Article

Emerging and re-emerging viruses in Malaysia, 1997–2007

Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases (Impact Factor: 1.86). 12/2008; 13(3):307-18. DOI: 10.1016/j.ijid.2008.09.005
Source: PubMed

ABSTRACT

Over the past decade, a number of unique zoonotic and non-zoonotic viruses have emerged in Malaysia. Several of these viruses have resulted in significant morbidity and mortality to those affected and they have imposed a tremendous public health and economic burden on the state. Amongst the most devastating was the outbreak of Nipah virus encephalitis in 1998, which resulted in 109 deaths. The culling of more than a million pigs, identified as the amplifying host, ultimately brought the outbreak under control. A year prior to this, and subsequently again in 2000 and 2003, large outbreaks of hand-foot-and-mouth disease due to enterovirus 71, with rare cases of fatal neurological complications, were reported in young children. Three other new viruses - Tioman virus (1999), Pulau virus (1999), and Melaka virus (2006) - whose origins have all been linked to bats, have been added to the growing list of novel viruses being discovered in Malaysia. The highly pathogenic H5N1 avian influenza has also been detected in Malaysia with outbreaks in poultry in 2004, 2006, and 2007. Fortunately, no human infections were reported. Finally, the HIV/AIDS epidemic has seen the emergence of an HIV-1 recombinant form (CRF33_01B) in HIV-infected individuals from various risk groups, with evidence of ongoing and rapid expansion.

Download full-text

Full-text

Available from: Adeeba Kamarulzaman
  • Source
    • "Several countries in Asia have instituted surveillance to provide early warning of outbreaks, which are largely depended on the timely case reports with pathogenic diagnosis from community clinics [19], [20]. Traditional laboratory diagnosis for EV71 is by cell culture followed by neutralization tests with serotype-specific antisera [9]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Enterovirus 71 (EV71) infection is more likely to induce severe complications and mortality than other enteroviruses. Methods for detection of IgM antibody against EV71 had been established for years, however, the performance of the methods in the very early diagnosis of EV71 infection had not been fully evaluated, which is especially meaningful because of the short incubation period of EV71 infection. In this report, the performance of an IgM anti-EV71 assay was evaluated using acute sera collected from 165 EV71 infected patients, 165 patients infected with other enteroviruses, and more than 2,000 sera from healthy children or children with other infected diseases. The results showed a 90% sensitivity in 20 patients who were in their first illness day, and similar sensitivity remained till 4 days after onset. After then the sensitivity increased to 95% to 100% for more than one month. The specificity of the assay in non-HFMD children is 99.1% (95% CI: 98.6-99.4), similar as the 99.9% specificity in healthy adults. The cross-reaction rate in patients infected with other non-EV71 enteroviruses was 11.4%. In conclusion, the data here presented show that the detection of IgM anti-EV71 by ELISA affords a reliable, convenient, and prompt diagnosis of EV71 infection.
    Full-text · Article · Jun 2010 · PLoS ONE
  • Source
    • "Additional outbreaks were reported in February and March 2006 in free-range poultry flocks and then again in chickens in June 2007. No human cases were detected in Malaysia [41]. Early detection and drastic culling measures could be attributed with such a successful control of H5N1 outbreaks in this country. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Highly Pathogenic Avian Influenza (HPAI) H5N1 virus is an ongoing public health and socio-economic challenge, particularly in South East Asia. H5N1 is now endemic in poultry in many countries, and represents a major pandemic threat. Here, we describe the evolution of H5N1 virus in South East Asia, the reassortment events leading to high genetic diversity in the region, and factors responsible for virus spread. The virus has evolved with genetic variations affecting virulence, drug-resistance, and adaptation to new host species. The constant surveillance of these changes is of primary importance in the global efforts of the scientific community.
    Full-text · Article · Dec 2009 · Viruses
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Pathogen dynamics are inseparable from the broader environmental context in which pathogens occur. Although some pathogens of people are primarily limited to the human population, occurrences of zoonoses and vector-borne diseases are intimately linked to ecosystems. The emergence of these diseases is currently being driven by a variety of influences that include, among other things, changes in the human population, long-distance travel, high-intensity animal-production systems, and anthropogenic modification of ecosystems. Anthropogenic impacts on ecosystems have both direct and indirect (foodweb mediated) effects. Therefore, understanding disease risk for zoonoses is a social-ecological problem. The articles in this special feature focus on risk assessment for avian influenza. They include analyses of the history and epidemiological context of avian influenza; planning and policy issues relating to risk; the roles of biogeography and spatial and temporal variation in driving the movements of potential avian influenza carriers; approaches to quantifying risk; and an assessment of risk-related interactions among people and birds in Vietnamese markets. They differ from the majority of published studies of avian influenza in that they emphasize unknowns and uncertainties in risk mapping and societal responses to avian influenza, rather than concentrating on known or proven facts. From a systems perspective, the different aspects of social-ecological systems that are relevant to the problem of risk mapping can be summarized under the general categories of structural, spatial, and temporal components. I present some examples of relevant system properties, as suggested by this framework, and argue that, ultimately, risk mapping for infectious disease will need to develop a more holistic perspective that includes explicit consideration of the roles of policy, disease management, and feedbacks between ecosystems and societies.
    Full-text · Article · Jan 2010 · ECOLOGY AND SOCIETY
Show more