{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T21:41:26Z","timestamp":1793137286645,"version":"4.5.0"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Health Serv."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nipah virus (NiV) is a highly pathogenic zoonotic henipavirus that continues to pose a significant threat to global health security because of its high case fatality rate, ability to cause human-to-human transmission, and absence of licensed vaccines or specific therapeutics. Although more than two decades of research have advanced the understanding of NiV ecology, epidemiology, and clinical disease, major uncertainties remain regarding spillover mechanisms, environmental drivers, surveillance integration, and outbreak preparedness. These persistent knowledge gaps limit the ability to predict, prevent, and respond effectively to future outbreaks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This review synthesises current evidence on Nipah virus across the human\u2013animal\u2013environment interface and identifies critical One Health knowledge gaps that hinder surveillance, risk forecasting, and health system preparedness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A structured narrative review was conducted using literature published between 1998 and 2025. Evidence was identified through systematic searches of major scientific databases and relevant outbreak reports and was synthesised according to three interconnected One Health domains: animal reservoirs and viral ecology, environmental and anthropogenic drivers of spillover, and human infection, transmission, and health system response. Additional emphasis was placed on diagnostics, surveillance, governance, and socio-behavioural determinants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 210 studies were included in the final synthesis. The evidence base was strongly concentrated in bat ecology and human clinical research, whereas environmental modelling, social science, governance, and implementation research remained comparatively limited. Key gaps included incomplete understanding of viral shedding dynamics in reservoir hosts, limited integration of climate and land-use data into spillover prediction models, insufficient evidence on asymptomatic infection and transmission patterns, restricted access to rapid diagnostics, fragmented surveillance systems, and weak cross-sectoral coordination. Significant deficiencies were also identified in governance frameworks, ethical preparedness, and evaluation of community-based prevention strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Current Nipah virus preparedness remains constrained by fragmented knowledge and limited operationalisation of the One Health approach. Strengthening integrated surveillance systems, ecological forecasting, decentralised diagnostics, implementation research, and cross-sector governance will be essential for improving outbreak prevention and response. Addressing these priorities can enhance resilience against Nipah virus and provide a framework for preparedness against future emerging zoonotic threats.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/frhs.2026.1825624","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T12:19:55Z","timestamp":1782908395000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["From spillover to preparedness: a One Health analysis of knowledge gaps in Nipah virus surveillance, prevention, and health system response"],"prefix":"10.3389","volume":"6","author":[{"given":"Sirwan","family":"Sleman","sequence":"first","affiliation":[{"name":"College of Veterinary Medicine, University of Sulaimani","place":["Sulaymaniyah, Iraq"]},{"name":"Masi Altuni Company","place":["Sulaymaniyah, Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omed I.","family":"Abid","sequence":"additional","affiliation":[{"name":"Masi Altuni Company","place":["Sulaymaniyah, Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barham J.","family":"Abdullah","sequence":"additional","affiliation":[{"name":"Sulaimani Private Veterinary Hospital","place":["Sulaymaniyah, Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basim A.","family":"Ali","sequence":"additional","affiliation":[{"name":"College of Veterinary Medicine, University of Sulaimani","place":["Sulaymaniyah, Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaniar A.","family":"Abass","sequence":"additional","affiliation":[{"name":"Masi Altuni Company","place":["Sulaymaniyah, Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masood B.","family":"Ameen","sequence":"additional","affiliation":[{"name":"Sulaimani Private Veterinary Hospital","place":["Sulaymaniyah, Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"235","DOI":"10.3201\/eid1202.051247","article-title":"Nipah virus-associated encephalitis outbreak, Siliguri, India","volume":"12","author":"Chadha","year":"2006","journal-title":"Emerg Infect Dis"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1743","DOI":"10.1086\/647951","article-title":"Transmission of human infection with Nipah virus","volume":"49","author":"Luby","year":"2009","journal-title":"Clin Infect Dis"},{"key":"B3","doi-asserted-by":"publisher","first-page":"124","DOI":"10.3390\/microorganisms13010124","article-title":"Nipah virus: a zoonotic threat re-emerging in the wake of global public health challenges","volume":"13","author":"Branda","year":"2025","journal-title":"Microorganisms"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e463","DOI":"10.1016\/S2542-5196(24)00119-0","article-title":"Mapping the distribution of Nipah virus infections: a geospatial modelling analysis","volume":"8","author":"Sun","year":"2024","journal-title":"Lancet Planet Health"},{"key":"B5","year":""},{"key":"B6","volume-title":"Nipah Virus Infection\u2014Bangladesh. Disease Outbreak News","year":"2025"},{"key":"B7","doi-asserted-by":"publisher","first-page":"169","DOI":"10.3390\/v13020169","article-title":"The ecology of Nipah virus in Bangladesh: a nexus of land-use change and opportunistic feeding behavior in bats","volume":"13","author":"McKee","year":"2021","journal-title":"Viruses"},{"key":"B8","doi-asserted-by":"publisher","first-page":"328","DOI":"10.3201\/eid2102.141433","article-title":"Outbreak of henipavirus infection, Philippines, 2014","volume":"21","author":"Ching","year":"","journal-title":"Emerg Infect Dis"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e01875-17","DOI":"10.1128\/JCM.01875-17","article-title":"Nipah virus infection","volume":"56","author":"Ang","year":"2018","journal-title":"J Clin Microbiol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"2062","DOI":"10.3390\/v15102062","article-title":"Nipah virus: an overview of diagnostics and preparedness in endemic countries","volume":"15","author":"Garbuglia","year":"2023","journal-title":"Viruses"},{"key":"B11","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1016\/S1474-4422(23)00445-3","article-title":"Neurological infections in 2023: surveillance and prevention","volume":"23","author":"van de Beek","year":"2024","journal-title":"Lancet Neurol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1031","DOI":"10.3201\/eid1307.061128","article-title":"Person-to-person transmission of Nipah virus in a Bangladeshi community","volume":"13","author":"Gurley","year":"2007","journal-title":"Emerg Infect Dis"},{"key":"B13","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1098\/rsif.2011.0223","article-title":"Agricultural intensification and the emergence of Nipah virus","volume":"9","author":"Pulliam","year":"2012","journal-title":"J R Soc Interface"},{"key":"B14","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1086\/529147","article-title":"Clinical presentation of Nipah virus infection in Bangladesh","volume":"46","author":"Hossain","year":"2008","journal-title":"Clin Infect Dis"},{"key":"B15","doi-asserted-by":"publisher","first-page":"20142124","DOI":"10.1098\/rspb.2014.2124","article-title":"Ecological dynamics of emerging bat virus spillover","volume":"282","author":"Plowright","year":"2015","journal-title":"Proc Biol Sci"},{"key":"B16","doi-asserted-by":"publisher","first-page":"2577","DOI":"10.1038\/s41467-024-46151-9","article-title":"Ecological countermeasures to prevent pathogen spillover and subsequent pandemics","volume":"15","author":"Plowright","year":"2024","journal-title":"Nat Commun"},{"key":"B17","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1111\/1365-2656.70213","article-title":"Cohorts of immature Pteropus bats show interannual variation in Hendra virus serology","volume":"95","author":"Crowley","year":"2026","journal-title":"J Anim Ecol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"14","DOI":"10.3389\/fvets.2018.00014","article-title":"The One Health concept: 10 years old and a long road ahead","volume":"5","author":"Destoumieux-Garz\u00f3n","year":"2018","journal-title":"Front Vet Sci"},{"key":"B19","doi-asserted-by":"publisher","first-page":"7143","DOI":"10.1038\/nrmicro.2017.45","article-title":"Pathways to zoonotic spillover","volume":"117","author":"Plowright","year":"2020","journal-title":"Proc Natl Acad Sci USA"},{"key":"B20","doi-asserted-by":"publisher","first-page":"123","DOI":"10.3201\/eid1408.071492","article-title":"Henipavirus infection in fruit bats: viral shedding dynamics","volume":"19","author":"Epstein","year":"2013","journal-title":"Emerg Infect Dis"},{"key":"B21","doi-asserted-by":"publisher","first-page":"210","DOI":"10.3201\/eid1902.120971","article-title":"Nipah virus infection outbreak with nosocomial and corpse-to-human transmission, Bangladesh","volume":"19","author":"Sazzad","year":"2013","journal-title":"Emerg Infect Dis"}],"container-title":["Frontiers in Health Services"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frhs.2026.1825624\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T13:41:56Z","timestamp":1783086116000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frhs.2026.1825624\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,1]]},"references-count":21,"alternative-id":["10.3389\/frhs.2026.1825624"],"URL":"https:\/\/doi.org\/10.3389\/frhs.2026.1825624","relation":{},"ISSN":["2813-0146"],"issn-type":[{"value":"2813-0146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,1]]},"article-number":"1825624"}}