GLOBAL HEALTH SECURITY: INNOVATIVE THERAPEUTIC AND DIAGNOSTIC APPROACHES AGAINST NIPAH VIRUS - A DISTANT DANGER OR A REAL THREAT?

Abstract

Background: Nipah virus (NiV) is an emerging zoonotic paramyxovirus causing severe respiratory distress and devastating neurological complications. Given its high fatality rates and human-to-human transmission, NiV holds significant epidemic potential, prompting the World Health Organization to designate it a priority pathogen. Aim: This review synthesizes current knowledge on the molecular virology, pathogenesis, clinical manifestations, and therapeutic strategies of NiV infection. Material and methods: We analyzed literature from PubMed and Google Scholar, including observational studies, trials, and reviews focusing on the clinical symptoms, diagnostic mechanisms, and molecular virology of NiV. Results: NiV enters cells via highly conserved ephrin-B2/B3 receptors and employs sophisticated immune evasion strategies. We focus on central nervous system (CNS) invasion, detailing how NiV breaches the blood-brain barrier via direct endothelial infection and a leukocyte-mediated "Trojan horse" mechanism. Clinically, NiV induces rapidly progressive acute encephalitis with profound brainstem dysfunction. The virus's unique capacity for persistence often causes delayed-onset or relapsing neurological sequelae, frequently leaving survivors with irreversible cognitive impairments. We address diagnostic complexities, emphasizing the prognostic value of electroencephalography and neuroimaging, alongside rigorous molecular and serological testing. Finally, we review the current frontier of clinical management, including experimental small-molecule antivirals, neutralizing monoclonal antibodies, and next-generation vaccines. Conclusions: Further research into NiV neuroinvasion is essential to develop targeted neuroprotective interventions, improve patient outcomes, and mitigate this severe global health threat.