1998–1999 Malaysia Nipah virus outbreak

Disease outbreak in Malaysia August 2019 August 2019 Flying fox distribution.png The first site of the virus in Ipoh in 1998 and later occurrence to other places with the virus extent in blue while Hendra virus in red, both belong to the Paramyxoviridae family. 280px The 1998–1999 Nipah virus outbreak areas in West Malaysia, blue is the origin source of the virus while the red are further affected areas. Nipah virus infection Nipah virus September 1998 Ipoh, Perak 105 265 The 1998–1999 Malaysia Nipah virus outbreak occurred from September 1998 to May 1999 in the states of Perak, Negeri Sembilan and Selangor in Malaysia. A total of 265 cases of acute encephalitis with 105 deaths caused by the virus were reported in the three states throughout the outbreak.http://www.mjpath.org.my/2007.2/02Nipah_Virus_lessons.pdf Lessons from the Nipah virus outbreak in Malaysia Lai-Meng Looi Kaw-Bing Chua Department of Pathology, University of Malaya and National Public Health Laboratory of the Ministry of Health, Malaysia The Malaysian Journal of Pathology 2007 29 2 63–67 19108397 https://web.archive.org/web/20190830060915/http://www.mjpath.org.my/2007.2/02Nipah_Virus_lessons.pdf 30 August 2019 live At first, the Malaysian health authorities thought that Japanese encephalitis (JE) was the cause of the infection. This misunderstanding hampered the deployment of effective measures to prevent the spread, before the disease was identified by a local virologist from the Faculty of Medicine, University of Malaya as a newly discovered agent. It was named Nipah virus (NiV). The disease was as deadly as the Ebola virus disease (EVD), but attacked the brain system instead of the blood vessels.https://www.npr.org/sections/goatsandsoda/2017/02/25/515258818/a-taste-for-pork-helped-a-deadly-virus-jump-to-humans A Taste For Pork Helped A Deadly Virus Jump To Humans Michaeleen Doucleff Jane Greenhalgh NPR 25 February 2017 30 August 2019 The disease was as deadly as Ebola, but instead of attacking blood vessels, it attacked the brain. Young men would be healthy one day, the next day their brains would swell up. They couldn't walk or talk. They'd become comatose and some of them became paralysed. Yet the Malaysian government told people not to worry, it said the disease was coming from mosquitoes and it had it under control because it was spraying for mosquitoes. Both C. T. Tan and Kaw Bing Chua thought the government was wrong and there was one big clue: No Muslims were getting sick, mosquitoes don't care which religion you practice so if the disease was coming from mosquitoes, you would have Muslims, Hindus and Christians getting sick. But only Chinese Malaysians were catching the disease — and even more specifically, only Chinese farmers raising pigs. As you know, Muslims don't handle pigs. University of Malaya's Faculty of Medicine and the University of Malaya Medical Centre played a major role in serving as a major referral centre for the outbreak, treating majority of the Nipah patients and was instrumental in isolating the novel virus and researched on its features. This emerging disease caused major losses to both animal and human lives, affecting livestock trade. It also created a significant setback to the swine sector of the animal industry in Malaysia.http://www.fao.org/3/ah690e/ah690e00.pdf Manual on the Diagnosis of Nipah Virus Infection in Animals Food and Agriculture Organization 2002 v [11/90] https://web.archive.org/web/20190830074249/http://www.fao.org/3/ah690e/ah690e00.pdf RAP Publication 30 August 2019 live The country became the origin of the virus, but had no more cases since 1999. Further outbreaks continue to occur in Bangladesh and India.Nipah Virus Infection Brenda S. P. Ang Tchoyoson C. C. Lim Linfa Wang Journal of Clinical Microbiology 56 6 e01875-17 American Society for Microbiology 2018 10.1128/JCM.01875-17 29643201 5971524https://www.who.int/news-room/fact-sheets/detail/nipah-virus Nipah virus World Health Organization 30 May 2018 30 August 2019 Background The virus firstly struck pig-farms in the suburb of Ipoh in Perak with the occurrence of respiratory illness and encephalitis among the pigs, where it was initially believed to have been caused by Japanese encephalitis (JE), due to four serum samples from 28 infected humans in the area which tested positive for JE-specific Immunoglobulin M (IgM) which is also confirmed by the findings of the World Health Organization (WHO) Collaborating Centre for Tropical Disease at Nagasaki University. A total of 15 infected people died during the ensuing outbreak, before the virus began to spread into Sikamat, Nipah River Village and Pelandok Hill in Negeri Sembilan, when farmers impacted by the control measures began to sell their infected pigs to these areas. This resulted 180 patients infected by the virus and 89 deaths. With further movement of infected pigs, more cases emerged from around Sepang District and Sungai Buloh in Selangor, with 11 cases and 1 death reported among abattoir workers in Singapore who had handled the infected pigs imported from Malaysia. Response and further investigation Since the cause was initially wrongly identified, early control measures such as mosquito foggings and vaccination of pigs against JE were deployed to the affected area, which proved to be ineffective, with more cases emerging despite these early measures. With the increasing deaths reported from the outbreak, this caused nationwide fear from the public and the near-collapse of the local pig-farming industry. Most healthcare workers who were taking care of their infected patients had been convinced that the outbreak was not caused by JE, since the disease affected more adults than children, including those who had been vaccinated earlier against JE. Through further autopsies on the victims, the findings were inconsistent with the earlier results, and suggested it may have come from another agent. This was supported by several findings, including that all of the infected people had had direct physical contact with pigs, and all of the infected pigs had developed severe symptoms of a "barking cough" before dying. Despite the evidence gathered from autopsy results, with new findings among local researchers, the federal government, especially the health authorities, insisted that it was solely caused by JE, which delayed further appropriate action taken for outbreak control. Identification of the source of infection In early March 1999, a local medical virologist at the University of Malaya finally found the root cause of the infection. The infection was found to be caused by a new agent named Nipah virus (NiV), taken from the investigation area name of Nipah River Village (ms Kampung Sungai Nipah),http://www.searo.who.int/entity/emerging_diseases/links/CDS_Nipah_Virus.pdf Nipah Virus Infection World Health Organization The virus is named after the Malaysian village where it was first discovered. This virus along with Hendra virus comprises a new genus designated Henipavirus in the subfamily Paramyxovirinae. https://web.archive.org/web/20190830072817/http://www.searo.who.int/entity/emerging_diseases/links/CDS_Nipah_Virus.pdf 30 August 2019 dead where it was unknown in available scientific records at the time.https://www.cdc.gov/vhf/nipah/index.html Nipah Virus (NiV) Centers for Disease Control and Prevention 20 March 2014 30 August 2019 The virus origin was determined to be from a native fruit bat species.Malaysian Researchers Trace Nipah Virus Outbreak to Bats Science Martin Enserink American Association for the Advancement of Science 2000 289 5479 518–9 10.1126/science.289.5479.518 10939954 3166643 Together with the Hendra virus (HeV), the novel virus was subsequently recognised as a new genus, Henipavirus (Hendra + Nipah) in the Paramyxoviridae family. NiV and HeV shared enough epitopes for HeV antigens to be used in a prototype serological test for NiV antibodies which helped in the subsequent screening and diagnosis of NiV infection. Following the findings, widespread surveillance of pig populations, together with the culling of over a million pigs was undertaken, and the last human fatality occurred on 27 May 1999. The outbreak in neighbouring Singapore also ended with immediate prohibition of pig importation to the country and the subsequent closure of abattoirs. The virus discovery received the attention from the American Centers for Disease Control and Prevention (CDC), Commonwealth Scientific and Industrial Research Organisation (CSIRO) and Singapore General Hospital (SGH) which gave swift assistance towards the characterisation of the virus and the development of surveillance and control measures. Aftermath Until the 2010s, the pig farming ban on Pelandok Hill was still in force to prevent the recurrence of the outbreak, despite some farmers having quietly restarted their businesses after being encouraged by community leaders.https://www.thestar.com.my/news/nation/2014/07/03/1998-ban-on-pig-farming-in-bukit-pelanduk-still-in-force/ 1998 ban on pig farming in Bukit Pelanduk still in force Sarban Singh The Star 3 July 2014 31 August 2019 Most of the surviving pig farmers have turned to palm oil and Artocarpus integer (cempedak) cultivation.https://www.thestar.com.my/news/nation/2018/04/14/nipah-virus-outbreak-memorialised-in-museum Nipah virus outbreak memorialised in museum Yimie Yong The Star 14 April 2018 31 August 2019 Since the virus has been named Nipah from the sample taken in Nipah River Village of Pelandok Hill, the latter area has become synonyms with the deadly virus.https://www.theborneopost.com/2018/05/27/bukit-pelandok-revisited/ Bukit Pelandok revisited Chang Yi The Borneo Post 27 May 2018 31 August 2019 In a response from the Singapore's government, its country's food agency, Agri-Food and Veterinary Authority of Singapore (now Singapore Food Agency (SFA)), banned the exports of pig blood curd in 1999.Pig blood: Why and when was it banned in Singapore? https://www.channelnewsasia.com/singapore/pig-blood-why-and-when-was-it-banned-singapore-1398776 CNA 13 April 2026 en The ban has since been lifted after 27 years on 1 April 2026, with the pig blood curd imports from Thailand requiring approval from SFA beforehand.Pig blood products to return to Singapore after ban https://www.straitstimes.com/singapore/pigs-blood-food-products-to-return-to-singapore-markets-after-nearly-three-decades The Straits Times 13 April 2026 en 2 April 2026Singapore gives green light for pork blood products after almost three decades https://www.channelnewsasia.com/singapore/singapore-food-agency-thailand-pig-blood-products-6033126 CNA 13 April 2026 en Before the ban was lifted, one seller was prosecuted for selling imported pig blood curd online in 2021.Woman fined S$8,000 for possessing, selling illegally imported pig blood curd https://www.channelnewsasia.com/singapore/sfa-pig-blood-curd-products-online-illegal-fine-3117846 CNA 13 April 2026 en See also Paramyxoviridae Asia Biology Malaysia Medicine Viruses Further reading Nipah virus infection in bats (order Chiroptera) in peninsular Malaysia Yob J. M. Field H. Rashdi A. M. Morrissy C. van der Heide B. Rota P. bin Adzhar A. White J. Daniels P. Jamaluddin A. Ksiazek T. Emerging Infectious Diseases 7 3 439–441 2001 10.3201/eid0703.010312 2631791 11384522 Nipah Virus Encephalitis Outbreak in Malaysia Sai Kit Lam Kaw Bing Chua Clinical Infectious Diseases 34 2 S48–S51 Oxford Academic 2002 10.1086/338818 11938496 free Nipah virus--a potential agent of bioterrorism? Lam S. K. Department of Medical Microbiology, Faculty of Medicine, University of Malaya 57 1–2 113–9 2003 12615307 10.1016/s0166-3542(02)00204-8 Transmission of Human Infection with Nipah Virus James M. Hughes Mary E. Wilson Stephen P. Luby Emily S. Gurley M. Jahangir Hossain Clinical Infectious Diseases 49 11 1743–1748 Oxford Academic 2009 10.1086/647951 19886791 2784122 Nipah virus disease: A rare and intractable disease Sayantan Banerjee Nitin Gupta Parul Kodan Ankit Mittal Yogiraj Ray Neeraj Nischal Manish Soneja Ashutosh Biswas Naveet Wig Intractable & Rare Diseases Research 8 1 1–8 2019 10.5582/irdr.2018.01130 6409114 30881850 Diagnostics for Nipah virus: a zoonotic pathogen endemic to Southeast Asia Laura T. Mazzola Cassandra Kelly-Cirino 4 2 e001118 The BMJ 2019 10.1136/bmjgh-2018-001118 30815286 6361328 References Category:1998 disease outbreaks Category:1999 disease outbreaks Category:Paramyxoviridae Category:Health disasters in Malaysia Category:Disease outbreaks in Singapore Category:1998 in Malaysia Category:1999 in Malaysia Category:1998 disasters in Malaysia Category:1999 disasters in Malaysia