DISEASES IN MALAYSIA
Major infectious diseases: degree of risk: high: food or waterborne diseases: bacterial diarrhea. Vectorborne diseases: dengue fever and malaria. Highly pathogenic H5N1 avian influenza has been identified in this country; it poses a negligible risk with extremely rare cases possible among US citizens who have close contact with birds (2009). [Source: CIA World Factbook]
Increasing deaths from heart disease, cancer, and diabetes suggest increasing health problems associated with high-income countries, but the country is also still affected by health problems that are more common in low-income countries. In 2004 the most common communicable diseases were dengue fever, malaria, measles, and tuberculosis. [Source: Library of Congress, 2006]
A DDT campaign in Malaysia was successful in eliminating mosquitoes and reducing malaria as a threat. It also brought about an increase in bed bugs. It turns out that a certain kind of ant eats bed bugs. The DDT killed the ants but not the bed bugs.
Malaysia Battles Worst-ever Dengue Outbreak in 2009
In January 2009, AFP reported: “Malaysia said it was battling its worst ever outbreak of dengue fever, with 14 deaths and some 5,062 cases of the mosquito-borne disease in less than a month. The crisis, which is centred on Kuala Lumpur and populous Selangor state surrounding the capital, compares to just five deaths and 2,855 cases in the same period a year ago. "This is the worst outbreak ever but this is not just a Malaysian problem, but a global problem," health ministry director-general Ismail Merican told a press conference. [Source: AFP, January 29, 2009]
Ismail said that despite the crisis, householders were refusing to allow local authorities to enter their premises to conduct pesticide "fogging" to kill the aedes mosquito which transmits dengue fever. He urged residents to keep their environment clean and remove rubbish and pots that collect water where mosquitoes can breed. "It is important for the public to come together to destroy the mosquito breeding grounds," he said. Malaysia's health minister has warned that the dengue outbreak could damage the economy by discouraging tourism and lowering productivity.
Dengue fever is endemic in Southeast Asia and cases in Malaysia have surged since 2003. In 2008 there were 49,335 cases in Malaysia with 112 deaths, compared to 48,846 cases with 98 deaths in 2007.
See Dengue fever factsanddetails.com
Malaysia Releases GM Mosquitoes to Combat Dengue Fever
In January 2011, AFP reported: “Malaysia has released 6,000 genetically modified mosquitoes designed to combat dengue fever, in a landmark trial slammed by environmentalists who say the experiment is unsafe. In the first experiment of its kind in Asia, about 6,000 male Aedes aegypti mosquitoes were released at an uninhabited site in the central state of Pahang, the government-run Institute of Medical Research (IMR) said. [Source: AFP, January 26, 2011]
The IMR, which was tasked with carrying out the trial, said the experiment was conducted on December 21 to "study the dispersal and longevity of these mosquitoes in the field". "The experiment was successfully concluded on January 5, 2011," the institute said in a statement dated Tuesday, adding that no further releases are planned until the trial results are analysed. The insects in the experiment have been engineered so that their offspring quickly die, curbing the growth of the population in a technique researchers hope could eventually eradicate the dengue mosquito altogether.
Females of the Aedes species are responsible for spreading dengue, a deadly disease which killed at least 134 people last year in Malaysia alone. The trial has sparked widespread concern among environmental groups and non-government organisations (NGOs), and had been postponed due to their protests as well as unfavourable weather conditions. "I am surprised that they did this without prior announcement given the high level of concerns raised not just from the NGOs but also scientists and the local residents," said researcher Lim Li Ching from Third World Network.
The network is part of 29 public health and environmental groups which have repeatedly demanded the government cancel the trial, saying it was risky and could lead to unintended consequences. "We don't agree with this trial that has been conducted in such an untransparent way. There are many questions and not enough research has been done on the full consequences of this experiment," she told AFP.
Critics have also said that too little is known about the Aedes mosquito, and how the genetically modified insects would interact with their cousins in the wild. Authorities have dismissed the fears and said the trial would be harmless as the GM mosquitoes can live for only a few days. Dengue infection leads to a sudden onset of fever with severe headaches, muscle and joint pains, and rashes, which can lead to death if left untreated.
Hendra Virus
In 1998 and 1999, more than 111 people were killed and 229 became seriously ill in Malaysia from a mysterious disease transferred to humans from pigs. Originally thought to have been the brain-wasting disease, Japanese encephalitis, the disease turned out to be a strain of the Hendra virus, a disease usually associated with pigs that mutated into a disease lethal to humans.
One farmer told the Washington Post, "The first pigs to die were always the males. When the pigs were dead, they had phlegm coming out of the nose...That phlegm was what affected the people. They took the pigs and buried them. When they came back they had headaches. By the third day, they were shivering. The forth day, they were in a coma. The fifth day, they were dead."
The disease was centered around Bukit Pelandok, which is only 60 mile south of Kuala Lumpur and 10 miles for the new airport. Scientists who visited this areas were the iutbreak occurred wore rubber suits with battery-powered respirators.
Around one million pigs in three states—Megri Sembilan, Perak and Selangor — were shot, clubbed and suffocated with bags an carbon monoxide. Residents of the towns where the disease broke out fled and the stench of dead pigs hung in the air. Soldiers, wearing surgical masks and white jump suits, descended on farms in Bukit Pelandok and massacred hundred of pigs of with rifles, hammers and metal rods.
The Hendra virus was first identified in Australia in 1994, where it killed three people and some race horses. Doctors first thought the victims died of Japanese encephalitis because the symptoms were similar but became suspicious when people who had been vaccinated with Japanese encephalitis came down with disease and some pigs got it (pigs don’t get Japanese encephalitis).
Nipah Virus
An outbreak of Nipah virus in 1999 killed more than 100 people and caused the slaughter of roughly 1 million pigs. The disease was first detected at pig farms in Malaysia and slaughter houses in Singapore. Roughly 4 out of 10 people who came down with the disease died. Victims had flulike symptoms, a high fever, aches. Those that died went into a coma and died. There is no known cure or vaccine for the disease.
The Nipah virus has been linked with fruit bats and flying foxes. In 2000, scientists in Malaysia isolated strains of the deadly virus in the urine of flying foxes. The disease crossed over from bats to pigs (bats sometimes roost near pigsties) and then pigs to humans. Most likely a pig contacted the disease by eating an infected bat or some its or urine or feces or possibly eating fruit that infected bats had also ate. How it was passed from pigs to humans is not known, possibly from saliva coughed up a pig. It is similar to the Hendra virus, a disease that killed 14 horses and their trainer in Australia.
David Quammen wrote in National Geographic, “In September 1998, a pork seller in peninsular Malaysia checked into a hospital with some sort of brain inflammation and died. Around the same time, a number of pig-farm workers came down with similar symptoms, bad fever leading to coma; several of them also died. Pigs in the area meanwhile suffered an illness of their own (or what seemed their own), coughing and wheezing, keeling over dead. The pig disease was taken to be classical swine fever. The human deaths were attributed to Japanese encephalitis. But within a few months, scientists showed that both the pigs and the people had been infected with the same virus, a new one, first isolated from a patient whose home village was called Sungai Nipah. The virus was highly contagious from pig to pig, but not from person to person. It spread elsewhere in Malaysia, and even to Singapore, with shipments of live pigs, infecting people who came in contact with the sick animals or their meat. Within seven months, the outbreak had caused 265 human cases, 105 human deaths, and led to the culling of 1.1 million pigs. [Source: David Quammen, National Geographic, October 2007]
“The molecular profile of this new virus suggested a close kinship with Hendra. That provided a clue. Not long afterward, researchers found Nipah living sedately in a reservoir host: Pteropus hypomelanus, another species of fruit bat. They also noted that fruit bats, deprived of habitat elsewhere, had been congregating in orchards near the pig farms.” [Ibid]
According to News Medical: Nipah virus and Hendra virus emerged in the 1990s causing serious disease outbreaks in humans and livestock in Australia, Malaysia, Singapore, Bangladesh and India. Recent Nipah outbreaks have resulted in acute respiratory distress syndrome and encephalitis, person-to-person transmission, and greater than 75 percent case fatality rates among humans. The viruses are found naturally in several species of Pteropid fruit bats (flying foxes). The NIH and Centers for Disease Control and Prevention have classified Nipah and Hendra as biothreat agents, and the U.S. Department of Agriculture has characterized them as agriculture threat agents. In fact, the infectious agent of last year's cinematic release "Contagion" was modeled after Nipah virus. [Source: News Medical, August 10, 2012]
Nipah Virus Vaccine Developed
In August 2012, News Medical reported: “A major breakthrough in the development of a highly effective vaccine against the deadly Nipah virus has been reported by a team of federal and university scientists. The results of their study, "A Hendra virus G glycoprotein subunit vaccine protects African green monkeys from Nipah virus challenge," appeared in Science Translational Medicine online. [Source: News Medical, August 10, 2012]
The research team members are a collaborative group of investigators from the Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland; the University of Texas Medical Branch (UTMB) and Galveston National Laboratory (GNL); the National Institutes of Health (NIH's) National Institute of Allergy and Infectious Diseases (NIAID) and Rocky Mountain Laboratories (RML); and the Boston University School of Medicine and National Emerging Infectious Diseases Laboratories Institute (NEIDL).
In experiments carried out in African green monkeys at the RML in Hamilton, Mont., where there is a high-level safety and security facility for working with live Nipah virus, the team of researchers, under the direction of Heinz Feldmann, M.D., Ph.D., chief of the RML, Laboratory of Virology, demonstrated that immunizing monkeys with a vaccine based on the Hendra virus attachment G glycoprotein afforded complete protection against Nipah virus infection with no evidence of disease. "These findings are really quite promising and appear to offer a real potential treatment for Hendra virus infection in people," said Christopher C. Broder, Ph.D., professor of Microbiology at USU and study corresponding author.
The vaccine is a soluble portion of the G glycoprotein of Hendra virus, known as Hendra-sG, which mediates viral infection and is produced in the laboratory using molecular techniques. Lead author, Katharine Bossart, Ph.D., a USU alumna and assistant professor in the Department of Microbiology, Boston University School of Medicine, developed the Hendra-sG vaccine while a student in Dr. Broder's laboratory at USU. "Since the vaccine is only a recombinant piece of the virus, it can be produced by itself and purified, and is a type of vaccine known as a subunit, thus making it extremely safe to use," Dr. Bossart said.
According to study co-author Thomas W. Geisbert, Ph.D., professor in the Department of Microbiology and Immunology at UTMB and GNL, "This work now provides key evidence that a simple and safe recombinant vaccine against Nipah virus is possible. Demonstrating this in a nonhuman primate model is a major step forward in developing it for future therapeutic use in people."
"There are currently no approved vaccines for prevention of infection and disease caused by Nipah and Hendra for use people or livestock," Dr. Broder said. "This Hendra-sG vaccine has now been shown to be fully effective against infection by both Nipah and Hendra virus in at least three animal species, demonstrating its potential as a safe and effective vaccine as a possible livestock vaccine and now also as possible vaccine for use in people."
Malacca Virus: a New Bat-derived Virus Discovered in Malaysia
In 2006, a new virus, likely carried by bats, has infected a family in the Malaysian state of Malacca, according to a report in the New Straits Times. A soldier, his wife and two children fell ill a week after a bat flew into his house. Health Minister Chua Soi Lek told the newspaper that the family developed high fever accompanied by headache, cough, sore throat and other flu-like symptoms. They eventually recovered from the illness after receiving medical treatment. Scientists from Australia's CSIRO research organization and Malaysia's National Public Health Laboratory determined that the previously unknown virus is a reoviridae, a family of viruses first detected in humans during the 1950s. “This type of groundbreaking discovery ... is going to make future diagnoses of unknown viruses more accurate, as we can now add it to the list of new and emerging viruses,” said Dr. Linfa Wang, who led the CSIRO team that helped identify the virus. Malaysian health officials initially called the new pathogen "Malacca virus" after the name of the state in which it was discovered. [Source: Earthweek, July 6, 2007]
CSIRO reported: “Scientists at CSIRO's Australian Animal Health Laboratory (AAHL) and collaborators from the National Public Health Laboratory in Malaysia identified bats as the likely host of a new virus that can cause a serious but apparently non-fatal respiratory tract illness in humans. Respiratory infections constitute the most widespread human infectious diseases and a substantial proportion of them are caused by unknown disease agents. [Source: CSIRO, October 15, 2007]
The new virus was named Malacca after the location in Malaysia where it was isolated in early 2006. Since the first discovery of human infection with this type of virus, there have been similar events involving closely related viruses in Malaysia , Bali and Hong Kong. The Malacca virus was isolated from a 39-year-old male patient who showed signs of fever and acute respiratory illness. Retrospective research revealed that some members of the patient’s family developed similar symptoms approximately one week later and showed serological evidence of infection with the same virus. The delay in onset of symptoms suggests human-to-human transmission of the virus.
This is the only recorded case of the Malacca virus infecting humans. Although the symptoms were severe and persisted for four days, there is no evidence to suggest Malacca virus is fatal. Bats are reservoir hosts of many viruses that can infect and cause illness in people, but the bats rarely display clinical signs of infection. Malacca virus is a type of reovirus (Respiratory Enteric Orphan viruses) that was first isolated in humans in the early 1950s and so named because they were not associated with any known disease. Since the Malacca virus was characterised, researchers have identified related viruses in bats, including the Xi River virus discovered by Chinese researchers. A new species name, Pteropine orthoreovirus, has been created for this group of closely related viruses, which have wide distribution in bats around the world.
The scientists at AAHL used scientific techniques including virology, serology, electron microscopy and molecular biology to establish that the virus was a reovirus and to what species group it belonged. Bats were examined as the host of the virus, not only because previous unknown viruses have originated in bats, but also because epidemiological tracing revealed that the family was exposed to a bat in the house one week before the patient became ill.
Genetic sequencing indicated that Malacca virus is closely related to a small group of bat-borne reoviruses, including Nelson Bay virus, isolated in 1968 from a fruit bat in New South Wales, Australia, and Pulau virus, isolated in 1999 from fruit bats on Tioman Island, Malaysia. Although bats are known reservoir hosts of an increasing number of zoonotic viruses (animal viruses capable of also infecting people), they rarely display clinical signs of infection. AAHL scientists subsequently worked closely with the group in the National Public Health Laboratory and other Malaysian scientists to identify the distribution of the Malacca virus and to further investigate related viruses in the bat reovirus group.
Malacca CM objects to new virus being called 'Malacca Virus'
State officials in Malacca objected to name Malacca virus, saying that name was "an insult" and would harm the tourism industry in Malacca, which is a popular destination for foreign visitors. "We will rename the virus if we can, as we do not want to tarnish the good name of the state," Health Minister Chua Soi Lek later told reporters.
Marsha Tan of Associated Press wrote: “Mohd Ali said the state government would send an official letter of objection to the Health Ministry on this matter immediately. "If it is already the official name for the virus, then we want the ministry to change that name and if it is already used overseas, we will also send a letter of objection to the usage of that name," said Mohd Ali added. Mohd Ali urged the ministry to retract the use of the name immediately, adding it was "not a good name" and that the virus should just be named after the doctor or scientist who discovered it. "Malacca is a good state, beautiful and peaceful, not the birthplace of diseases," said Mohd Ali after launching the Tok Moyang Lajis Badariah descendents memorial at Serkam here. [Source: Marsha Tan, AP, June 30, 2007]
SARS and Malaria
Malaysia managed to largely to avoid the SARS outbreak. It had five cases of SARS and two deaths connected to the disease. The government moved aggressively to prevent the spread of the disease. It imposed visa restrictions, particularly on people arriving from China, Taiwan, Hong Kong and Toronto, where the disease had appeared, and carefully screened people entering the country.
Malaria was eradicated in the 1950s and 60s but came back in the 1970s.A DDT campaign in Malaysia was successful in eliminating mosquitoes and reducing malaria as a threat. It also brought about an increase in bed bugs. It turns out that a certain kind of ant eats bed bugs. The DDT killed the ants but not the bed bugs. DDT is still used, in part because it is effective in controlling mosquitos that carry the malaria parasite.
AIDS
HIV/AIDS - adult prevalence rate: 0.5 percent (2009 est.), country comparison to the world: 68. HIV/AIDS - people living with HIV/AIDS: 100,000 (2009 est.), country comparison to the world: 41. HIV/AIDS - deaths: 5,800 (2009 est.), country comparison to the world: 36. [Source: CIA World Factbook]
Human immunodeficiency virus (HIV) was among common communicable diseases, but figures vary as to its prevalence. According to United Nations data, approximately 51,000 persons aged 15 to 49 had HIV in 2003, and the HIV prevalence rate was 0.4 percent, lower than the 0.6 percent rate for South and Southeast Asia overall.
The International AIDS-HIV charity Art reports: HIV and AIDS statistics from Malaysia show that an estimated 0.5 percent of the population are living with HIV. Although most people infected with HIV in the country are male, there has been a steep increase in the number of new cases among women. During the late 1990s women made up around 5 percent of new infections, compared to around 20 percent in 2006. Malaysia's epidemic is largely driven by injecting drug use, but heterosexual transmission is accounting for an increasing number of new infections. Recent trends have demonstrated a promising decrease in annual HIV infections, from 7,000 in 2002 to 5,830 in 2006. In 2006 the government launched a five-year strategic plan to tackle HIV, which includes drug substitution therapy and needle exchange programmes for drug users. In 2009, 5,800 people died from AIDS in Malaysia. [Source: Avert, International AIDS-HIV charity website]
As of 1997, about 20,000 people had AIDS or were infected with HIV. At that point the disease was doubling every 18 months but infection rates were still much lower than those in Thailand or Cambodia. HIV was spread primarily bu drug users and ex workers. The HIV rate among prostitutes leapt from 0.3 percent in 1992 to 10 percent in 1995.
Marina Mahathir, the daughter of Prime Minister Mahathir Mohamad, was a leader in Malaysia’s effort to fight AIDS. Prevention efforts have been way behind those in Thailand. They consisting many of advertising campaigns against promiscuous sex and drug use. The use of condoms and giving out needles to drug addicts are sensitive issues in Malaysia.
December 2008, AFP reported: “Malaysia’s HIV infection rate has dropped by nearly half over the past five years but the number of women infected is rising sharply, deputy premier Najib Razak reportedly said. Mr Najib said there were 3,452 new HIV cases in 2008, compared to 6,756 in 2003, thanks to a national program to stem infections. 'Malaysia is categorised as a country with a concentrated epidemic...meaning in certain, high risk groups,' he said according to the state Bernama news agency. However, Mr Najib expressed concern over the increase in HIV infections among women through normal sexual intercourse, saying their numbers rose from 5.02 percent in 1997 to 16.3 percent last year. [Source: AFP, December 18, 2008]
Islamists Complain About Malaysia Plan to Battle AIDS
In May 2005, Evelyn Rusli wrote in the New York Times, “Alarmed by the rising number of AIDS cases, the Malaysian government has announced a plan to distribute condoms, needles and methadone treatment for drug users, igniting opposition from the conservative Islamic community here. Muslim clerics have strongly criticized the plan, worth $40 million, saying that it would encourage drug abuse and extramarital sex and that it violated Islamic law. "When you give free condoms and free needles, you give drug abusers the motivation to engage in risky behavior," said Mahfoz Omar, a leader of the Islamic Party of Malaysia, an opposition political party. "Why should we give the people's money to those that do not have the will for life?" [Source: Evelyn Rusli, New York Times, July 4, 2005 ////]
“Local AIDS groups and the conservative Malaysian government, led by Prime Minister Abdullah Ahmad Badawi, an Islamic scholar, disagree. While the government had rejected plans to distribute condoms or needles, it now argued that dramatic steps were justified because the AIDS problem had reached a critical level, health officials said. "When the condition reaches an epidemic level, unconventional methods are necessary," the health minister, Chua Soi Lek, said in an interview Sunday. The government argues that the new policies do not violate Islamic law because in cases of emergency, people can break rules to survive. ////
“About 15,000 children have already been made orphans by AIDS in Malaysia, and the country is on the brink of an AIDS epidemic, the World Health Organization has said. The Health Ministry has identified 64,000 people with HIV or AIDS, but government officials and the United Nations fear that the number of HIV cases is closer to 300,000. ////
“In Malaysia, addressing the problem of drug abuse is an important step in the fight against AIDS because 75 percent of those with HIV or AIDS are drug users, according to the Malaysian AIDS Council, a nongovernmental AIDS group. In the past, the government has shunned needle-exchange programs in favor of abstinence programs. But 70 percent to 90 percent of drug users who followed the government's abstinence program returned to drug abuse, according to a study in 2004 by the Burnet's Institute Center for Harm Reduction, a research group based in Australia. "It was a wake-up call for the government," a Malaysian Aids Council official, Sangreta Kaur, said. ////
“The Malaysian government plans to start the first phase of its new AIDS program in October by offering methadone drug therapy, a treatment that weans users off their addictions by using methadone as a substitute, said the country's health minister, Chua. In January, the government plans to provide condoms and start needle-exchange programs at four or five nongovernmental sites. But as the government pushes ahead with its AIDS plan, a sensitive debate over whether the policies violate Islamic law looms in a country where more than 60 percent of the population is Muslim. ////
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Text Sources: New York Times, Washington Post, Los Angeles Times, Times of London, Lonely Planet Guides, Library of Congress, Malaysia Tourism Promotion Board, Compton’s Encyclopedia, The Guardian, National Geographic, Smithsonian magazine, The New Yorker, Time, Newsweek, Reuters, AP, AFP, Wall Street Journal, The Atlantic Monthly, The Economist, Foreign Policy, Wikipedia, BBC, CNN, and various books, websites and other publications.
Last updated June 2015