Risk of Nipah Virus Seroprevalence in Healthcare Workers: A Systematic Review with Meta-Analysis.

Nipah virus (NiV) is a zoonotic pathogen with the potential to cause human outbreaks with a high case fatality ratio. In this systematic review and meta-analysis, available evidence on NiV infections occurring in healthcare workers (HCWs) was collected and critically appraised. According to the PRISMA statement, four medical databases (PubMed, CINAHL, EMBASE, and Scopus) and the preprint repository medRixv were inquired through a specifically designed searching strategy. A total of 2593 entries were identified; of them, 16 studies were included in qualitative and quantitative analysis detailing the outcome of NiV infection on HCWs and estimates of seroprevalence among healthcare professions. All studies reported data from Asian countries: Malaysia, Singapore, Bangladesh, India (States of Kerala and Bengal), and Philippines. Seroprevalence was estimated from seven studies in 0.00% (95%CI 0.00 to 0.10) for IgM-class antibodies and 0.08% (95%CI 0.00 to 0.72) for IgG class-antibodies, but four of the sampled studies did not report any seropositive cases. A case fatality ratio of 73.52% (95%CI 34.01 to 99.74) was calculated from 10 studies. In conclusion, the present study shows that NiV may result in a possible occupational infection among HCWs involved in managing incident cases. As most NiV outbreaks occur in limited resources settings, it is reasonable that even basic preventive measures (i.e., mandatory use of PPE and appropriate isolation of incident cases with physical distancing) may be quite effective in avoiding the occurrence of new infections among HCWs.