Nipah outbreak in India: why is the world afraid?

India announced two confirmed cases of Nipah virus in mid-January 2026 and that started a global concern. Multiple Asian countries have now started border and airport screenings. China, Nepal, Thailand, Myanmar, Indonesia, Pakistan, Singapore and Malaysia are among the growing list of countries which are strengthening their border control measures and screenings.

However, it's still surprising that a disease which may be very deadly in nature but has just killed approximately 260-400 people over the years could initiate such a fear globally. There are very valid reasons for me and others trained in combating infectious diseases outbreaks to be alert even when a disease has such a small footprint until now.

Nipah is a very deadly virus. Its natural hosts or reservoirs are fruit bats and flying foxes. It's a zoonotic disease which means it is spread from animals to humans. It's very fatal and in countries with weak health systems its fatality rate could reach up to 75%. With no vaccines or approved treatment, the WHO has put it in its priority list of pathogens which could start a global pandemic.

Nipah was first identified in 1999 in a major outbreak in pig farms in Malaysia and then Singapore killing more than one hundred people. Fruits partially eaten by bats and later consumed by pigs made them sick. People taking care of these sick animals also got infected with the same virus. Later in Bangladesh bat contaminated palm sap (bat saliva/feces) was the route of transmission and then human to human transmission was also established. In the earlier outbreak exposure to a sick animal or bat contaminated food was a major source of transmission but in later years more human to human transmission was observed. WHO describes human to human transmission as still limited in nature.

Recent Nipah outbreak in India is concerning because the index case or the first case has not been identified. The two confirmed cases are healthcare providers who may have taken care of an infected patient without knowing. We don't have the outbreak investigation report to know if there was a suspect case found retrospectively or not. If we don't know how this deadly virus infected these two healthcare workers, the threat of the virus evolving into asymptomatic spread or with non-specific symptoms increases. This has not been established yet. However, diseases, which could be spread by asymptomatic carriers or people with mild symptoms, increase the risk of silent transmission, making any outbreak very difficult to control.

The Indian government has not shared an outbreak investigation report or even a preliminary one. India has good disease detectives, and I hope they have been given the task to investigate it and not to administrative teams who tend to want to say that everything is under control. India could alleviate the global fears by sharing reliable and timely information about the outbreak and its numbers. Here even the number of cases is in dispute, as initially five cases were reported by Indian social media circles but later two cases were lab-confirmed.

As teachers we always instruct our outbreak investigation teams to share reliable information to key stakeholders and the public in a timely manner. An information void creates fertile grounds for panic in the population and makes outbreak control even harder.

The lack of reliable information about the ongoing outbreak is making the world less sure of what is happening in India. This initiates conspiracy theories and panic which is never good for anyone. I hope that the technical arms of the Indian government start sharing reliable data to make sure the world is still safe and not on the verge of a next pandemic. This incident also shows the need to strengthen Global Health Security infrastructure. In its absence, there is a lack of transparency and resulting lack of trust. Pathogens don't respect international borders, and our response needs to be of global cooperation and collaboration. We all are in this boat together.