Nipah Virus: Symptoms, Spread, Risks, and What to Know

News reports on the 2026 Nipah virus outbreak in India have raised questions for people in Singapore. While the overall risk to Singapore remains low, understanding what the Nipah virus is, its symptoms, who is at risk, and when to seek medical attention is crucial, especially for travellers or those planning to travel.

What is the Nipah virus?

The Nipah virus (NiV) is an RNA zoonotic virus. It is primarily an infection confined within animals, but it may spread to humans. Fruit bats, specifically the flying fox bats, are the natural hosts of the virus. As the bats leave their habitats for food, it can also spread from pigs, cats, dogs, horses, and goats. Contact with infected animals can lead to transmission to humans and thereafter human-to-human transmission.

Nipah virus infections can range from asymptomatic to mild illness to severe neurological disease and respiratory illness, including encephalitis (inflammation of the brain), seizures, and pneumonia. In cases where the virus causes severe illness, fatality rates may range from 40% to 75%. Long-term neurologic conditions have been reported in some people who have recovered.

Most recently, India’s West Bengal state has reported an outbreak of the Nipah virus, with two confirmed cases since December 2025. These were two healthcare workers. So far, of the 200 contacts that have been tracked and tested, none have fallen ill further.

What are the symptoms of NiV?

Symptoms of the Nipah virus typically appear 4 – 14 days after exposure, although longer incubation periods of up to 45 days have been reported.

Symptoms of NiV may include:

• Fever
• Headache
• Muscle pain
• Fatigue
• Sore throat
• Cough
• Vomiting
• Drowsiness, dizziness, or confusion
• Seizures and neurological decline in severe cases
• Atypical pneumonia, and acute respiratory distress
• Encephalitis (brain inflammation) or meningitis, which may result in a coma

Because early signs can mimic common viral illnesses, including influenza or influenza-like illnesses, differentiation is extremely difficult. Travel and exposure history help healthcare providers assess risk.

How is the Nipah virus diagnosed?

Diagnosis relies on:

• Clinical history (symptoms, exposure risk)
• Laboratory tests using molecular detection methods (PCR or polymerase chain reaction) are the mainstay of testing. These tests are performed in highly specialised laboratories and are not routinely available in most facilities. Samples which may be submitted include respiratory samples, urine, blood and cerebrospinal fluid (CSF).

How does the Nipah virus spread?

Nipah virus can spread through:

• Animal-to-human transmission: Contact with infected bats, pigs, cats or other animals, or contaminated food products. Transmission is through bodily fluids. The most common scenario is consuming contaminated fruits or fresh date palm sap, which are contaminated with the body fluid (urine / saliva) of the infected bats. These bats are healthy, not diseased, and do not appear sick.
• Human-to-human transmission: Through close contact with bodily fluids (e.g., saliva, respiratory secretions) of infected humans. In the previously transmitted cases, it is often the family members who share the same living quarters, share meals and beds together who fall sick. Health care workers without the necessary protective gear are also at risk.

Prolonged or close exposure to patients increases risk. As the individual’s illness progresses, the virus shedding increases, peaking at day 5 - 7 of illness when the illness is expected to be most severe.

Nipah virus was first identified among pig farmers in Singapore and Malaysia in 1998 and 1999, with over 100 deaths and 300 cases reported. Since then, it has also been detected in India, Bangladesh, and the Philippines. In Singapore, no healthcare workers became infected because of the personal protective equipment used to prevent cross-transmission

How contagious is the Nipah virus?

Although Nipah virus is not as contagious as viruses like influenza or COVID-19, it can still spread from person to person under certain conditions. The virus basic reproduction number is 0.5, meaning that it spreads to one person for every two confirmed cases.

COVID-19 and influenza have a higher number of 1.6 to 2, while measles and chicken pox can be as high as 15. This means that the Nipah virus is likely to be less contagious but more severe in some cases, while COVID-19 and measles / chickenpox spreads far easily between people.

The World Health Organization (WHO) also reports that it has a high fatality rate, which based on past outbreaks has ranged from roughly 40% to 75%.

Overall, the current circulating strains of Nipah virus is not expected to have changed significantly in transmission compared to the strain in 1999. Hence the WHO does not expect Nipah virus to spread like COVID-19.

How is Nipah virus different from flu, COVID-19 and RSV?

Early symptoms of Nipah virus can resemble common respiratory infections such as influenza, COVID-19 or RSV. However, there are important differences in severity, transmission and prevention.

Nipah virus

• Less contagious than flu or COVID-19
• Higher risk of severe complications such as encephalitis and seizures
• No approved vaccine or specific antiviral treatment
• Higher reported fatality rates in past outbreaks

Influenza, COVID-19 and RSV

• Spread more easily between people
• Usually cause mild to moderate illness in most individuals
• Vaccines are available for influenza and COVID-19
• Antiviral or targeted treatments may be available for selected patients

Because early symptoms can overlap, travel history and exposure risk are key factors that help doctors distinguish Nipah virus from more common viral infections.

Are there vaccines for the Nipah virus?

Currently, there are no approved vaccines or curative treatments for Nipah virus. In contrast, vaccines are widely available for influenza and COVID-19, and help reduce the risk of severe illness.

Who is at risk of the Nipah virus?

Higher-risk groups include:

• People who have travelled to outbreak areas, especially India and Bangladesh where outbreaks have occurred before, including tourists and migrant domestic workers
• People who are exposed to infected patients (e.g., family caregivers, healthcare workers)
• People exposed to sick animals or contaminated food in affected regions

Children, older adults, and individuals with weakened immunity may be more likely to develop severe disease.

What to do if you suspect an infection

If you think you’ve been exposed to the Nipah virus:

• Seek medical evaluation promptly
• Share your travel history and exposure risks, especially if you have recently travelled to India or other outbreak regions
• Avoid contact with others until assessed
• Follow public health advice and isolation guidance if recommended

How can I prevent an infection?

People travelling to affected areas or who may have close contact with confirmed patients are encouraged to adopt these health precautions:

• Washing hands regularly
• Avoiding contact with bats, pigs, and areas where bats roost
• Avoiding consumption of unwashed fruit and raw foods that might be contaminated
• Following overseas travel advisories
• Practising good hygiene when caring for sick people
• Wearing surgical masks in areas with active transmission or when coming in contact with sick individuals

These steps are recommended by Singapore’s Ministry of Health (MOH) and international health bodies such as the World Health Organization.

What people in Singapore need to know

• There are no reported Nipah cases in Singapore as of 6 February 2026.
• Authorities maintain public health surveillance and airport screening due to regional outbreaks.
• If you develop symptoms after travel to affected areas, consider seeing a doctor and mention your travel history.

Consult a doctor early

While Nipah virus infections are currently rare in Singapore, early medical assessment is important if you feel unwell after travel or possible exposure.

Consider visiting a GP if you:

• Develop fever, cough, headache or fatigue after recent travel
• Experience worsening symptoms or breathing difficulty
• Notice neurological symptoms such as confusion or drowsiness
• Have concerns about possible exposure and need reassurance

A GP can assess your symptoms, review your travel and exposure history, and determine whether further testing, monitoring or referral is needed. Early evaluation also helps rule out more common conditions such as flu or COVID-19.

If you’re unsure, it’s better to be assessed early.

Seeing a doctor can provide clarity, reassurance and timely care if needed.