyses suggest that repeated introduction of NiV from wildlife changed infection dynamics in pigs. Initial viral introduction produced an explosive epizootic that drove itself to extinction but primed the population for enzootic persistence upon reintroduction of the virus. The resultant within-farm persistence permitted regional spread and increased the number of human infections. This study refutes an earlier hypothesis that anomalous El Niño Southern Oscillation-related climatic conditions drove emergence and suggests that priming for persistence drove the emergence of a novel zoonotic pathogen. Thus, we provide empirical evidence for a causative mechanism previously proposed as a precursor to widespread infection with H5N1 avian influenza and other emerging pathogens.

Matched MeSH terms: Henipavirus Infections/epidemiology*
Meeting the challenge of epidemic infectious disease outbreaks: an agenda for research

Phua KL, Lee LK

J Public Health Policy, 2005 Apr;26(1):122-32.
PMID: 15906881

Challenges arising from epidemic infectious disease outbreaks can be more effectively met if traditional public health is enhanced by sociology. The focus is normally on biomedical aspects, the surveillance and sentinel systems for infectious diseases, and what needs to be done to bring outbreaks under control quickly. Social factors associated with infectious disease outbreaks are often neglected and the aftermath is ignored. These factors can affect outbreak severity, its rate and extent of spread, influencing the welfare of victims, their families, and their communities. We propose an agenda for research to meet the challenges of infectious disease outbreaks. What social factors led to the outbreak? What social factors affected its severity and rate and extent of spread? How did individuals, social groups, and the state react to it? What are the short- and long-term effects on individuals, social groups, and the larger society? What programs can be put in place to help victims, their families, and affected communities to cope with the consequences--impaired mental and physical health, economic losses, and disrupted communities? Although current research on infectious disease outbreaks pays attention to social factors related to causation, severity, rate and extent of spread, those dealing with the "social chaos" arising from outbreaks are usually neglected. Inclusion, by combining traditional public health with sociological analysis, will enrich public health theory and understanding of infectious disease outbreaks. Our approach will help develop better programs to combat outbreaks and equally important, to help survivors, their families, and their communities cope better with the aftermath.

Matched MeSH terms: Henipavirus Infections/epidemiology
Late clinical and magnetic resonance imaging follow up of Nipah virus infection

Lim CC, Lee WL, Leo YS, Lee KE, Chan KP, Ling AE, et al.

J Neurol Neurosurg Psychiatry, 2003 Jan;74(1):131-3.
PMID: 12486285

The Nipah virus is a newly identified paramyxovirus responsible for an outbreak of fatal encephalitis in Malaysia and Singapore. This paper reports the follow up clinical and magnetic resonance imaging findings in 22 affected subjects. Of 13 patients with encephalitis, one died, one was lost to follow up, and seven recovered. Among the four remaining patients, one had residual sixth nerve palsy, another suffered from severe clinical depression, and a third patient had evidence of retinal artery occlusion. One patient with delayed onset Horner syndrome had a single lesion in the cervical spinal cord. The brain magnetic resonance findings were stable or improved in nine patients over 18 months of follow up. Among a second group of nine asymptomatic seropositive abattoir workers, magnetic resonance examination in seven subjects revealed discrete small lesions in the brain; similar to those detected in encephalitis patients. These findings suggest that in addition to encephalitis, the newly discovered Nipah virus affects the spinal cord and the retina. Late clinical and radiological findings can occur in Nipah virus infections as with other paramyxoviruses.

Matched MeSH terms: Henipavirus Infections/epidemiology
Origin and evolution of Nipah virus

Lo Presti A, Cella E, Giovanetti M, Lai A, Angeletti S, Zehender G, et al.

J Med Virol, 2016 Mar;88(3):380-8.
PMID: 26252523 DOI: 10.1002/jmv.24345

Nipah virus, member of the Paramyxoviridae family, is classified as a Biosafety Level-4 agent and category C priority pathogen. Nipah virus disease is endemic in south Asia and outbreaks have been reported in Malaysia, Singapore, India, and Bangladesh. Bats of the genus Pteropus appear to be the natural reservoir of this virus. The aim of this study was to investigate the genetic diversity of Nipah virus, to estimate the date of origin and the spread of the infection. The mean value of Nipah virus N gene evolutionary rate, was 6.5 × 10(-4) substitution/site/year (95% HPD: 2.3 × 10(-4)-1.18 × 10(-3)). The time-scaled phylogenetic analysis showed that the root of the tree originated in 1947 (95% HPD: 1888-1988) as the virus entered in south eastern Asiatic regions. The segregation of sequences in two main clades (I and II) indicating that Nipah virus had two different introductions: one in 1995 (95% HPD: 1985-2002) which correspond to clade I, and the other in 1985 (95% HPD: 1971-1996) which correspond to clade II. The phylogeographic reconstruction indicated that the epidemic followed two different routes spreading to the other locations. The trade of infected pigs may have played a role in the spread of the virus. Bats of the Pteropus genus, that are able to travel to long distances, may have contributed to the spread of the infection. Negatively selected sites, statistically supported, could reflect the stability of the viral N protein.

Matched MeSH terms: Henipavirus Infections/epidemiology
Insurance and epidemics: SARS, West Nile virus and Nipah virus

von Overbeck J

J Insur Med, 2003;35(3-4):165-73.
PMID: 14971089

Severe acute respiratory syndrome (SARS) reminds us that sudden disease emergence is a permanent part of our world--and should be anticipated in our planning. Historically the emergence of new diseases has had little or no impact beyond a small, localized cluster of infections. However, given just the right conditions, a highly virulent pathogen can suddenly spread across time and space with massive consequences, as has occurred on several occasions in human history. In the wake of the SARS outbreak, we are now forced to confront the unpleasant fact that human activities are increasing the frequency and severity of these kinds of emergences. The idea of more frequent biological "invasions" with economic and societal impacts comparable to SARS, presents stakeholders in and the global economy with unprecedented new risks, challenges and even opportunities. As a major contributor to economic stability, the insurance industry must follow these trends very closely and develop scenarios to anticipate these events.

Matched MeSH terms: Henipavirus Infections/epidemiology*
Fulltext Nipah virus: A review on epidemiological characteristics and outbreaks to inform public health decision making

Ambat AS, Zubair SM, Prasad N, Pundir P, Rajwar E, Patil DS, et al.

J Infect Public Health, 2019 02 23;12(5):634-639.
PMID: 30808593 DOI: 10.1016/j.jiph.2019.02.013

The objectives of this review were to understand the epidemiology and outbreak of NiV infection and to discuss the preventive and control measures across different regions. We searched PubMed and Scopus for relevant articles from January 1999 to July 2018 and identified 927 articles which were screened for titles, abstracts and full texts by two review authors independently. The screening process resulted in 44 articles which were used to extract relevant information. Information on epidemiology of NiV, outbreaks in Malaysia, Singapore, Bangladesh, India and Philippines, including diagnosis, prevention, treatment, vaccines, control, surveillance and economic burden due to NiV were discussed. Interdisciplinary and multi sectoral approach is vital in preventing the emergence of NiV. It is necessary to undertake rigorous research for developing vaccines and medicines to prevent and treat NiV.

Matched MeSH terms: Henipavirus Infections/epidemiology*
The emergence of Nipah virus, a highly pathogenic paramyxovirus

Lo MK, Rota PA

J Clin Virol, 2008 Dec;43(4):396-400.
PMID: 18835214 DOI: 10.1016/j.jcv.2008.08.007

Nipah virus first emerged in Malaysia and Singapore between 1998 and 1999, causing severe febrile encephalitis in humans with a mortality rate of close to 40%. In addition, a significant portion of those recovering from acute infection had relapse encephalitis and long-term neurological defects. Since its initial outbreak, there have been numerous outbreaks in Bangladesh and India, in which the mortality rate rose to approximately 70%. These subsequent outbreaks were distinct from the initial outbreak, both in their epidemiology and in their clinical presentations. Recent developments in diagnostics may expedite disease diagnosis and outbreak containment, while progress in understanding the molecular biology of Nipah virus could lead to novel therapeutics and vaccines for this deadly pathogen.

Matched MeSH terms: Henipavirus Infections/epidemiology*
Fulltext Nipah Virus Infection

Ang BSP, Lim TCC, Wang L

J Clin Microbiol, 2018 06;56(6).
PMID: 29643201 DOI: 10.1128/JCM.01875-17

Nipah virus, a paramyxovirus related to Hendra virus, first emerged in Malaysia in 1998. Clinical presentation ranges from asymptomatic infection to fatal encephalitis. Malaysia has had no more cases since 1999, but outbreaks continue to occur in Bangladesh and India. In the Malaysia-Singapore outbreak, transmission occurred primarily through contact with pigs, whereas in Bangladesh and India, it is associated with ingestion of contaminated date palm sap and human-to-human transmission. Bats are the main reservoir for this virus, which can cause disease in humans and animals. There are currently no effective therapeutics, and supportive care and prevention are the mainstays of management.

Matched MeSH terms: Henipavirus Infections/epidemiology*
Fulltext Genetic diversity of Nipah virus in Bangladesh

Rahman MZ, Islam MM, Hossain ME, Rahman MM, Islam A, Siddika A, et al.

Int J Infect Dis, 2021 Jan;102:144-151.
PMID: 33129964 DOI: 10.1016/j.ijid.2020.10.041

BACKGROUND: Nipah virus (NiV) infection, often fatal in humans, is primarily transmitted in Bangladesh through the consumption of date palm sap contaminated by Pteropus bats. Person-to-person transmission is also common and increases the concern of large outbreaks. This study aimed to characterize the molecular epidemiology, phylogenetic relationship, and the evolution of the nucleocapsid gene (N gene) of NiV.
METHODS: We conducted molecular detection, genetic characterization, and Bayesian time-scale evolution analyses of NiV using pooled Pteropid bat roost urine samples from an outbreak area in 2012 and archived RNA samples from NiV case patients identified during 2012-2018 in Bangladesh.
RESULTS: NiV-RNA was detected in 19% (38/456) of bat roost urine samples and among them; nine N gene sequences were recovered. We also retrieved sequences from 53% (21 out of 39) of archived RNA samples from patients. Phylogenetic analysis revealed that all Bangladeshi strains belonged to NiV-BD genotype and had an evolutionary rate of 4.64 × 10-4 substitutions/site/year. The analyses suggested that the strains of NiV-BD genotype diverged during 1995 and formed two sublineages.
CONCLUSION: This analysis provides further evidence that the NiV strains of the Malaysian and Bangladesh genotypes diverged recently and continue to evolve. More extensive surveillance of NiV in bats and human will be helpful to explore strain diversity and virulence potential to infect humans through direct or person-to-person virus transmission.

Matched MeSH terms: Henipavirus Infections/epidemiology
Fulltext Nipah outbreak in North Kerala - What worked? Insights for future response and recovery based on examination of various existing frameworks

Rahim AA, Chacko TV

Indian J Public Health, 2019 9 26;63(3):261-264.
PMID: 31552860 DOI: 10.4103/ijph.IJPH_117_19

Asia Pacific region has been witnessing numerous public health emergencies in recent years with the Nipah outbreak in North Kerala (2018), India, needs special mention. Threats posed and experiences gained have compelled health systems to draft frameworks nationally and internationally for preparedness, outbreak response, and recovery. Our failure to obtain comprehensive guiding frameworks for application in the Indian context for Ebola, Severe Acute Respiratory Syndrome, Influenza A (H1N1), and Nipah outbreaks led us to the search outside India for frameworks that have worked in the past. A thorough review of the WHO, Centers for Disease Control and Prevention, and Malaysian framework was done to identify explicit components and replicable objectives to the national context. In the absence of a specific framework, Nipah recovery and response experience that worked in Kerala outbreak (2018) was compared against novel H1N1 (2015) guidelines at national level. This article provides the groundwork and insights as a value addition toward an India-specific framework of action for response and recovery for Nipah outbreaks in future.

Matched MeSH terms: Henipavirus Infections/epidemiology*
Fulltext Emerging paramyxoviruses: molecular mechanisms and antiviral strategies

Aguilar HC, Lee B

Expert Rev Mol Med, 2011;13:e6.
PMID: 21345285 DOI: 10.1017/S1462399410001754

In recent years, several paramyxoviruses have emerged to infect humans, including previously unidentified zoonoses. Hendra and Nipah viruses (henipaviruses within this family) were first identified in the 1990s in Australia, Malaysia and Singapore, causing epidemics with high mortality and morbidity rates in affected animals and humans. Other paramyxoviruses, such as Menangle virus, Tioman virus, human metapneumovirus and avian paramyxovirus 1, which cause less morbidity in humans, have also been recently identified. Although the Paramyxoviridae family of viruses has been previously recognised as biomedically and veterinarily important, the recent emergence of these paramyxoviruses has focused our attention on this family. Antiviral drugs can be designed to target specific important determinants of the viral life cycle. Therefore, identifying and understanding the mechanistic underpinnings of viral entry, replication, assembly and budding will be critical in the development of antiviral therapeutic agents. This review focuses on the molecular mechanisms discovered and the antiviral strategies pursued in recent years for emerging paramyxoviruses, with particular emphasis on viral entry and exit mechanisms.

Matched MeSH terms: Henipavirus Infections/epidemiology

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