Nipah virus: a summary for clinicians

Objectives: This article is one of a series on acute, severe diseases of humans caused by emerging viruses for which there are limited or no licensed medical countermeasures. Nipah virus (NiV) is recognized as a pathogen of concern by health experts and is included on the WHO list of emerging pathogens with pandemic concern. However, NiV is a relatively poorly understood pathogen, due to the small number of outbreaks and human clinical studies. The primary objective of this summary on NiV is to provide a global understanding of clinical perspectives, providing overviews of pathogenesis, clinical features, and diagnostics while emphasizing medical countermeasures. The focus is on potential therapies and vaccines that have demonstrated potential efficacy to combat NiV infection to provide clinicians candidates for use in an emergency situation or clinical research settings. Methods: A literature review was conducted for NiV vaccines and therapeutics tested in animal models of disease. Results: We identified two antiviral medications approved by the U.S. FDA with potential benefit for the off-label treatment of NiV infection, and a larger number of potential candidates are currently being evaluated in early development. Multiple vaccine platforms are in pre-clinical development for NiV prevention, but data from human clinical trials are not yet available. Conclusion: We provide specific background information on NiV and disease manifestations along with succinct summaries of medical countermeasures against NiV to provide clinicians a rapid reference to review the literature if faced with a patient in whom NiV infection is suspected. Moreover, the information provides several candidates for human clinical research studies in outbreak settings.