Two geographies, one virus: What recurrent Nipah spillover in India reveals

Abstract

Recurrent Nipah virus infections in India reveal two distinct epidemiological patterns despite a shared bat reservoir. In Kerala, frequent spillover rarely progresses beyond small clusters due to surveillance and one health approaches, while in West Bengal, limited events have enabled healthcare-associated transmission, and enhanced surveillance has detected the recent 2026 outbreak. This contrast underscores the roles of ecological exposure and the health system response in shaping outbreaks and highlights that large-scale transmission can often be prevented.