Nipah virus (NiV) is a highly lethal zoonotic paramyxovirus that emerged in Malaysia in 1998. It is a human pathogen capable of causing severe respiratory infection and encephalitis. The natural reservoir of NiV, Pteropus fruit bats, remains a continuous virus source for future outbreaks, although infection in the bats is largely asymptomatic. NiV provokes serious disease in various mammalian species. In the recent human NiV outbreaks in Bangladesh and India, both bats-to-human and human-to-human transmissions have been observed. NiV has been demonstrated to interfere with the innate immune response via interferon type I signaling, promoting viral dissemination and preventing antiviral response. Studies of humoral immunity in infected NiV patients and animal models have shown that NiV-specific antibodies were produced upon infection and were protective. Studies on cellular immunity response to NiV infection in human and animal models also found that the adaptive immune response, specifically CD4+ and CD8+ T cells, was stimulated upon NiV infection. The experimental vaccines and therapeutic strategies developed have provided insights into the immunological requirements for the development of successful medical countermeasures against NiV. This review summarizes the current understanding of NiV pathogenesis and innate and adaptive immune responses induced upon infection.

Chikungunya is an arboviral disease caused by the chikungunya virus (CHIKV) afflicting tropical and sub-tropical countries worldwide. It has been identified as a priority pathogen by the Coalition for Epidemics Preparedness Innovations (CEPI) and as an emerging infectious disease (EID) necessitating further action as soon as possible by the World Health Organization (WHO). Recent studies suggest that disability-adjusted life years (DALYs) due to CHIKV infection are as high as 106,089 DALYs lost globally. Significant progress has been made in the development of several vaccines, aimed at preventing CHIKV infections. This perspective article summarizes CEPI’s efforts and strategic considerations for developing a CHIKV vaccine and ensuring equitable access for CHIKV endemic countries.

To evaluate the long-term humoral immune response to Nipah virus (NiV) in a cohort of 25 survivors after 25 years of post-infection. A total of 25 survivors of NiV infection from the 1998 outbreak were recruited for sample collection. The serum IgG antibody response to NiV antigens, specifically nucleocapsid (N), fusion glycoprotein (F) and attachment glycoprotein (G) was evaluated using ELISA. Additionally, the samples were tested for neutralizing antibodies and memory B cell responses. Detection rates of anti-NiV-F and anti-NiV-G were 56% and 60%, respectively, among the survivors at a 1:100 dilution, whereas only 20% were specifically reactive to rNiV-N. Notably, all samples that tested positive for NiV-F and NiV-G at this dilution also exhibited neutralizing antibodies, highlighting the specificity of these assays. Live virus neutralization assay showed that 72% of survivors had detectable neutralizing antibodies, with varying titers, indicating long-lasting immune memory. Furthermore, memory B cell responses specific to NiV-F and NiV-G were observed in six randomly selected survivors, suggesting the presence of enduring immunological memory. These findings highlight the potential of NiV-F and NiV-G as reliable markers for NiV exposure and underscore the need for continuous surveillance and research. Such efforts are crucial for advancing vaccine development and improving preparedness for future NiV outbreaks.

Since 2001, Bangladesh has experienced recurrent outbreaks of Nipah virus (NiV) infection. While acute-phase manifestations are well documented, long-term clinical and functional sequelae poorly characterized. We conducted a cross-sectional assessment of 52 adult NiV survivors in Bangladesh between November 2021 and February 2022 to document the persistence, severity, and functional impact of post infection symptoms. Symptom history, clinical evaluation, and functional status were assessed using structured questionnaires and the Washington Group Extended Set on Functioning (WG-ES). All the survivors reported fever during acute illness, with frequent symptoms including headache (71%), severe weakness (67%), and altered mental status (44%). Following recovery, survivors reported a wide range of symptoms including sleep disturbance (58%), gait disturbance (54%), chronic fatigue (52%), memory and concentration difficulties (54%) and myoclonus (48%). Neurological, musculoskeletal, and respiratory symptoms persisted with varying severity and chronicity. Functional assessments revealed notable disability in several domains, particularly anxiety (48%), mobility (31%), and cognition (25%). Although post-infection symptoms were common, 65% of survivors met criteria for disability in at least one functional domain, and 48% had disabilities across multiple domains. These findings highlight the substantial and enduring burden experienced by NiV survivors in Bangladesh. The range and persistence of sequelae in this cohort appear broader than previously documented in Malaysia–Singapore survivor studies; however, methodological differences limit formal comparison. As the largest clinical and functional assessment of NiV survivors to date, this study provides essential evidence to inform long-term care strategies and underscores the need for survivor-focused rehabilitation and monitoring in outbreak-prone settings. This study was supported by the 10.13039/100016302 Coalition for Epidemic Preparedness Innovations (CEPI) (Grant No: GR-02160). The funding body had no role in the study design; data collection, management, analysis, or interpretation; writing of the manuscript; or the decision to submit the manuscript for publication. The views and conclusions expressed in this manuscript are those of the authors and should not be construed as representing the official viewpoints of CEPI or the U.S. Centers for Disease Control and Prevention.

Artificial intelligence (AI) provides paradigm-shifting opportunities to accelerate epidemic preparedness and response and ensure health security. Such benefits may be particularly applicable to countries in Africa, which have to date struggled to meet compliance obligations under international health security frameworks. Here, we build on discussions that took place at the March 2024 Health Security Partnership for Africa workshop in Addis Ababa, Ethiopia, to describe potential applications of AI-enabled approaches to accelerate activities throughout the preparedness ecosystem, with a particular focus on the rapid development and deployment of novel vaccines in support of the 100 Days Mission, focusing on Africa. We also consider the risks and barriers that may challenge successful deployment of AI for health security in African settings, and opportunities to elevate African leadership on governance and implementation.