Why Aren't We Talking About A Virus With Up To 90% Fatality Rate? Inside The Nipah Outbreak Asia Missed

A killer is spreading across Asia, and nobody's screaming about it. The Nipah virus, which claims the lives of roughly nine in every ten people it infects, has just triggered a fresh outbreak in India. Yet whilst news cycles obsess over variants with single-digit fatality rates, this biological catastrophe barely registers a mention.

Taiwan has just moved to classify it as a Category 5 notifiable disease. The question haunting public health officials isn't whether we should be concerned—it's why we aren't alarmed already.

On January 19th, Indian health authorities confirmed five cases of Nipah virus infection in West Bengal's eastern regions. For context, that's five people in a country of 1.4 billion. But the numbers don't reflect the true threat.

With a mortality rate hovering between 80 and 91 per cent, depending on the outbreak variant, Nipah dwarfs COVID-19's lethality by orders of magnitude. Yet the media silence is deafening.

Taiwan's health authorities have recognised the urgency. The island's Centers for Disease Control announced on January 16th that it intends to reclassify Nipah virus as a Category 5 notifiable disease—a designation reserved for emerging or rare infections posing major public health risks. The classification requires immediate reporting and special control measures. The proposal now enters a 60-day public consultation period before formal implementation.

'The Nipah virus has only been under priority surveillance in Taiwan since 2018,' CDC officials told the Central News Agency. 'Globally, more than 750 cases have been reported since the virus was first identified in 1998, with a fatality rate of about 58 percent.'

That figure masks a grimmer reality: the fatality rate varies sharply depending on strain and transmission route, with some variants reaching 91 per cent.

The Nipah Virus Outbreak: Why This Time Feels Different

West Bengal's emergence as a new hotspot raises alarms within the epidemiological community. Historically, Nipah has been confined to Kerala, the southwestern coastal state where fruit bats—the virus's natural reservoir—are endemic. The westward spread into densely populated eastern regions signals potential for wider dissemination.

CDC Deputy Director-General Lin Ming-cheng explained the current situation to CNA: 'India is taking action to contain its Nipah virus outbreak in the eastern state of West Bengal after five infections were confirmed there as of Jan. 19.'

Yet Taiwan is maintaining only a Level 2 'yellow' travel alert for Kerala, with no warning for West Bengal or other affected regions. Under Taiwan's four-tier advisory system, a Level 2 alert advises heightened caution but permits travel. The distinction matters: it suggests authorities believe the situation remains contained within healthcare settings rather than spreading through communities.

'If community transmission occurs, alerts may be raised; if infections remain confined to hospitals, travellers would simply be advised to avoid medical facilities in affected areas,' Lin said.

The virus spreads through multiple pathways. Humans can contract Nipah via direct contact with infected bats or intermediate animals such as pigs, through respiratory droplets, or via contact with bodily fluids. Limited human-to-human transmission has also been documented—a feature that keeps epidemiologists awake at night.

Lin issued a stark warning for anyone travelling to India: fruit bats are the natural source, and coconuts contaminated by bat saliva or urine pose genuine infection risk. 'Visitors to India should avoid raw or unheated foods and drinks, with raw coconut juice to especially be avoided,' he cautioned.

The Silence Surrounding a 90% Death Rate

Symptoms present across a bewildering spectrum—from asymptomatic infection all the way to acute respiratory illness and fatal encephalitis. That unpredictability compounds the danger. Someone could carry the virus for days without knowing, potentially spreading it through respiratory droplets before symptoms emerge.

The media's relative indifference to Nipah's reemergence reflects a troubling pattern in health reporting: we fixate on familiar threats whilst overlooking novel ones with vastly higher lethality. When COVID-19 variants with 1 per cent mortality rates dominate headlines, why does a pathogen with 80–91 per cent fatality get relegated to backpage health announcements?

The answer may lie in familiarity bias and scale. Nipah's limited caseload—750 globally across nearly three decades—feels manageable. Yet that benign statistic disguises a profound danger: if transmission patterns shift, if the virus adapts, if it reaches a major population centre unprepared for containment, the mathematics become catastrophic.

Taiwan's proactive reclassification suggests some governments understand the stakes. Whether others will follow remains an open question.