for the Nipah Encephalitis Outbreak Investigation Team

An outbreak of encephalitis affecting 265 patients (105 fatally) occurred during 1998±1999 in Malaysia and was linked to a new paramyxovirus, Nipah, that infected pigs, humans, dogs, and cats. Most patients were pig farmers. Clinically undetected Nipah infection was noted in 10 (6%) of 166 community-farm controls (persons from farms without reported encephalitis patients) and 20 (11%) of 178 case-farm controls (persons from farms with encephalitis pa-tients). Case patients (persons with Nipah infection) were more likely than community-farm controls to report increased numbers of sick/dying pigs on the farm (59 % vs. 24%,)P =.001 and were more likely than case-farm controls to perform activities requiring direct contact with pigs (86 % vs. 50%,). Only 8 % of case patients reported no contact with pigs.P =.005 The outbreak stopped after pigs in the affected areas were slaughtered and buried. Direct, close contact with pigs was the primary source of human Nipah infection, but other sources, such as infected dogs and cats, cannot be excluded. From September 1998 through May 1999, 265 cases of en-cephalitis (105 fatal) were reported from 3 statesÐPerak, Ne-geri Sembilan, and SelangorÐof Malaysia [1±3]. Most patient