Shiloh
Editor, Senior Moderator
Source: http://www.nst.com.my/Current_News/NST/Sunday/Frontpage/2391141/Article/index_html
2008/11/02
NIPAH VIRUS: Eight years on, it's still a threat
By : Chai Mei Ling
KUALA LUMPUR: This is the eighth year that Malaysia is free of the Nipah virus since the 1998-99 outbreak that took more than 100 lives, but the authorities are not letting their guard down.
Abbatoirs are still being screened, samples from cattle, strays and pets tested, and clinical surveillance carried out in major hospitals.
"I won't rule out the possibility of another Nipah outbreak in Malaysia or in any part of the world," said Professor Dr Tan Chong Tin, speaking at University Malaya's Nipah Virus colloquium last week.
"More and more countries, including Bangladesh, Indonesia, Thailand, Cambodia and India, have found their bats to have Nipah virus. So the potential of an outbreak is there," said Dr Tan, a consultant neurologist with UM's department of medicine.
The movement of labour across borders could pose a threat to Malaysia, which is home to migrant labour from these countries.
Research in the past 10 years have shown the ability of the virus to evolve and infect people differently and directly. If it ever does so, it could be in a strain so different from the virus that struck Malaysia in 1998-99, that we could find ourselves grappling for answers again.
While the disease then had pigs as the intermediary and amplifying hosts to the virus with a connection to fruit bats and flying foxes, reports from Bangladesh now talk of another bat connection.
And in Bangladesh, which continued to experience Nipah virus outbreaks almost annually in the last seven years, the virus was found to manifest itself a little differently. For one, it caused more respiratory problems, said Tan.
"We saw Nipah virus as mainly a brain disease, but the Bangladeshis and Indians saw it with a very strong lung component. Sometimes, it can produce a disease like SARS where there's a lot of lung infection.
"So, it very well can spread from human to human. It can even spread the whole world over."
Indeed, person-to-person transmission forms half of the cases in Bangladesh, unlike in Malaysia, where we had none recorded.
Although statistics showed that each person in Bangladesh infects only half a person, Dr Dr Steve Luby from the International Centre for Diarrhoeal Disease Research, Bangladesh, said the outbreak could still be devastating.
"It's not yet a pandemic. It's not going into lots and lots of people and spreading beyond village areas, but we do have devastating outbreaks.
"My suspicion is that this virus knows no borders and I doubt that the zone of risk ends at the border."
The Nipah disease also took a new twist in Bangladesh in the form of direct infection of humans by bats -- there is a high possibility that humans can get infected by drinking raw, contaminated date palm juice.
Infrared cameras put up at night have caught images of bats visiting palm trees and licking the cut segment from which the sap drips into a jar.
The next morning, some of the juice would be sold and drunk raw.
The third notable difference in the Bangladeshi case, also a serious cause for concern, is that although the outbreaks have been small, having only 206 reported cases in seven years, the disease has become almost twice as deadly. It records a fatality rate of 74 per cent, as opposed to Malaysia's 40 per cent.
However, the marked jump is not solely attributable to the new strain of virus, as culturally, Bangladeshis' social norm in providing personal care for the sick is also believed to have given rise to more close contact.
Whatever its ugly manifestation in other parts of the world, the Nipah disease is never the problem of only that one country.
The very real risk that it could evolve into a pandemic, much like SARS and the Avian influenza, means that it is a global issue.
Dr Peter Daszak of the Consortium for Conservation Medicine, New York, said that a review of past literatures showed that zoonoses -- animal diseases that can be passed on to humans -- are on the rise.
"There are 50,000 vertebrate species on the planet. Let's assume each species has 20,000 viruses that are endemic, and that's a pretty low estimate considering that studies have shown that humans, cats and dogs have many more viruses.
"We've known only 2,000 viruses, so if you work out the math, there are millions of viruses waiting to be discovered. There are 20,000 in bats alone."
People are at risk, wherever they are, says Dr Daszak.
"Even if it emerges in Bangladesh or Amazon, once it gets into the human population, it starts to spread.
"Once a virus gets into the pandemic status, it would gravitate to the countries that have the most people flying around the world."
Many of the speakers at the conference said that international co-operation was essential to handling the threat posed by new diseases.
"Internationalism is very important. There's no border. The whole world is sensitised towards these emerging diseases, so it's very useful to keep in touch," said Emeritus Prof Datuk Dr Lam Sai Kit, who headed the research team in UM that identified the Nipah virus 10 years ago.
Dr Lam should know; he placed many phone calls to colleagues the world over when Malaysia was facing that Nipah threat then, and they came over to help.
The experience gained from containing the Nipah virus outbreak has been important in making Malaysia today a better prepared nation.
"Nipah taught us a lesson. We were ill-equipped," said Prof Sazaly Abu Bakar, head of UM's department of medical microbiology.
"The ministries didn't work together. But when the outbreak took place, they were forced to collaborate.
"It forced Malaysia to look into its capacity on whether it can handle this kind of outbreak in the future."
2008/11/02
NIPAH VIRUS: Eight years on, it's still a threat
By : Chai Mei Ling
KUALA LUMPUR: This is the eighth year that Malaysia is free of the Nipah virus since the 1998-99 outbreak that took more than 100 lives, but the authorities are not letting their guard down.
Abbatoirs are still being screened, samples from cattle, strays and pets tested, and clinical surveillance carried out in major hospitals.
"I won't rule out the possibility of another Nipah outbreak in Malaysia or in any part of the world," said Professor Dr Tan Chong Tin, speaking at University Malaya's Nipah Virus colloquium last week.
"More and more countries, including Bangladesh, Indonesia, Thailand, Cambodia and India, have found their bats to have Nipah virus. So the potential of an outbreak is there," said Dr Tan, a consultant neurologist with UM's department of medicine.
The movement of labour across borders could pose a threat to Malaysia, which is home to migrant labour from these countries.
Research in the past 10 years have shown the ability of the virus to evolve and infect people differently and directly. If it ever does so, it could be in a strain so different from the virus that struck Malaysia in 1998-99, that we could find ourselves grappling for answers again.
While the disease then had pigs as the intermediary and amplifying hosts to the virus with a connection to fruit bats and flying foxes, reports from Bangladesh now talk of another bat connection.
And in Bangladesh, which continued to experience Nipah virus outbreaks almost annually in the last seven years, the virus was found to manifest itself a little differently. For one, it caused more respiratory problems, said Tan.
"We saw Nipah virus as mainly a brain disease, but the Bangladeshis and Indians saw it with a very strong lung component. Sometimes, it can produce a disease like SARS where there's a lot of lung infection.
"So, it very well can spread from human to human. It can even spread the whole world over."
Indeed, person-to-person transmission forms half of the cases in Bangladesh, unlike in Malaysia, where we had none recorded.
Although statistics showed that each person in Bangladesh infects only half a person, Dr Dr Steve Luby from the International Centre for Diarrhoeal Disease Research, Bangladesh, said the outbreak could still be devastating.
"It's not yet a pandemic. It's not going into lots and lots of people and spreading beyond village areas, but we do have devastating outbreaks.
"My suspicion is that this virus knows no borders and I doubt that the zone of risk ends at the border."
The Nipah disease also took a new twist in Bangladesh in the form of direct infection of humans by bats -- there is a high possibility that humans can get infected by drinking raw, contaminated date palm juice.
Infrared cameras put up at night have caught images of bats visiting palm trees and licking the cut segment from which the sap drips into a jar.
The next morning, some of the juice would be sold and drunk raw.
The third notable difference in the Bangladeshi case, also a serious cause for concern, is that although the outbreaks have been small, having only 206 reported cases in seven years, the disease has become almost twice as deadly. It records a fatality rate of 74 per cent, as opposed to Malaysia's 40 per cent.
However, the marked jump is not solely attributable to the new strain of virus, as culturally, Bangladeshis' social norm in providing personal care for the sick is also believed to have given rise to more close contact.
Whatever its ugly manifestation in other parts of the world, the Nipah disease is never the problem of only that one country.
The very real risk that it could evolve into a pandemic, much like SARS and the Avian influenza, means that it is a global issue.
Dr Peter Daszak of the Consortium for Conservation Medicine, New York, said that a review of past literatures showed that zoonoses -- animal diseases that can be passed on to humans -- are on the rise.
"There are 50,000 vertebrate species on the planet. Let's assume each species has 20,000 viruses that are endemic, and that's a pretty low estimate considering that studies have shown that humans, cats and dogs have many more viruses.
"We've known only 2,000 viruses, so if you work out the math, there are millions of viruses waiting to be discovered. There are 20,000 in bats alone."
People are at risk, wherever they are, says Dr Daszak.
"Even if it emerges in Bangladesh or Amazon, once it gets into the human population, it starts to spread.
"Once a virus gets into the pandemic status, it would gravitate to the countries that have the most people flying around the world."
Many of the speakers at the conference said that international co-operation was essential to handling the threat posed by new diseases.
"Internationalism is very important. There's no border. The whole world is sensitised towards these emerging diseases, so it's very useful to keep in touch," said Emeritus Prof Datuk Dr Lam Sai Kit, who headed the research team in UM that identified the Nipah virus 10 years ago.
Dr Lam should know; he placed many phone calls to colleagues the world over when Malaysia was facing that Nipah threat then, and they came over to help.
The experience gained from containing the Nipah virus outbreak has been important in making Malaysia today a better prepared nation.
"Nipah taught us a lesson. We were ill-equipped," said Prof Sazaly Abu Bakar, head of UM's department of medical microbiology.
"The ministries didn't work together. But when the outbreak took place, they were forced to collaborate.
"It forced Malaysia to look into its capacity on whether it can handle this kind of outbreak in the future."