尼帕病毒演化特征及防控技术研究进展

doi:10.3969/j.issn.1674-8115.2026.06.002

摘要/Abstract

摘要：

尼帕病毒（Nipah virus，NiV）是一种高致死性单股负链RNA病毒，被世界卫生组织列为防范大流行的优先关注病原体。NiV以果蝠为自然宿主，可通过直接接触、食用被污染食物及人际传播等多种途径感染人类，引发急性脑炎和呼吸窘迫综合征等重症疾病，病死率达40%~75%。基于全基因组序列同源性和地理分布特征，NiV分化为两大主要基因谱系：马来西亚型（NiV-Malaysia）和孟加拉型（NiV-Bangladesh）。马来西亚型主要通过中间宿主（猪、马）传播，可采用扑杀中间宿主实现疫情控制；孟加拉型能直接从果蝠溢出感染人类，具有更强的人际传播能力，呈现地方性流行特征。当前NiV防控面临病毒基因组持续演化、现有检测方法无法进行谱系区分、缺乏获批的人用疫苗等挑战。该文系统阐述了NiV的演化特征、跨种传播模式、疫苗与药物的研究进展，分析了病毒演化对监测策略的影响，从大流行防范角度为优化防控策略提供建议。

关键词: 尼帕病毒, 基因组演化, 跨种传播, 监测

Abstract:

Nipah virus (NiV) is a highly lethal single-stranded negative-sense RNA virus designated by the World Health Organization (WHO) as a priority pathogen for pandemic preparedness. NiV has fruit bats as its natural reservoir and can infect humans through direct contact, consumption of contaminated food, and person-to-person transmission, causing severe diseases such as acute encephalitis and acute respiratory distress syndrome, with case fatality rates ranging from 40% to 75%. Based on whole-genome sequence homology and geographical distribution patterns, NiV has differentiated into two major genetic lineages, NiV-Malaysia (NiV-M) and NiV-Bangladesh (NiV-B). NiV-M is primarily transmitted via intermediate hosts (pigs and horses) and outbreaks can be controlled through culling of infected intermediate hosts, whereas NiV-B can directly spill over from fruit bat reservoirs to humans, exhibits greater person-to-person transmissibility, and shows endemic transmission characteristics. Current NiV outbreak prevention and control efforts face multiple challenges, including persistent viral genome evolution, lack of lineage-discriminating capability of diagnostic assays, and the absence of licensed human vaccines. This review systematically summarizes the evolutionary characteristics of NiV, its cross-species transmission patterns, recent advances in vaccine and antiviral drug development, analyzes the impact of viral evolution on surveillance strategies, and provides recommendations for optimizing prevention and control strategies from a pandemic preparedness perspective.

Key words: Nipah virus (NiV), genomic evolution, cross-species transmission, surveillance

中图分类号:

R183

靳大卫, 张欣欣, 万紫琳, 郭锦政, 任丽丽. 尼帕病毒演化特征及防控技术研究进展[J]. 上海交通大学学报（医学版）, 2026, 46(6): 705-712.

Jin Dawei, Zhang Xinxin, Wan Zilin, Guo Jinzheng, Ren Lili. Research progress in the evolutionary characteristics and prevention and control of Nipah virus[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2026, 46(6): 705-712.

图/表 5

参考文献 57

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Country	Year	Case/n	Case fatality rate/%	Lineage	Primary transmission route	Main clinical feature
Malaysia	1998—1999	283	40	NiV-M	Pig→Human	Fever, acute encephalitis, impaired consciousness
Singapore	1999	11	9	NiV-M	Pig→Human	Acute encephalitis, mild respiratory involvement
Bangladesh	2001—present	≥348	77 (adjusted)	NiV-B (BD1/BD2)^[8,13]	Consumption of raw date palm sap, person-to-person transmission, nosocomial transmission	ARDS-predominant disease
India	2001—present	≈140	78 (adjusted)	NiV-B	Consumption of raw date palm sap, person-to-person transmission, nosocomial transmission	ARDS combined with encephalitis
Philippines	2014	17	53	NiV-M	Horse→Human	Encephalitis with respiratory symptoms

Country	Year	Case/n	Case fatality rate/%	Lineage	Primary transmission route	Main clinical feature
Malaysia	1998—1999	283	40	NiV-M	Pig→Human	Fever, acute encephalitis, impaired consciousness
Singapore	1999	11	9	NiV-M	Pig→Human	Acute encephalitis, mild respiratory involvement
Bangladesh	2001—present	≥348	77 (adjusted)	NiV-B (BD1/BD2)^[8,13]	Consumption of raw date palm sap, person-to-person transmission, nosocomial transmission	ARDS-predominant disease
India	2001—present	≈140	78 (adjusted)	NiV-B	Consumption of raw date palm sap, person-to-person transmission, nosocomial transmission	ARDS combined with encephalitis
Philippines	2014	17	53	NiV-M	Horse→Human	Encephalitis with respiratory symptoms

Vaccine vector	Candidate vaccine	Target antigen	Animal model	Immunization schedule (dose, route, frequency)	Clinical trial stage	Reference
rVSV viral vector	rVSV-∆G-EBOV GP/NiV G	NiV G	African green monkey	10⁷PFU, IM, single dose	Phase Ⅰ completed	[38]
	rVSV expressing NiV G	NiV G	Hamster	10⁵PFU, IM, single dose	Not yet initiated	[39]
	rVSV-ΔG-NiVB/G	NiV G, F	Ferret	10⁷PFU, IM, single dose	Not yet initiated	[40]
	Replication-deficient VSV	NiV G	Syrian golden hamster	10⁶PFU, IM, single dose	Not yet initiated	[41]
Adenoviral vector	ChAdOx1 Nipah B	NiV G	Syrian golden hamster	10⁸PFU, IM, single dose	Phase Ⅱ ongoing	[42]
Nucleic acid vaccine	mRNA-1215	NiV M, F, G	Mouse	IM, two doses	Phase Ⅰ completed	[43]
Subunit vaccine	HeV-sG-V	HeV sG	African green monkey	50‒100 μg, IM, two doses	Phase Ⅰ ongoing	[44]
Other	NiV-VLPs	NiV M, F, G	Syrian golden hamster	20 μg, IM, three doses	Not yet initiated	[45]
	Canarypox virus vector	NiV G, F	Pig	10⁸PFU, IM, two doses	Not yet initiated	[46]
	Measles virus vector	NiV G	African green monkey/Hamster	10⁵TCID₅₀, SC/IP, two doses	Not yet initiated	[47]
	Newcastle disease virus vector	NiV G, F	Mouse/Pig	10⁸‒10⁹EID₅₀, IM, single dose	Not yet initiated	[48]

Vaccine vector	Candidate vaccine	Target antigen	Animal model	Immunization schedule (dose, route, frequency)	Clinical trial stage	Reference
rVSV viral vector	rVSV-∆G-EBOV GP/NiV G	NiV G	African green monkey	10⁷PFU, IM, single dose	Phase Ⅰ completed	[38]
	rVSV expressing NiV G	NiV G	Hamster	10⁵PFU, IM, single dose	Not yet initiated	[39]
	rVSV-ΔG-NiVB/G	NiV G, F	Ferret	10⁷PFU, IM, single dose	Not yet initiated	[40]
	Replication-deficient VSV	NiV G	Syrian golden hamster	10⁶PFU, IM, single dose	Not yet initiated	[41]
Adenoviral vector	ChAdOx1 Nipah B	NiV G	Syrian golden hamster	10⁸PFU, IM, single dose	Phase Ⅱ ongoing	[42]
Nucleic acid vaccine	mRNA-1215	NiV M, F, G	Mouse	IM, two doses	Phase Ⅰ completed	[43]
Subunit vaccine	HeV-sG-V	HeV sG	African green monkey	50‒100 μg, IM, two doses	Phase Ⅰ ongoing	[44]
Other	NiV-VLPs	NiV M, F, G	Syrian golden hamster	20 μg, IM, three doses	Not yet initiated	[45]
	Canarypox virus vector	NiV G, F	Pig	10⁸PFU, IM, two doses	Not yet initiated	[46]
	Measles virus vector	NiV G	African green monkey/Hamster	10⁵TCID₅₀, SC/IP, two doses	Not yet initiated	[47]
	Newcastle disease virus vector	NiV G, F	Mouse/Pig	10⁸‒10⁹EID₅₀, IM, single dose	Not yet initiated	[48]

Category	Drug	Mechanism of action	Animal model	Clinical trial stage	Reference
Monoclonal antibodies	m102.4	Targets the binding site of viral G glycoprotein with Ephrin B2/B3 receptor on host epithelial cells	Non-human primates	Phase Ⅰ completed	[50]
Monoclonal antibodies	h5B3.1	Inhibits conformational change of NiV-F	Ferret	Not yet initiated	[51]
Nucleotides and nucleoside analogues	Remdesivir	Competitively binds viral RNA-dependent RNA polymerase (RdRp), inhibits RdRp activity	African green monkey	Not yet initiated	[52]
	Favipiravir	Competitively binds RdRp site, blocks viral genome replication	Hamster	Not yet initiated	[53]
	Ribavirin	Broad-spectrum inhibitior of viral RNA synthesis	African green monkey	Not yet initiated	[54]
	VV116	Targets RdRp	Syrian golden hamster	Not yet initiated	[55]
	4'-fluorouridine	Broad-spectrum anti-RNA virus, inhibits RdRp and terminates viral RNA chain synthesis	Syrian golden hamster	Not yet initiated	[56]
Fusion inhibitory peptides	Cholesterol-tagged fusion inhibitory peptide	Alters F protein conformation, inhibits viral entry into host cells	African green monkey/hamster	Not yet initiated	[57]