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  1. Fulltext Emerging henipaviruses and flying foxes - Conservation and management perspectives
    Breed AC, Field HE, Epstein JH, Daszak P
    Biol Conserv, 2006 Aug;131(2):211-220.
    PMID: 32226079 DOI: 10.1016/j.biocon.2006.04.007
    Wildlife populations are affected by a series of emerging diseases, some of which pose a significant threat to their conservation. They can also be reservoirs of pathogens that threaten domestic animal and human health. In this paper, we review the ecology of two viruses that have caused significant disease in domestic animals and humans and are carried by wild fruit bats in Asia and Australia. The first, Hendra virus, has caused disease in horses and/or humans in Australia every five years since it first emerged in 1994. Nipah virus has caused a major outbreak of disease in pigs and humans in Malaysia in the late 1990s and has also caused human mortalities in Bangladesh annually since 2001. Increased knowledge of fruit bat population dynamics and disease ecology will help improve our understanding of processes driving the emergence of diseases from bats. For this, a transdisciplinary approach is required to develop appropriate host management strategies that both maximise the conservation of bat populations as well as minimise the risk of disease outbreaks in domestic animals and humans.
  2. Nipah virus: impact, origins, and causes of emergence
    Epstein JH, Field HE, Luby S, Pulliam JR, Daszak P
    Curr Infect Dis Rep, 2006 Jan;8(1):59-65.
    PMID: 16448602
    Nipah virus is an emerging zoonotic pathogen that causes severe febrile encephalitis resulting in death in 40% to 75% of human cases. Nipah virus is considered a biosafety level-4 pathogen and is listed as a select agent with high risk for public health and security due to its high mortality rate in people and the lack of effective vaccines or therapies. The natural reservoir for Nipah virus and related members of the genus Henipavirus are fruit bats of the genus Pteropus. Nipah virus emerged in Malaysia in 1998 as a porcine neurologic and respiratory disease that spread to humans who had contact with live, infected pigs. Research reviewed in this paper suggests that anthropogenic factors, including agricultural expansion and intensification, were the underlying causes of its emergence. Nipah virus has caused five subsequent outbreaks between 2001 and 2005 in Bangladesh. Here, it appears to have spilled over directly from bats to humans, and person-to-person transmission is evident suggesting a heightened public health risk.
  3. Fulltext Mental Model of Malaysian Pig Farmers in Implementing Disease Prevention and Control Practices
    Suit-B Y, Hassan L, Krauss SE, Ooi PT, Ramanoon SZ, Yasmin AR, et al.
    Front Vet Sci, 2021;8:695702.
    PMID: 34820433 DOI: 10.3389/fvets.2021.695702
    The 1998 Nipah virus outbreak in Malaysia resulted in major financial losses to the multi-million-dollar swine industry. While productivity and biosecurity of pig farms have improved since, biosecurity in some farms remains substandard with farmers struggling to adapt to current national pig farming policies. Farm viability and animal health depends on farmers' role as decision-makers in managing disease threats and other aspects of farm management. This study aimed to describe the mental model of farmers in making decisions about disease prevention and control measures during the 1998 Nipah virus outbreak, and in 2019, 20 years after the last reported Nipah case. Using a qualitative approach, in-depth, semi-structured interviews with 12 pig farmers (mostly small-scale or medium-scale farms) were conducted in three states in Malaysia. Data were analyzed via inductive content analysis. Thirty-six unique dimensions in the mental model were identified, representing six interrelated themes corresponding to participants' decision making related to disease prevention and control: drivers of action to prevent and control disease; perception of practice options; individual determinants of familiar practices; external social factors; external economic factors; and additional external factors. Key drivers of disease control and prevention responses during the Nipah outbreak included heightened perception of risk, emotions, perceived economic loss, and subjective norms whereas key drivers in 2019 included perception of risk, perceived effectiveness, perceived benefits, and other dimensions such as perception of the future, perceived economic cost, barriers, and loss. An unfavorable future outlook, perceived economic factors, and socio-political and personal factors currently hinders farm improvement and adoption of Pig Farming Areas (PFAs) and Modern Pig Farming (MPF) systems. Private sector service providers and veterinarians are highly influential in advocating for good biosecurity, herd health, and animal health intervention practices. Insights gained can inform the development of strategic policies and interventions.
  4. Fulltext Interdisciplinary approaches to understanding disease emergence: the past, present, and future drivers of Nipah virus emergence
    Daszak P, Zambrana-Torrelio C, Bogich TL, Fernandez M, Epstein JH, Murray KA, et al.
    Proc Natl Acad Sci U S A, 2013 Feb 26;110 Suppl 1:3681-8.
    PMID: 22936052 DOI: 10.1073/pnas.1201243109
    Emerging infectious diseases (EIDs) pose a significant threat to human health, economic stability, and biodiversity. Despite this, the mechanisms underlying disease emergence are still not fully understood, and control measures rely heavily on mitigating the impact of EIDs after they have emerged. Here, we highlight the emergence of a zoonotic Henipavirus, Nipah virus, to demonstrate the interdisciplinary and macroecological approaches necessary to understand EID emergence. Previous work suggests that Nipah virus emerged due to the interaction of the wildlife reservoir (Pteropus spp. fruit bats) with intensively managed livestock. The emergence of this and other henipaviruses involves interactions among a suite of anthropogenic environmental changes, socioeconomic factors, and changes in demography that overlay and interact with the distribution of these pathogens in their wildlife reservoirs. Here, we demonstrate how ecological niche modeling may be used to investigate the potential role of a changing climate on the future risk for Henipavirus emergence. We show that the distribution of Henipavirus reservoirs, and therefore henipaviruses, will likely change under climate change scenarios, a fundamental precondition for disease emergence in humans. We assess the variation among climate models to estimate where Henipavirus host distribution is most likely to expand, contract, or remain stable, presenting new risks for human health. We conclude that there is substantial potential to use this modeling framework to explore the distribution of wildlife hosts under a changing climate. These approaches may directly inform current and future management and surveillance strategies aiming to improve pathogen detection and, ultimately, reduce emergence risk.
  5. Fulltext Evidence for Nipah virus recrudescence and serological patterns of captive Pteropus vampyrus
    Sohayati AR, Hassan L, Sharifah SH, Lazarus K, Zaini CM, Epstein JH, et al.
    Epidemiol Infect, 2011 Oct;139(10):1570-9.
    PMID: 21524339 DOI: 10.1017/S0950268811000550
    This study aimed to describe the transmission dynamics, the serological and virus excretion patterns of Nipah virus (NiV) in Pteropus vampyrus bats. Bats in captivity were sampled every 7-21 days over a 1-year period. The data revealed five NiV serological patterns categorized as high and low positives, waning, decreasing and increasing, and negative in these individuals. The findings strongly suggest that NiV circulates in wild bat populations and that antibody could be maintained for long periods. The study also found that pup and juvenile bats from seropositive dams tested seropositive, indicating that maternal antibodies against NiV are transmitted passively, and in this study population may last up to 14 months. NiV was isolated from the urine of one bat, and within a few weeks, two other seronegative bats seroconverted. Based on the temporal cluster of seroconversion, we strongly believe that the NiV isolated was recrudesced and then transmitted horizontally between bats during the study period.
  6. 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.

  7. 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.
  8. Fulltext No Evidence of Coronaviruses or Other Potentially Zoonotic Viruses in Sunda pangolins (Manis javanica) Entering the Wildlife Trade via Malaysia
    Lee J, Hughes T, Lee MH, Field H, Rovie-Ryan JJ, Sitam FT, et al.
    Ecohealth, 2020 09;17(3):406-418.
    PMID: 33226526 DOI: 10.1007/s10393-020-01503-x
    The legal and illegal trade in wildlife for food, medicine and other products is a globally significant threat to biodiversity that is also responsible for the emergence of pathogens that threaten human and livestock health and our global economy. Trade in wildlife likely played a role in the origin of COVID-19, and viruses closely related to SARS-CoV-2 have been identified in bats and pangolins, both traded widely. To investigate the possible role of pangolins as a source of potential zoonoses, we collected throat and rectal swabs from 334 Sunda pangolins (Manis javanica) confiscated in Peninsular Malaysia and Sabah between August 2009 and March 2019. Total nucleic acid was extracted for viral molecular screening using conventional PCR protocols used to routinely identify known and novel viruses in extensive prior sampling (> 50,000 mammals). No sample yielded a positive PCR result for any of the targeted viral families-Coronaviridae, Filoviridae, Flaviviridae, Orthomyxoviridae and Paramyxoviridae. In the light of recent reports of coronaviruses including a SARS-CoV-2-related virus in Sunda pangolins in China, the lack of any coronavirus detection in our 'upstream' market chain samples suggests that these detections in 'downstream' animals more plausibly reflect exposure to infected humans, wildlife or other animals within the wildlife trade network. While confirmatory serologic studies are needed, it is likely that Sunda pangolins are incidental hosts of coronaviruses. Our findings further support the importance of ending the trade in wildlife globally.
  9. 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.

  10. Feral cats and risk for Nipah virus transmission
    Epstein JH, Abdul Rahman S, Zambriski JA, Halpin K, Meehan G, Jamaluddin AA, et al.
    Emerg Infect Dis, 2006 Jul;12(7):1178-9.
    PMID: 16848051
  11. Fulltext Risk Factors for Nipah virus infection among pteropid bats, Peninsular Malaysia
    Rahman SA, Hassan L, Epstein JH, Mamat ZC, Yatim AM, Hassan SS, et al.
    Emerg Infect Dis, 2013 Jan;19(1):51-60.
    PMID: 23261015 DOI: 10.3201/eid1901.120221
    We conducted cross-sectional and longitudinal studies to determine the distribution of and risk factors for seropositivity to Nipah virus (NiV) among Pteropus vampyrus and P. hypomelanus bats in Peninsular Malaysia. Neutralizing antibodies against NiV were detected at most locations surveyed. We observed a consistently higher NiV risk (odds ratio 3.9) and seroprevalence (32.8%) for P. vampyrus than P. hypomelanus (11.1%) bats. A 3-year longitudinal study of P. hypomelanus bats indicated nonseasonal temporal variation in seroprevalence, evidence for viral circulation within the study period, and an overall NiV seroprevalence of 9.8%. The seroprevalence fluctuated over the study duration between 1% and 20% and generally decreased during 2004-2006. Adult bats, particularly pregnant, with dependent pup and lactating bats, had a higher prevalence of NiV antibodies than juveniles. Antibodies in juveniles 6 months-2 years of age suggested viral circulation within the study period.
  12. Fulltext Macacine Herpesvirus 1 in Long-Tailed Macaques, Malaysia, 2009-2011
    Lee MH, Rostal MK, Hughes T, Sitam F, Lee CY, Japning J, et al.
    Emerg Infect Dis, 2015 Jul;21(7):1107-13.
    PMID: 26080081 DOI: 10.3201/eid2107.140162
    Macacine herpesvirus 1 (MaHV1; B virus) naturally infects macaques (Macaca spp.) and can cause fatal encephalitis in humans. In Peninsular Malaysia, wild macaques are abundant, and translocation is used to mitigate human-macaque conflict. Most adult macaques are infected with MaHV1, although the risk for transmission to persons who handle them during capture and translocation is unknown. We investigated MaHV1 shedding among 392 long-tailed macaques (M. fascicularis) after capture and translocation by the Department of Wildlife and National Parks in Peninsular Malaysia, during 2009-2011. For detection of MaHV1 DNA, PCR was performed on urogenital and oropharyngeal swab samples. Overall, 39% of macaques were shedding MaHV1 DNA; rates of DNA detection did not differ between sample types. This study demonstrates that MaHV1 was shed by a substantial proportion of macaques after capture and transport and suggests that persons handling macaques under these circumstances might be at risk for exposure to MaHV1.
  13. Fulltext Pteropid bats are confirmed as the reservoir hosts of henipaviruses: a comprehensive experimental study of virus transmission
    Halpin K, Hyatt AD, Fogarty R, Middleton D, Bingham J, Epstein JH, et al.
    Am J Trop Med Hyg, 2011 Nov;85(5):946-51.
    PMID: 22049055 DOI: 10.4269/ajtmh.2011.10-0567
    Bats of the genus Pteropus have been identified as the reservoir hosts for the henipaviruses Hendra virus (HeV) and Nipah virus (NiV). The aim of these studies was to assess likely mechanisms for henipaviruses transmission from bats. In a series of experiments, Pteropus bats from Malaysia and Australia were inoculated with NiV and HeV, respectively, by natural routes of infection. Despite an intensive sampling strategy, no NiV was recovered from the Malaysian bats and HeV was reisolated from only one Australian bat; no disease was seen. These experiments suggest that opportunities for henipavirus transmission may be limited; therefore, the probability of a spillover event is low. For spillover to occur, a range of conditions and events must coincide. An alternate assessment framework is required if we are to fully understand how this reservoir host maintains and transmits not only these but all viruses with which it has been associated.
  14. Fulltext In silico prediction of interaction between Nipah virus attachment glycoprotein and host cell receptors Ephrin-B2 and Ephrin-B3 in domestic and peridomestic mammals
    Hoque AF, Rahman MM, Lamia AS, Islam A, Klena JD, Satter SM, et al.
    Infect Genet Evol, 2023 Dec;116:105516.
    PMID: 37924857 DOI: 10.1016/j.meegid.2023.105516
    Nipah virus (NiV) is a lethal bat-borne zoonotic virus that causes mild to acute respiratory distress and neurological manifestations in humans with a high mortality rate. NiV transmission to humans occurs via consumption of bat-contaminated fruit and date palm sap (DPS), or through direct contact with infected individuals and livestock. Since NiV outbreaks were first reported in pigs from Malaysia and Singapore, non-neutralizing antibodies against NiV attachment Glycoprotein (G) have also been detected in a few domestic mammals. NiV infection is initiated after NiV G binds to the host cell receptors Ephrin-B2 and Ephrin-B3. In this study, we assessed the degree of NiV host tropism in domestic and peridomestic mammals commonly found in Bangladesh that may be crucial in the transmission of NiV by serving as intermediate hosts. We carried out a protein-protein docking analysis of NiV G complexes (n = 52) with Ephrin-B2 and B3 of 13 domestic and peridomestic species using bioinformatics tools. Protein models were generated by homology modelling and the structures were validated for model quality. The different protein-protein complexes in this study were stable, and their binding affinity (ΔG) scores ranged between -8.0 to -19.1 kcal/mol. NiV Bangladesh (NiV-B) strain displayed stronger binding to Ephrin receptors, especially with Ephrin-B3 than the NiV Malaysia (NiV-M) strain, correlating with the observed higher pathogenicity of NiV-B strains. From the docking result, we found that Ephrin receptors of domestic rat (R. norvegicus) had a higher binding affinity for NiV G, suggesting greater susceptibility to NiV infections compared to other study species. Investigations for NiV exposure to domestic/peridomestic animals will help us knowing more the possible role of rats and other animals as intermediate hosts of NiV and would improve future NiV outbreak control and prevention in humans and domestic animals.
  15. Fulltext Characterization of Nipah virus from naturally infected Pteropus vampyrus bats, Malaysia
    Rahman SA, Hassan SS, Olival KJ, Mohamed M, Chang LY, Hassan L, et al.
    Emerg Infect Dis, 2010 Dec;16(12):1990-3.
    PMID: 21122240 DOI: 10.3201/eid1612.091790
    We isolated and characterized Nipah virus (NiV) from Pteropus vampyrus bats, the putative reservoir for the 1998 outbreak in Malaysia, and provide evidence of viral recrudescence. This isolate is monophyletic with previous NiVs in combined analysis, and the nucleocapsid gene phylogeny species.
  16. Fulltext Living Safely With Bats: Lessons in Developing and Sharing a Global One Health Educational Resource
    Martinez S, Sullivan A, Hagan E, Goley J, Epstein JH, Olival KJ, et al.
    Glob Health Sci Pract, 2022 Dec 21;10(6).
    PMID: 36951282 DOI: 10.9745/GHSP-D-22-00106
    As part of a public health behavior change and communication strategy related to the identification of a novel ebolavirus in bats in Sierra Leone in 2016, a consortium of experts launched an effort to create a widely accessible resource for community awareness and education on reducing disease risk. The resulting picture book, Living Safely With Bats, includes technical content developed by a consortium of experts in public health, animal health, conservation, bats, and disease ecology from 30 countries. The book has now been adapted, translated, and used in more than 20 countries in Africa and Asia. We review the processes used to integrate feedback from local stakeholders and multidisciplinary experts. We also provide recommendations for One Health and other practitioners who choose to pursue the development and evaluation of this or similar zoonotic disease risk mitigation tools.
  17. 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.
  18. Author Correction: Predicting the potential for zoonotic transmission and host associations for novel viruses
    Pandit PS, Anthony SJ, Goldstein T, Olival KJ, Doyle MM, Gardner NR, et al.
    Commun Biol, 2023 Jan 10;6(1):25.
    PMID: 36627372 DOI: 10.1038/s42003-022-04364-y
  19. Fulltext Predicting the potential for zoonotic transmission and host associations for novel viruses
    Pandit PS, Anthony SJ, Goldstein T, Olival KJ, Doyle MM, Gardner NR, et al.
    Commun Biol, 2022 Aug 19;5(1):844.
    PMID: 35986178 DOI: 10.1038/s42003-022-03797-9
    Host-virus associations have co-evolved under ecological and evolutionary selection pressures that shape cross-species transmission and spillover to humans. Observed virus-host associations provide relevant context for newly discovered wildlife viruses to assess knowledge gaps in host-range and estimate pathways for potential human infection. Using models to predict virus-host networks, we predicted the likelihood of humans as hosts for 513 newly discovered viruses detected by large-scale wildlife surveillance at high-risk animal-human interfaces in Africa, Asia, and Latin America. Predictions indicated that novel coronaviruses are likely to infect a greater number of host species than viruses from other families. Our models further characterize novel viruses through prioritization scores and directly inform surveillance targets to identify host ranges for newly discovered viruses.
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