Nipah virus; information for travellers and health professionals

Information on risks and prevention for travellers and health professionals

Nipah virus (NiV) is a virus that spreads to humans from animals (a zoonosis); the natural hosts of the virus are fruit bats; it can also infect pigs and humans. Most human infections result from direct contact with animals, particularly pigs and bats, or their bodily fluids, such as saliva or urine, or consuming food which has been contaminated by infected bodily fluids from these animals, such as date palm sap or fruit [1]. Person to person spread is also possible, through close contact with an infected patient or their body fluids.

Countries with previously reported Nipah virus outbreaks in people are Bangladesh, India, Malaysia, the Philippines, and Singapore [1-4].

NiV can cause mild to severe disease ranging from mild symptoms to illnesses including fatal encephalitis. There are currently no licensed treatments for NiV. Treatment is limited to intensive supportive care to treat severe infections [1].

Advice for travellers

Before you travel

Check and follow the advice from the Foreign, Commonwealth & Development Office on safety, security, and any travel restrictions at your destination.

Check our Country Information pages to research general health risks, prevention advice and any vaccine recommendations or malaria advice for your destination.

There is currently no licensed vaccine to prevent NiV [1].

While you are away

The risk of NiV infection for tourists to endemic countries is currently very low if the following precautions are taken [1, 4]:

• Pay careful attention to personal hygiene.
• Do not consume raw date palm sap (NiV can survive in the palm sap for days). Raw or partially fermented date palm juice should be boiled before consumption.
• All fruit should be thoroughly washed with clean water and peeled before consumption; fruit found on the ground which may have been partially eaten by animals should not be consumed.
• Close, unprotected physical contact with people with NiV infection should be avoided. Avoid contact with blood or body fluids of anyone infected with NiV. Regular hand washing should be carried out after caring for or visiting sick people.
• Avoid contact with bats (e.g. areas where they roost) and pigs as much as possible.
• Gloves and other protective clothing should be worn if handling sick animals or their tissues, and during slaughtering and culling.

The risk to other UK travellers (such as those visiting friends and family) may be higher, depending on activities undertaken (e.g. local practices such as collection of date palm sap) [1].

You should seek advice from a health professional if you develop symptoms whilst you are overseas.

When you return

If you think you, or anyone in your family has symptoms after you return to the UK you should seek medical advice. It is important to tell your healthcare provider about any recent travel.

Advice for health professionals

In the UK NiV is classed as a high consequence infectious disease. UK Health Security Agency provides Guidance: High consequence infectious diseases for health professionals and for the management of Nipah virus infections.

Healthcare professionals should be aware of the signs and symptoms of NiV in any patient with a relevant travel history and symptoms compatible with NiV infection. Most patients present within 4 to 21 days of exposure but in some cases the incubation period was up to two months [2]. Specialist advice must be sought when persons suspected of having NiV infection are evaluated [1].

Health professionals caring for patients with suspected or confirmed NiV infection, or handling specimens from them, should always implement standard infection control precautions.