Complications

Complication
Timeframe
Likelihood
long term
medium

Up to 31% of survivors of Nipah virus (NiV) infection had persistent fatigue at 10-year follow-up in the Malaysian outbreak.[43] Even higher rates of persistent fatigue appear to have been seen in patients in Bangladesh.[54]

long term
medium

As many as 26% of survivors of NiV infection reported persistent day-time somnolence at 10-year follow-up.[43]

long term
medium

In one study, 21% of survivors of NiV infection were found to have persistent neurological deficits, with a range of severity seen.[43] The risk of residual neurological deficits is much higher if the initial presentation was encephalitis, and worse still after relapsed encephalitis.[43][36][55]

variable
low

Nipah encephalitis may present for the first time many months after an initial non-neurological presentation, termed ‘late-onset’ encephalitis.[36] This occurred with a frequency of 3.4% in the Malaysian outbreak.[55] Late-onset encephalitis can occur years after the initial infection, the longest interval being 11 years after an asymptomatic infection.[56]

Encephalitis

variable
low

Henipavirus infections can cause a relapse of encephalitis some time after recovery from an initial encephalitis presentation. This was found to occur in approximately 7.5% of NiV cases in the Malaysian outbreak, and 1 out of 7 cases of Hendra virus had relapsed encephalitis.[55][48] The prominent clinical presentation is with seizures and focal neurological deficits.[36]

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