Open Outbreak

尼帕病毒感染

又称: Nipah, NiV, henipavirus, Henipavirus nipahense

尼帕病毒感染是一种罕见但严重的疾病，由尼帕病毒引起，该病毒通常在果蝠中传播。人类可通过接触感染的动物、食用或饮用被蝙蝠污染的食物，或与感染者密切接触而被感染。疾病表现从无症状到严重影响大脑或肺部的疾病不等。世卫组织表示潜伏期通常为3至14天，但也有罕见病例潜伏期长达45天。根据孟加拉国、印度、马来西亚和新加坡的疫情，世卫组织报告病例致死率为40%至75%，不同疫情间的差异部分反映了病例发现的速度和支持性护理的可用程度。尚无获批疫苗和特定抗病毒治疗。护理主要是支持性治疗，如氧气、通气、液体、营养和并发症治疗。疫情曾在亚洲部分地区报告，尤其是孟加拉国和印度，世卫组织持续监测零星病例和小规模聚集。

关键事实

传播通过感染的果蝠和其他动物传染给人类；通过受污染的食物如生椰枣汁或水果制品；以及通过与感染者的密切接触，包括家庭和医疗机构内。
潜伏期通常为3至14天；罕见报道最长达45天。
病死率在孟加拉国、印度、马来西亚和新加坡报告的疫情中，病例致死率为40%至75%，部分取决于检测和临床管理。
再生数未知
疫苗无获批人用疫苗；候选疫苗正在开发中，包括已进入一期临床试验的亚单位疫苗。
治疗无特定获批治疗。建议早期强化支持治疗；文献中讨论了实验性抗体方法，但尚未获批为标准治疗。
宿主果蝠或翼手科飞狐，尤其是狐蝠属（Pteropus）物种。
流行地区孟加拉国、印度、马来西亚、菲律宾和新加坡曾报告疫情；果蝠宿主广泛分布于南亚、东南亚及大洋洲部分地区。

传播途径

尼帕病毒主要是动物传人感染，但也可在人与人之间传播。世卫组织称自然宿主为果蝠，人类可通过直接接触感染的蝙蝠或其他动物如猪或马而感染。感染也可通过食用或饮用受污染的食物，尤其是被蝙蝠唾液、尿液或粪便污染的生椰枣汁或水果制品而发生。在孟加拉国和印度，已记录有人际传播，尤其是在家庭照护者和医疗机构中与病人密切接触后。世卫组织指出，在拥挤、通风不良且感染预防措施薄弱的医院中传播更可能发生。通常潜伏期为3至14天，罕见病例潜伏期可达45天。世卫组织资料中未给出广泛接受的基本传染数，故最好描述为未知。

症状和严重程度

Nipah virus infection does not always look the same. Some people have no symptoms, while others develop fever and symptoms affecting the brain or lungs. WHO lists headache, confusion, cough, difficulty breathing, chills, fatigue, drowsiness, dizziness, vomiting and diarrhoea among common features. Severe disease can progress to encephalitis, meaning inflammation and swelling of the brain. WHO says seizures and coma can follow quickly in severe cases. Respiratory disease can also be severe, including pneumonia or acute respiratory distress. The disease is serious: WHO reports that the case fatality ratio across outbreaks in Bangladesh, India, Malaysia and Singapore has ranged from 40% to 75%. That figure varies by outbreak and is influenced by how fast cases are recognized and how much intensive supportive care is available. WHO also notes that about 1 in 5 survivors may have long-term neurologic problems.

治疗和疫苗

世卫组织资料显示，尼帕病毒感染尚无获批疫苗和特定药物治疗。因此治疗主要是支持性。世卫组织称早期诊断有助于临床医生尽早开始支持治疗，高质量的支持性医疗可防止死亡。支持治疗包括氧气、通气、必要时透析、谨慎的液体和营养管理，以及脑肿胀或肺炎等并发症的治疗。世卫组织2026年疾病暴发报告也指出，严重呼吸和神经系统并发症推荐强化支持治疗。多种疫苗正在开发中，但仍为候选产品，尚未获批。2021年NPJ Vaccines论文报道，一种基于亨德拉病毒附着糖蛋白的人用亚单位疫苗已进入一期临床试验。文献中还讨论了单克隆抗体和其他实验性方法，但这些仍属研究阶段，不应视为既定治疗。

分布地区

尼帕病毒感染曾在有限国家报告，但动物宿主分布更广。世卫组织称人类病例首次报告于1998年马来西亚，随后1999年新加坡报告，之后这两国未再报告新疫情。自2001年以来，孟加拉国和印度检测到疫情。世卫组织称孟加拉国几乎每年都有疫情报告，印度则有周期性疫情，包括近期喀拉拉邦和西孟加拉邦事件。世卫组织还指出2014年菲律宾爆发过疫情，之后无新病例。自然宿主为翼手科果蝠，尤其是狐蝠属，分布于亚洲和大洋洲部分地区。果蝠广泛分布意味着溢出风险不仅与国界相关，还与蝙蝠、家畜、食物采集习惯及人类的局部接触有关。

近期历史

This site’s archive lists 10 WHO-notice events for Nipah since 1996. The pattern is not one of steady global spread, but of recurring small outbreaks and sporadic cases, especially in South Asia. WHO items retrieved here include Bangladesh in 2023, 2024, 2025 and 2026, and India in 2023, 2025 and 2026. In Bangladesh, WHO described the 2023 outbreak as unusual compared with the previous seven years, with 11 cases and eight deaths reported by mid-February. In India, WHO reported six confirmed cases in Kerala in September 2023, four confirmed cases in Kerala in 2025, two health-care worker cases in West Bengal in January 2026, and one confirmed case in Kerala in June 2026 with no secondary cases identified by 2026-06-18. WHO’s fact sheet says Bangladesh has outbreaks almost every year, while India reports them periodically in several parts of the country.

关注重点

The main warning signs would be changes that suggest Nipah is becoming easier to spread or harder to control. One is spread into new regions or repeated outbreaks outside the usual pattern in Bangladesh and India. Another is clearer, sustained person-to-person transmission, especially beyond households and hospitals, because that would increase the chance of larger outbreaks. WHO’s recent India reports are somewhat reassuring on this point only in the narrow sense that extensive contact tracing in June 2026 found no secondary cases by 2026-06-18, but WHO also says additional cases could not be excluded because the infection source was not identified. Other important signals are failures in infection prevention in crowded health facilities, animal or food exposures that become more common, and any evidence that investigational vaccines or treatments remain unavailable if a larger outbreak occurs. Continued absence of a licensed vaccine or specific treatment keeps preparedness dependent on surveillance, isolation, contact tracing, and supportive care.

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