ABSTRACT

Nipah virus (NiV), a lethal zoonotic paramyxovirus, poses a significant public health threat in South Asia, with the Bengal region as a recurrent epicentre. This review synthesises the historical trajectory, epidemiological impact, and multifaceted challenges of NiV in Bengal and India. It details the outbreak chronology from its initial identification to recurrent emergence, examining the ecology centred on Pteropus bats and spillover via contaminated date palm sap. The clinical spectrum, from asymptomatic infection to severe encephalitis, is critically analysed. The review systematically examines the limitations of current diagnostics and therapeutics, including scarce monoclonal antibodies, and discusses supportive management. Preventive strategies, surveillance strengthening, and infection control are outlined. Future directions emphasise accelerating vaccine development, improving point-of-care diagnostics, and fortifying One Health networks to mitigate anticipated outbreaks driven by the virus's endemicity in bat populations.