Nipah virus: Sindh urges strict border surveillance amid outbreak in India

Seeking to enhance border surveillance, the Sindh Health Services department has urged the authorities to ensure early detection of any suspected Nipah virus (NiV) case arriving through international travel or exhibiting unexplained encephalitis, amid surfacing of Nipah virus in neighbouring India.

The health department said this in an alert on Nipah virus outbreak in West Bengal region of India.

“Nipah virus (NiV) is a highly pathogenic zoonotic virus that causes severe respiratory illness and fatal encephalitis. While Pakistan has not yet reported a human case, a significant situation is emerging in South Asia.

“As of January 2026, an outbreak has been confirmed in West Bengal, India, where at least five confirmed cases have been reported, including healthcare workers in Kolkata. Due to its high case fatality rate ranging from 40% to 75% and the potential for human-to-human transmission, health authorities are placing the region on high alert,” it said, alerting all health departments.

In a letter, the Sindh health department urged Border Health Services (BHS) to take precautionary measures to stop spillover of the virus into Pakistan.

The department asked it to provide a unified framework for isolation, sample transportation, and infection control across all healthcare settings.

It also asked healthcare providers to educate the public and healthcare workers on transmission routes (zoonotic and human-to-human) to prevent localised outbreaks, in a bid to mitigate risk.

The health department also asked to ensure Rapid Response Teams (RRTs) and Public Health Emergency Operations Centres (PHEOCs) are in a state of active readiness.

Nipah virus

Nipah virus belongs to the genus Henipavirus of the Paramyxoviridae family. It is listed on the WHO R&D Blueprint as a priority disease with epidemic potential.

Initial symptoms include fever, headache, myalgia, vomiting, and sore throat. This can progress to severe encephalitis characterised by dizziness, drowsiness, altered consciousness, and seizures, leading to coma within 24 to 48 hours.

Incubation period typically lasts four to 14 days, though periods as long as 45 days have also been documented.

Nipah virus is primarily transmitted to humans through: Consumption of fruits or fruit products (such as raw date palm sap) contaminated with the saliva or urine of infected fruit bats; handling infected animals, mainly fruit bats (genus Pteropus) or infected pigs and close, unprotected contact with the secretions or body fluids of an infected human being, frequently occurring in healthcare settings.

There is currently no specific antiviral treatment or licensed vaccine available for Nipah virus infection. Management remains primarily supportive and focuses on symptomatic treatment, including management of fever, respiratory distress, and neurological complications. Severely ill patients often require hospitalisation and may need intensive care support, including mechanical ventilation. The clinical effectiveness of ribavirin remains inconclusive and it is not routinely recommended.

The situation is being monitored closely in coordination with WHO and NIH-PHEOC is currently on watch mode and monitoring the situation vigilantly. The World Health Organization (WHO) considers the risk of further spread of Nipah infection from the Indian cases is low, adding that there is no evidence yet of increased human-human transmission.