Initial signs and symptoms of NiV infection are non-specific and the diagnosis is often not suspected at the time of manifestation. This can hinder accurate diagnosis and creates challenges in outbreak detection and institution of effective and timely infection control measures and outbreak response activities. In addition, clinical sample quality, quantity, type, timing of collection and the time necessary to transfer samples from patients to the laboratory can affect the accuracy of laboratory results. NiV infection can be diagnosed together with clinical history during the acute and convalescent phase of the disease. Tests include real time polymerase chain reaction (RT-PCR) from bodily fluids as well as antibody detection via ELISA. Other tests include: enzyme-linked immunosorbent assay (ELISA); polymerase chain reaction (PCR) assay and virus isolation by cell culture.