Community engagement strategies for preventing recurrent Nipah virus outbreaks in Bangladesh and India: adapting a framework for outbreak preparedness and response.

The Nipah virus (NiV) infection is a highly fatal zoonotic disease with pandemic potential which has led to recurrent outbreaks in Bangladesh and India. While transmission pathways, including contaminated date palm sap and human-to-human spread, are increasingly identified, significant uncertainties remain. With no approved therapeutics or vaccines, prevention depends on addressing ecological and behavioural drivers of transmission. This viewpoint draws on selected evidence from NiV outbreaks and response to other zoonotic disease epidemics, such as Ebola, rabies, and the Marburg virus disease, we seek to foster discussion on why community engagement could be central to NiV prevention and preparedness. We highlight the relevance of community engagement through a spectrum of its intensity, which distinguishes between community-oriented, community-based, community-managed, and community-owned approaches. Adapting an existing model, we discuss how community engagement principles can be applied to tackle recurring NiV outbreaks in Bangladesh and India. By aligning interventions with sociocultural realities, community engagement can improve acceptability, enhance early detection, strengthen outbreak response, and support preparedness for future vaccine and therapeutic research. However, evidence specific to NiV remains limited and lessons from other diseases should be applied judiciously. In the absence of medical countermeasures, participatory, locally grounded approaches offer a sustainable pathway to reduce recurrent outbreaks and prevent future spillover events.