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STORY: Indian authorities are scrambling to contain an outbreak of the deadly Nipah virus, after two people died of the disease in Kerala and at least three others tested positive.

It's the state’s fourth outbreak since 2018 and has left the region on edge, with schools and offices closed, and a mass-testing effort underway.

So what do we know about the virus?

[Where did the virus come from?]

Nipah was first identified in 1998 when pig farmers in Malaysia and Singapore began to fall ill.

The outbreak ultimately killed more than 100 of the nearly 300 people infected.

Scientists learned that humans can contract Nipah directly through contact with the bodily fluids of infected bats and pigs, or through contaminated food, with some documented cases of transmission between humans.

They suspect Nipah has existed for millennia among flying foxes, and fear that a highly transmissible strain will emerge from bats.

[Where were the other outbreaks?]

So how far has Nipah spread since 1998, and what damage has it caused?

Nipah has spread thousands of miles since it was first identified 25 years ago.

Data from the World Health Organization (WHO) shows more than 600 human infections reported between 1998 and 2015.

A 2001 outbreak in India and two more in Bangladesh killed 62 of 91 people infected.

And in 2018, an outbreak killed 21 of the 23 infected in Kerala, one of the most at-risk regions globally for outbreaks of bat viruses, a Reuters investigation showed in May.

[How deadly is it?]

How deadly is it?

There are no vaccines to prevent or cure the infection, which has a mortality rate of up to 75%.

The WHO says infected people initially develop symptoms that include fever, respiratory distress, headaches, and vomiting.

Encephalitis and seizures can also occur in severe cases, leading to coma.

The usual treatment for Nipah patients is to provide supportive care.

The WHO lists the virus as a pathogen with epidemic potential.