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Large-particle aerosol exposure to the Bangladesh or Malaysia strain of Nipah virus results in markedly divergent disease presentation in African Green Monkeys
Large-particle aerosol exposure to the Bangladesh or Malaysia strain of Nipah virus results in markedly divergent disease presentation in African Green Monkeys
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Large-particle aerosol exposure to the Bangladesh or Malaysia strain of Nipah virus results in markedly divergent disease presentation in African Green Monkeys
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Large-particle aerosol exposure to the Bangladesh or Malaysia strain of Nipah virus results in markedly divergent disease presentation in African Green Monkeys
Large-particle aerosol exposure to the Bangladesh or Malaysia strain of Nipah virus results in markedly divergent disease presentation in African Green Monkeys

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Large-particle aerosol exposure to the Bangladesh or Malaysia strain of Nipah virus results in markedly divergent disease presentation in African Green Monkeys
Large-particle aerosol exposure to the Bangladesh or Malaysia strain of Nipah virus results in markedly divergent disease presentation in African Green Monkeys
Journal Article

Large-particle aerosol exposure to the Bangladesh or Malaysia strain of Nipah virus results in markedly divergent disease presentation in African Green Monkeys

2025
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Overview
Nipah virus (NiV), a highly pathogenic zoonotic paramyxovirus, causes severe respiratory and neurological disease in humans, with a case-fatality rate around 60%. Descriptions of cases in the clinical setting suggest that the two primary lineages of NiV cause disease with different presentations and outcomes. To define strain-specific differences in disease progression and host responses, African green monkeys were exposed to either the Malaysia (NiV-M) or Bangladesh (NiV-B) strain using a large-particle aerosol exposure. NiV-M infection resulted in a fatality rate of 27%, while NiV-B infection led to a 75% fatality rate characterized by rapid respiratory decline and systemic viral dissemination. Among survivors, NiV-M–infected animals mounted robust immunoglobulin M, immunoglobulin G, and neutralizing antibody responses, whereas NiV-B survivors exhibited weaker and delayed humoral responses. Non-survivors of both strains showed elevated pro-inflammatory cytokines, thrombocytopenia, and multi-organ dysfunction. Imaging showed that NiV-M infection was associated with neuroinflammation and systemic vasculitis, while NiV-B infection caused progressive pulmonary pathology. Histopathological analysis confirmed widespread vasculitis and encephalitis in animals with NiV-M infection and diffuse pulmonary hemorrhage and fibrin thrombi, consistent with vascular injury and coagulopathy, in animals with NiV-B infection. Cytokine profiling and flow cytometry showed a more intense and dysregulated immune response to NiV-B infection. Fatal outcomes in both groups were associated with thrombocytopenia, elevated pro-inflammatory cytokines, and multi-organ dysfunction. This study highlights fundamental differences in virulence, immune evasion, and pathogenesis between NiV strains and underscores the value of the African green monkey aerosol model for evaluating medical countermeasures under conditions that closely mimic natural human exposure.