Systematic review (PRISMA/PROSPERO) of Nipah virus epidemiological parameters, outbreak data, and mathematical models from 119 papers published up to March 14, 2025, covering seroprevalence, case-fatality ratios (CFRs), incubation period, and transmission parameters.
Pooled CFR ranged from 9·1% (95% CI 0·2–41·3) in Singapore to 81·9% (95% CI 71·9–88·9) in Bangladesh; median incubation period estimated at 8·77 days (95% CI 7·53–10·02) from 8 estimates; IgG seroprevalence in the general population ranged 0–12·5%; basic reproduction number (R₀) was <1 in 4 of 5 estimates; only 8 of 39 mathematical models were fitted to real data.
Transmission parameters were scarce, and the clinical/infection timeline remains poorly characterised; most mathematical models were not data-fitted, limiting their predictive value; full text was not available—analysis is based on the abstract only.
Nipah virus carries an extremely high CFR (up to ~82% in Bangladesh), making early recognition and outbreak containment critical for clinicians in south and southeast Asia. The low R₀ estimates suggest limited sustained human-to-human transmission, but sparse data mean uncertainty remains high.
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