Bats identified as origin of unexplained acute respiratory illness and encephalitis in Bangladesh
Infectious disease researchers have identified Pteropine orthoreovirus (PRV), an emerging bat-borne orthoreovirus, in archived throat swab samples and virus cultures from five patients in Bangladesh who were initially suspected to have Nipah virus infection but tested negative. This adds PRV to the list of zoonotic viruses detected in humans in Bangladesh and suggests that it should be considered in the differential diagnosis of Nipah-like illnesses. The study appears in the journal Emerging Infectious Diseases.
All five patients had recently consumed raw date-palm sap—a sweet liquid also enjoyed by bats, especially during winter months—and a known vector for Nipah infections in Bangladesh. Bats are the natural reservoir of numerous known and novel zoonotic viruses, including rabies, Nipah, Hendra, Marburg, and SARS-CoV-1.
“Our findings show that the risk of disease associated with raw date palm sap consumption extends beyond Nipah virus,” said Nischay Mishra, PhD, associate professor of epidemiology at the Center for Infection and Immunity (CII), Columbia University Mailman School of Public Health, and senior author of the study. “It also underscores the importance of broad-spectrum surveillance programs to identify and mitigate public health risks from emerging bat-borne viruses.”
Between December 2022 and March 2023, five patients were admitted with symptoms consistent with Nipah virus infection (including fever, vomiting, headache, fatigue, increased salivation, and neurological), but tested negative for Nipah virus by PCR and serology. Researchers used high-throughput, agnostic viral capture sequencing (VCS) to analyze biological samples from the five patients and detected PRV sequences in archived throat swab specimens. PRV was also cultured from three of these samples, providing evidence of infectious virus.
Patients were enrolled under a Nipah virus surveillance program established by the Institute of Epidemiology, Disease Control and Research (IEDCR), Bangladesh; International Centre for Diarrheal Disease Research, Bangladesh (icddr,b); and U.S. Centers for Disease Control and Prevention (CDC).
Viral Capture Sequencing (VCS) is a patented technology developed in the CII at Columbia University to rapidly screen for all viral infections of vertebrates, including infections of bats. It is as sensitive as the gold-standard polymerase chain reaction (PCR) assays while enabling simultaneous testing for thousands of viruses and providing near-complete genome sequences. A correlate method, Bacterial Capture Sequencing (BCS), allows detection of pathogenic bacteria and genes for antimicrobial resistance. Both VCS and BCS are approved for clinical and research use.
All five patients experienced severe disease, although PRV infections reported elsewhere in neighboring countries have often been milder, suggesting that less severe cases in Bangladesh may be undetected.
“A new addition of zoonotic spillover causes respiratory and neurological complications following consumption of raw date palm sap next to Nipah virus infection,” says Tahmina Shirin, PhD, Director, Institute of Epidemiology, Disease Control, and Research (IEDCR), as well as the National Influenza Centre (NIC) in Bangladesh.
In a study conducted more recently that was supported by the U.S. Department of Agriculture, Mishra and colleagues identified the source of infections by identifying genetically similar Pteropine orthoreoviruses in bats captured in proximity to the five human cases near the Padma River Basin (unpublished data).
“This [research] provides critical evidence linking bat reservoirs to human infection. We are now working to understand the spillover mechanisms from bats to humans and domestic animals, as well as the broader ecology of emerging bat-borne viruses in communities along the Padma River Basin,” says Ariful Islam, bat-borne disease ecologist and epidemiologist at Charles Sturt University, Australia, and co-first author of the study.
The study’s co-first author is Sharmin Sultana, assistant professor of Virology and Senior Scientific Officer at the Institute of Epidemiology, Disease Control and Research (IEDCR) in Bangladesh. Additional authors include James Ng, Sunil Kumar Dubey, Cheng Guo, and W. Ian Lipkin of the CII; Manjur Hossain Khan at IEDCR in Bangladesh; Mohammed Ziaur Rahman and Moinuddin Satter at icddr,b in Bangladesh; Joel M. Montgomery at the CDC’s National Center for Emerging and Zoonotic Infectious Diseases; and Lisa Hensley at the Zoonotic and Emerging Disease Research Unit, in the United States Department of Agriculture.
The research was supported with funds provided by United States Department of Agriculture agreements with Columbia University (NACA-58-3022-2-021, NACA- 58-3022-4-053).
The authors declare no conflicts
Journal
Emerging Infectious Diseases
Method of Research
Observational study
Subject of Research
People
Article Title
Bat Reovirus as Cause of Acute Respiratory Disease and Encephalitis in Humans, Bangladesh, 2022–2023
Article Publication Date
5-Jan-2026
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