Questions have been rightly raised, both in the newsgroups on the Internet as well among the public, as to why the Malaysian health authorities have not requested the help from the Singapore health authorities when the Malaysian government could ask for help from the Centre for Disease Control and Prevention (CDC) in Atlanta and the National Institute of Health in Tokyo.
I agree with some of the sentiments expressed on the Internet newsgroups and call on the Health Minister, Datuk Chua Jui Meng to contact his Singapore counterpart for assistance, as it is believed that Singapore has the up-to-date technology and state-of-the-art laboratories.
The failure of the Malaysia and Singapore medical and health experts to co-operate to combat the viral epidemic in Sarawak despite the loss of 26 lives is one of the most tragic consequences of the recent strain and tensions in Malaysia-Singapore relations, which shows how the ASEAN spirit of co-operation had been harmed in the process despite ASEAN celebrating its 30th anniversary this year.
If not for the recent spats between Malaysia and Singapore, Singapore would have been the first source of assistance enlisted by the Malaysian authorities to combat the viral epidemic in Sarawak as both countries are neighbours.
As one contributor to the Internet newsgroup had suggested, it is time for Malaysia and Singapoe to bury the hatchet and end the politicking so that lives might be saved. This would be for the good not only of Malaysia but also for Singapore, for Singaporeans cannot expect to be safely quarantined if there is a major viral epidemic in the region threatening the lives of infants.
Of course, the Singapore authorities can make things even easier if they express willingness to give the fullest co-operation in the battle to save lives, and in the process, repair the injured relationship between the two countries.
It is a failure of the viral epidemic crisis and public relations management when the Health Minister, Datuk Chua Jui Meng and the mass media continue to talk about Coxsackie B Virus epidemic when this has not been established at all.
Chua Jui Meng, for instance, would never live down his most unprofessional announcement as Health Minister on June 9 which caused one national newspaper, The Star, to splash the front-page headline "IT�S COXSACKIE" leading with the report:
"Kuala Lumpur: The Health Ministry has confirmed that the killer viral outbreak in Sarawak is caused by a virulent strain of the Coxsackie Virus B and called on parents nationwide to be extra careful with their children.
"Minister Datuk Chua Jui Meng said the virus� identity was confirmed yesterday by the Institute for Medical Research (IMR) after studying the cultures of specimens from four victims."
In actual fact, more than two months after the first death from the deadly viral outbreak on April 14, the authorities do not know whether the virus is Coxsackie B, A or any other enterovirus.
As the latest update of the University of Nebraska Medical Centre website monitoring the viral epidemic in Sarawak reported:
"To date, only the enterovirus called enterovirus 71 (or EV71), has been shown in samples from patients, one a fatality and one a hand-foot-mouth disease (HFM) case. To the best of our knowledge, there has been no demonstration of a coxsackievirus. A coxsackievirus has not been excluded; merely, to date, only EV71 has been demonstrated."
However, the Malaysian mass media, both printed and electronic, continue to refer to the viral outbreak as Coxsackie Virus epidemic.
For instance, Radio 4 news yesterday (June 17) reported that two persons were hospitalised with the Coxsackie A virus, one in Seberan Jaya and the other in Bukit Mertajam.
The Health Minister announced yesterday that under the Prevention and Control of Infections Diseases Act 1988, myocarditis (acute inflammation of the heart) had been gazetted in the schedule of infectious diseases - the 25th disease in the schedule. The last disease to be gazetted was Ebola following an outbreak in Zaire last year.
As a result of the gazette, government and private hospitals and clinics must notify the Health Ministry of deaths caused by myocarditis and any other life-threatening microbial or viral infection.
Is Sarawak the first in the world to declare and gazette myocarditis a deadly disease, when myocarditis could be caused by viral attack or by other non-viral factors?
The unprecedentedly large sweep in gazetting myocarditis as the 25th scheduled disease under the Prevention and Control of Infectious Diseases Act 1988 shows the tragic fact that after more than two months after the viral epidemic, we know very little about what caused the death of 26 infants!
The anger being shown by the Health Minister in the past few days, blaming parents for not being serious about the "coxsackievirus outbreak" is most amazing, when it Chua Jui Meng and other government leaders who had been advising the parents not to be alarmed - with even the Sarawak Deputy Chief Minister, Dr. George Chan, declaring on Sunday that he expected the "outbreak of the Coxsackie B virus to be over soon".
The government should review both the epidemic crisis management as well as the public relations management to restore public confidence, and the first step is for the Health Minister to give way to a professional officer to take over the overall conduct of the crisis management as well as public relations management of the viral epidemic.
(18/6/97)