Your Nipah Virus Questions Answered: What Murphy Families Are Asking Dr. Zaman

Since my article on Nipah virus was published, my inbox has been flooded with questions. Thoughtful questions. Specific questions. Sometimes worried questions from families right here in Murphy, Plano, and Wylie. Many of you have relatives in India, travel plans coming up, or just want to understand this virus better to make informed decisions for your families.

I’m not surprised by the level of concern, especially given the recent outbreaks in West Bengal in January 2026 and the ongoing situation in Kerala throughout 2025. When you’re watching news from home and have family members you care about half a world away, these aren’t academic questions. They’re personal.

So I’ve compiled the most common and important questions I’ve been hearing, organized them by topic, and provided clear, science-based answers. This is what you’ve been asking me during office visits, in emails, and even in the grocery store. Let’s tackle them one by one.

Travel and Family Concerns

These are easily the most common questions I’m getting from our South Asian American families.

I’m planning to visit family in Kerala or West Bengal this spring. Should I cancel my trip?

The short answer: probably not, but you need to stay informed and take precautions. Kerala and West Bengal have had outbreaks, but these are typically contained to specific districts. Not entire states. The risk for tourists and visitors following basic precautions is considered very low by both the WHO and CDC.

Here’s what I recommend: Check the current status before you go. If there’s an active outbreak in the exact district where you’ll be staying, consider postponing or changing your destination within India. If the outbreak was contained weeks or months ago, proceed with your trip but follow all the prevention measures I’ll outline. Most importantly, register with the U.S. Embassy when you arrive and keep in touch with local health advisories.

My elderly parents live in Malappuram/Kozhikode/Palakkad. What should I tell them to do?

Your parents are in a higher-risk area since these Kerala districts have had recurring outbreaks since 2018. However, Kerala has one of the best healthcare systems in India and has developed robust surveillance and response protocols.

Advise them to:

The good news? Kerala residents are now much more aware of Nipah. Healthcare workers are trained to recognize it quickly. And the state has multiple labs that can confirm diagnosis within 24-48 hours.

Is it safe to send my kids to visit grandparents in India during summer vacation?

This depends entirely on where your parents live and the timing. Most of India is not affected by Nipah. If your parents live in major cities like Delhi, Mumbai, Chennai, Bangalore, or Hyderabad, Nipah risk is essentially zero.

If they live in Kerala (particularly the northern districts like Kozhikode, Malappuram, or Palakkad), you need to make a more nuanced decision. Historically, these outbreaks have been sporadic. Not continuous. If there hasn’t been a case in several months and local authorities have given the all-clear, visiting is reasonable with proper precautions.

Consider your children’s ages and health status. Teenagers who can understand and follow hygiene rules are different from toddlers who put everything in their mouths. Kids with underlying health conditions (asthma, immune issues) might warrant extra caution.

What precautions should I take if I must travel to an outbreak area?

How soon after returning from India should I watch for symptoms?

The incubation period for Nipah virus is typically 4-14 days, but can be as long as 45 days in rare cases. I recommend monitoring yourself for at least 21 days after returning from an affected area.

Watch for: fever, severe headache, vomiting, muscle aches, drowsiness, confusion, or respiratory symptoms. If any of these develop, contact me immediately and mention your recent travel. Don’t just show up at an emergency room—call ahead so they can take proper precautions.

During this monitoring period, avoid donating blood, and if you develop any illness, mention your travel history to any healthcare provider you see.

Can I get travel insurance that covers Nipah?

Most comprehensive travel insurance policies will cover medical treatment for infectious diseases contracted while traveling, including Nipah. However, you need to read the fine print. Some policies exclude coverage if you travel to areas under active outbreak advisories.

Look for policies that specifically include medical evacuation coverage—if you became seriously ill with Nipah in India, you might need specialized transport to a facility with advanced intensive care. Call the insurance company directly and ask specific questions about coverage for emerging infectious diseases and pre-existing outbreak zones.

Transmission and Risk

Understanding how Nipah spreads—and doesn’t spread—is crucial for putting your risk in perspective.

Can I get Nipah from packages or mail sent from India?

No. Nipah virus doesn’t survive long outside a host, and it’s not transmitted through objects or packages. The virus requires direct contact with infected bodily fluids or consumption of contaminated food. Mail and packages that have been in transit for days or weeks pose zero risk.

You don’t need to disinfect or quarantine packages from family members in India, even from affected areas. Normal handling is fine.

Is Nipah contagious before symptoms appear?

This is a great question and one that really matters for containment. Based on current evidence, Nipah virus is not believed to be contagious during the incubation period. Before symptoms develop, people appear to be infectious only once they’re showing symptoms (particularly fever and respiratory symptoms).

This is actually good news from a public health standpoint. It means monitoring contacts of confirmed cases (like Kerala does so effectively) can actually prevent spread. You can identify who was exposed, watch them for symptoms, and isolate them if they become sick. Before they spread it to others.

Can pets carry Nipah virus?

Lab studies have shown that cats, dogs, and other domestic animals can be infected with Nipah virus, particularly if they’re exposed to infected bats or contaminated food. In the original Malaysia outbreak, pigs were major transmitters.

However, there’s no evidence that your pet in Texas poses any Nipah risk. The concern is mainly for animals in outbreak areas in Asia. If you’re visiting family in an affected area and they have outdoor cats or dogs that might encounter bats or contaminated fruit, be cautious about close contact with those animals.

How long does Nipah virus survive on surfaces?

Nipah virus is relatively fragile outside the body. In bodily fluids at room temperature, it may survive several hours to a few days. But it’s quickly inactivated by heat, UV light, and standard disinfectants.

This means doorknobs, countertops, and other environmental surfaces aren’t major transmission concerns (especially with basic cleaning). The virus doesn’t persist in the environment the way some other pathogens do. Transmission requires fairly direct contact with fresh infected materials.

Can Nipah spread through air conditioning or ventilation systems?

This is actually a topic of current research. Traditionally, Nipah has been classified as requiring close contact for human-to-human transmission. Through respiratory droplets when someone coughs or sneezes nearby. Or through contact with bodily fluids.

However, some scientists studying the Kerala outbreaks have hypothesized that aerosol transmission (true airborne spread) might occasionally occur. Particularly in the bat-to-human spillover events. This could explain some cases where people had no clear direct contact with bats or contaminated food.

For ventilation systems: there’s no documented case of Nipah spreading through HVAC systems. The concern with air conditioning is more about being in enclosed spaces with someone who’s actively infected and symptomatic. Good ventilation actually helps dilute any respiratory droplets.

Children and Pregnancy

Parents understandably have heightened concerns when it comes to their kids.

Are children more susceptible to Nipah than adults?

There’s no evidence that children are more biologically susceptible to Nipah virus infection than adults. The virus doesn’t discriminate by age—anyone can be infected if exposed.

However, children might be at somewhat higher practical risk in outbreak areas because they may be less likely to follow hygiene precautions consistently, might eat unwashed fruit, and could have more difficulty recognizing and reporting early symptoms.

The good news is that children can also recover if they receive prompt supportive care. Age alone doesn’t determine outcome—it’s more about how quickly treatment starts and the quality of intensive care available.

Is Nipah dangerous during pregnancy?

We don’t have extensive data on Nipah virus specifically in pregnant women. Simply because outbreaks have been small and not systematically studied in this population. However, we can make some educated inferences.

Pregnancy can affect immune function and potentially make severe infections more dangerous. Any serious illness with high fever and multi-organ involvement poses risks during pregnancy. There’s limited information about whether Nipah can be transmitted from mother to fetus. But other encephalitis-causing viruses sometimes can cross the placenta.

My recommendation: if you’re pregnant, this is not the time to visit outbreak-affected areas unless absolutely necessary. If you live in an affected area, follow all prevention measures meticulously and seek immediate medical care for any fever or illness.

Can breastfeeding mothers transmit Nipah to their babies?

Theoretically, yes. If a mother has active Nipah virus infection, the virus could be present in breast milk. And there would also be risk from close contact while nursing. However, a breastfeeding mother with active Nipah would be severely ill and hospitalized. Making nursing impractical anyway.

If a mother was exposed to Nipah but isn’t symptomatic, breastfeeding should be safe to continue while monitoring for symptoms. If symptoms develop, the baby would need to be cared for by someone else and monitored as a close contact.

Should I keep my kids home from school if there’s an outbreak in India?

No. An outbreak in India poses zero risk to children in Texas schools. Nipah doesn’t spread that way. It requires direct contact or proximity to infected individuals or contaminated materials.

The only scenario where school attendance might be a consideration is if your child recently returned from an outbreak area. In that case, monitoring them at home for 14-21 days would be prudent. Not because they’re definitely contagious. But because if they develop symptoms, you want to identify it quickly before potential exposure to others.

Medical Care and Testing

What happens if you actually need medical care for suspected Nipah?

If I develop symptoms after travel to India, where should I go in Texas?

Do NOT go directly to an emergency room or urgent care without calling first. Here’s the right protocol:

Call our office immediately, or if it’s after hours, call the hospital before going. Explain your symptoms and recent travel history. This allows the healthcare facility to prepare appropriate isolation precautions and notify infection control.

In the Dallas-Fort Worth area, hospitals with special pathogen programs and infectious disease specialists would be contacted. You’d be placed in isolation, and samples would be sent to specialized labs—likely to the CDC—for testing.

The Texas Department of State Health Services has protocols for handling suspected cases of high-consequence pathogens like Nipah. They’ll coordinate testing and care.

Does my insurance cover Nipah testing and treatment?

Testing for Nipah virus would be coordinated through public health authorities (CDC and state health department). It wouldn’t typically be billed to you. It’s considered a public health investigation, not standard clinical testing.

Treatment costs (hospitalization, intensive care, supportive care) would be covered by your health insurance under normal provisions for illness treatment. However, policies vary. Some might have limits on coverage for illnesses contracted outside the U.S. Check your specific policy.

If you’re traveling and become ill abroad, international medical evacuation insurance becomes crucial. Treatment for Nipah in India would require intensive care (potentially for weeks), which can be extremely expensive even in Indian hospitals.

How quickly can Nipah be diagnosed?

With modern RT-PCR testing, Nipah virus can be detected in blood, throat swabs, or cerebrospinal fluid within 24-48 hours if samples are sent to a capable laboratory. Kerala now has four labs that can do this testing rapidly.

In the U.S., samples would need to go to the CDC. That could take 24-72 hours depending on transport logistics. The testing itself is fast. It’s the logistics of getting samples to specialized labs safely that takes time.

Early in illness (first 3-5 days), RT-PCR on blood and throat swabs is most reliable. Later in illness or during recovery, antibody testing can confirm infection.

What’s the actual survival rate with good medical care?

This is where I can offer some cautious optimism. The overall case fatality rate for Nipah has ranged from 40-75% in various outbreaks. However (and this is important), those numbers include cases from the late 1990s and early 2000s when the virus was newly recognized and treatment wasn’t optimized.

More recent data from Kerala shows improvement. In the 2023 outbreak, the fatality rate was about 33%. Likely due to earlier recognition, immediate isolation, and aggressive supportive care including experimental treatments like Remdesivir.

With modern intensive care (mechanical ventilation, management of brain swelling, nutritional support, treatment of complications), outcomes are better than the historical averages suggest. Survival depends heavily on how quickly treatment starts and the quality of intensive care.

Vaccines and Treatment

Everyone wants to know about prevention and cures.

When will a vaccine be available?

The University of Oxford began Phase 2 human clinical trials of a Nipah vaccine in December 2025 in Bangladesh. This is encouraging progress. But there’s still a long road ahead.

Typical vaccine development takes years. Even with accelerated timelines, we’re probably looking at 2027-2028 at the earliest for a licensed vaccine. That’s assuming the trials show safety and effectiveness. The vaccine might be available first for high-risk populations in outbreak-prone areas before becoming widely available.

Other vaccine candidates are in earlier stages of development as well. The good news is that Nipah is now recognized as a priority pathogen by WHO. Which means funding and research attention have increased significantly.

Are there any experimental treatments available?

Yes. Several treatments have been used experimentally, particularly in the Kerala outbreaks:

It’s important to understand these are experimental. Not proven treatments. They’re used on a compassionate-use basis in outbreak settings. But we don’t have rigorous clinical trial data proving they work.

Can antibiotics help with Nipah?

No. Nipah is caused by a virus, not bacteria, so antibiotics are completely ineffective against the infection itself. However, antibiotics might be used to treat secondary bacterial infections that sometimes develop in critically ill patients—for example, pneumonia that develops in someone on a ventilator.

This is a common misconception about viral illnesses in general. Antibiotics won’t prevent Nipah, won’t treat Nipah, and taking them “just in case” only contributes to antibiotic resistance.

Living in Texas

Let’s address the concerns about potential spread to North America.

Could Nipah ever spread to Texas?

The theoretical risk exists but is extremely low. Here’s why.

The natural reservoir of Nipah (Pteropus fruit bats) doesn’t live in Texas or anywhere in North America. We have different bat species here. Without the natural animal reservoir, Nipah can’t establish itself in our ecosystem.

Could an infected traveler arrive in Texas? Theoretically yes. But it’s unlikely for several reasons: Nipah’s incubation period means most people would become symptomatic before or shortly after a long flight. The illness is severe enough that someone with active infection wouldn’t make it through airports and onto international flights. And there’s active screening at airports during outbreak periods.

If a case did somehow arrive here, our healthcare system is well-equipped to isolate and care for the patient while preventing further spread. We’ve successfully managed imported cases of Ebola and other serious infections without community transmission.

Are fruit bats in Texas dangerous?

Texas has several bat species (including Mexican free-tailed bats and others), but none of them are Pteropus fruit bats (the Nipah reservoir). Our local bats are insect-eaters, not the large fruit bats found in Asia, Australia, and parts of Africa.

That said, bats in Texas can carry other diseases. Most notably rabies. You should never handle bats regardless of species. And if you’re bitten or scratched by any bat, seek medical attention immediately for rabies evaluation.

The fruit bats that carry Nipah are huge. With wingspans up to 5 feet. They look completely different from our small Texas bats. You’d definitely know the difference.

What is Murphy/Plano/Collin County doing to prepare for Nipah?

Local health departments, in coordination with the Texas Department of State Health Services and the CDC, maintain preparedness plans for emerging infectious diseases. This includes:

These systems aren’t specific to Nipah—they’re part of broader preparedness for any emerging infection. The infrastructure we built during COVID-19 has actually strengthened our ability to respond to threats like this.

Additional Important Questions

Do I need to tell my employer if I traveled to an outbreak area?

While there’s no legal requirement, it’s considerate to inform your employer, particularly if you work in healthcare, food service, or childcare. Most employers would want to know if you need to be monitored for symptoms and might want you to work from home during the initial monitoring period.

If you develop any symptoms, you absolutely must tell your employer before returning to work, and you should stay home until cleared by a healthcare provider.

Can Nipah virus mutate to become more contagious?

This is a legitimate concern that scientists monitor carefully. All viruses can mutate. Nipah is no exception. The question is whether mutations could make it spread more easily between humans.

Currently, Nipah doesn’t transmit efficiently from person to person. It requires very close contact (typically in healthcare settings or within households). Most cases are still from direct bat-to-human spillover, not human chains of transmission.

Could it mutate to become more transmissible? Possibly. But there’s no evidence it’s moving in that direction. Researchers sequence the virus from each outbreak and watch for concerning changes. The virus has remained relatively stable over the years.

This is exactly why WHO designates Nipah as a priority pathogen. Not because of current threat. But because of potential future threat if the virus were to evolve.

Should I avoid Indian restaurants in Texas during outbreaks?

Absolutely not. This is unnecessary and (frankly) feeds into harmful stereotypes. Nipah virus doesn’t spread through food shipped from India or through restaurant food. The virus doesn’t survive the transport, storage, and cooking involved in restaurant operations.

The concern with food in outbreak areas is specifically about fresh, raw foods potentially contaminated by bat saliva or urine. Particularly raw date palm sap consumed locally. Cooked food, packaged goods, and anything that’s been through normal food safety handling is not a risk.

Indian restaurants in Texas are as safe as any other restaurant. Please don’t change your dining habits based on outbreaks happening half a world away.

If there’s no cure, why bother getting diagnosed?

This is such an important question because it touches on a common misconception. Yes, there’s no specific antiviral cure for Nipah—but that doesn’t mean diagnosis and treatment don’t matter. Here’s why early diagnosis is crucial:

The difference between survival and death often comes down to how quickly someone gets to an ICU with appropriate support. Diagnosis matters.

Final Thoughts: Informed, Not Fearful

Here’s what I want you to take away from all these questions and answers: Nipah virus is serious. But the risk to most families in Texas (even those with connections to India) remains very low when you take sensible precautions.

The situation in India (particularly Kerala and now West Bengal) requires vigilance. But it doesn’t require panic. These outbreaks are being managed by competent health authorities who have learned from previous experiences and improved their response with each occurrence.

For our families here in Murphy, Plano, and Wylie, the most important things you can do are:

• Stay informed through reliable sources (CDC, WHO, local health departments—not social media rumors)
• If you must travel to affected areas, follow all recommended precautions
• Watch for symptoms after travel and seek care promptly if they develop
• Communicate with your healthcare providers about your travel history
• Support family members in India with good information and encouragement to follow local health guidance

I’m here to answer your questions. That’s what your family doctor is for. If you have concerns specific to your family’s situation (especially if you’re planning international travel or have family in affected areas), schedule a visit so we can talk through your particular circumstances and create a plan that makes sense for you. You don’t have to navigate this alone.

Authoritative Resources for Latest Information

For the most current updates on Nipah virus outbreaks and guidance:

• CDC Nipah Virus Information: https://www.cdc.gov/nipah-virus/about/index.html
  U.S. government resource with current outbreak information and travel recommendations.
• World Health Organization – Nipah Virus: https://www.who.int/news-room/fact-sheets/detail/nipah-virus
  Global perspective and outbreak news from affected regions.
• Texas Department of State Health Services: https://www.dshs.texas.gov/infectious-diseases
  State-level infectious disease information and health alerts for Texas residents.
• Travel Health Pro – Nipah Disease: https://travelhealthpro.org.uk/disease/134/nipah-viral-disease
  Excellent travel-specific guidance and current outbreak updates.
• U.S. Embassy in India: https://in.usembassy.gov/
  Travel alerts and health information for U.S. citizens in India.
• India Ministry of Health – Nipah Updates: https://www.mohfw.gov.in/
  Official updates on outbreaks and containment measures in India.

Stay safe, stay informed, and remember—knowledge is the best defense against unnecessary worry. You’ve got this, and I’m here to help.

Dr. Hina Zaman, MD
Family Care Murphy
Serving Murphy, Plano, Wylie, Sachse, Frisco, Richardson, and surrounding North Texas communities