Emerging bat virus found in stored throat swabs from 5 patients with suspected Nipah virus infection

All five patients, who didn’t live near each other and had no contact, had clinical signs and symptoms that included fever, disorientation, altered mental status, abnormal gait, and difficulty breathing. A pediatric patient had fever-related convulsions. 

After release from the hospital two or three weeks after admission, two patients fully recovered, but two reported lingering fatigue, disorientation, and difficulties with breathing and walking, and one patient died in August 2024 after experiencing declining health and unexplained neurologic problems.

“Our findings show that the risk of disease associated with raw date palm sap consumption extends beyond NiV,” senior author Nischay Mishra, PhD, of the Center for Infection and Immunity at Columbia University Mailman School of Public Health, said in a press release.

Indications of virus reassortment

Complete coding sequences of all 10 Bangladesh PRV segments showed 91.1% to 100% genetic similarity. Certain segments of the virus’s double-stranded RNA genomes clustered with different PRVs isolated from fruit bats and, less often, from humans in Indonesia and Malaysia.

The potential for reassortment in segmented viruses like PRV can result in changes in transmissibility and virulence.

“That finding suggests unique evolution of each segment from reassortment events among strains circulating in Southeast Asia and long flight ranges of fruit bats,” the authors wrote. “Reassortment is common for segmented RNA virus evolution and enhances risk for zoonotic potential.” 

Because PRV and NiV can have similar signs and symptoms and be linked to consumption of raw date palm sap contaminated with bat droppings, the researchers recommended that health care providers include PRV in their differential diagnosis.

“The potential for reassortment in segmented viruses like PRV can result in changes in transmissibility and virulence,” they concluded. “Thus, in areas where raw date palm sap is consumed, molecular and serologic surveillance and differential diagnoses of respiratory illnesses with encephalitis and other unexplained febrile illnesses should include PRV, NiV, and other batborne viruses.”