A systematic review of Nipah virus disease epidemiological parameters, outbreaks and mathematical models

Abstract We conducted a systematic review (PROSPERO CRD42023393345) characterising the epidemiology, outbreaks and mathematical models of Nipah virus (NiV), an important public health threat in South and Southeast Asia. We extracted 243 parameters, 89 risk factors, 39 models and 23 distinct outbreaks from 119 papers. IgG seroprevalence estimates ranged from 0% to 12.5%. NiV causes severe disease, with pooled case-fatality ratio estimates ranging widely from 9.1% (95%CI: 0.2%-41.3%) in Singapore to 81.9% (95%CI: 71.9%-88.9%) in Bangladesh. NiV’s natural history is poorly characterised; we estimated a median incubation period of 8.77 days (95%CI: 7.53-10.02) based on 8 studies. Transmission parameter estimates were scarce, and all but one central estimate of the basic reproduction number were below 1. NiV mathematical models (n=39) were rarely fitted to data (n=8). All extracted information is accessible via our R package, epireview , a dynamic resource for informing responses to future outbreaks of NiV and related pathogens.