Potential for person-to-person transmission of henipaviruses: A systematic review of the literature

Abstract

AbstractNipah virus – Bangladesh (NiVB) is a bat-borne zoonosis transmitted between people through the respiratory route, posing a pandemic risk. The risk posed by related henipaviruses, including Hendra virus (HeV) and Nipah virus – Malaysia (NiVM) is less clear. We conducted a broad search of the literature encompassing both human infections and animal models to synthesize evidence about potential for person-to-person spread of these henipaviruses. More than 600 human infections have been reported in the literature, but information about biological processes related to transmission is limited; information on viral shedding was only available for 40 case-patients. There is substantial evidence demonstrating person-to-person transmission of NiVB, though there is also evidence that NiVMhas been transmitted from person to person. Less direct evidence is available about the risk for person-to-person transmission of HeV, but animals infected with HeV shed more virus in the respiratory tract than those infected with NiVMsuggesting potential for transmission. As the family of known henipaviruses continues to grow, shared protocols for conducting and reporting from human investigations and animal experiments are urgently needed to advance our understanding of transmission risk.