(Petaling Jaya, Sunday): When I spoke in Parliament during the debate on the Royal Address on April 8, 1999, I said that over 90 per cent of the deaths in Bukit Pelanduk, until recently the biggest pig-rearing centre not only in Malaysia but in South-East Asia, were unnecessary and avoidable - the result of criminal negligence and in particular Ministerial bungling in not putting in place an effective programme to contain the viral outbreak when deaths began to mount - at least by March 5, when there were already eight deaths in the Bukit Pelanduk area.
I had also pointed out that as early as January 16, a top Malaysian virologist Jane Cardoza from Unimas, Sarawak had already raised the alarm that it was probably not the Japanese encephalitis (JE) virus which was the causing the havoc to lives and the industry, but another killer virus.
I now wish to revise what I said in Parliament, and to declare that all the 85 deaths in Negri Sembilan (80 in Bukit Pelanduk and 5 in Sikamat) were avoidable and unnecessary and the ruination of the RM2.5 billion pig rearing and pork industry could have been averted if the Health Ministry had heeded the warning as far back as November that they should be looking for another virus killer.
The gravity of Ministerial bungling has been further highlighted in the recent article on the viral encephalitis disaster in Malaysia in the 16th April 1999 (Volume 284) of the Science magazine, the publication of the American Association for the Advancement of Science, entitled "New virus fingered in Malaysian Epidemic" by Martin Enserink.
Reporting on the unmasking of a new virus killer in Malaysia, the article said that the Malaysian health authorities initially assumed that they were dealing with an outbreak of JE, which causes similar symptoms. It reported the US Center for Disease Control (CDC) as stating that the Nipah virus was the main culprit and that the JE virus had played "at best a marginal role in the continuing tragedy."
It said:
"As for a link with JE, most researchers now think that a few cases of JE may have occurred simultaneously when the outbreak began but that JE didn't cause the epidemic. The presence of antibodies in some patients, they say, is not surprising given JE's prevalence in Malaysia, and because many people--especially pig industry workers--may have been exposed to JE without getting sick. ‘I don't think JE has been involved in any significant way in this current epidemic,’ says Mahy [director of CDC's div. of viral and rickettsial diseases].
"But Malaysian health authorities remain convinced that JE is involved. Lam (Lam Sai Kit, head of the University of Malaya department of medical microbiology) says he alerted the ministry immediately after the CDC informed him on 18 March about the new virus. But 5 days later, a press release by the ministry's director-general summed up the arguments behind the initial diagnosis and repeated that ‘the present outbreak is confirmed as JE.’ The release briefly mentioned the discovery of the Hendra-like virus but said ‘we are not sure if the virus is a pathogen.’
"This week, Mohamad Tah Arif, director of the Disease Control Div. of the Malaysian Min. of Health, said that ‘currently the [Nipah} outbreak is more prominent,’ but insists there is a dual epidemic and that measures to prevent the spread of JE need to remain in place. He says there wasn't enough proof on 18 March to say the new virus had caused the epidemic.
"Some Malaysian scientists say they are not surprised at the government's rigidity. Jane Cardosa, a virologist at the Inst. for Health and Community med. at the UM in Sarawak, says she called the health ministry in Nov. and again in Jan., urging officials to look for alternative infectious agents. She also expressed her doubts in a Jan. message to ProMED, an electronic forum for emerging-disease researchers. The government's response, she says, was an e-mail reprimanding her for questioning the official theory. ‘The ministry made an early presumptive diagnosis, and they had difficulty admitting it was a mistake,’ she says. When costly fogging and vaccination campaigns failed to halt the disease, she adds, ‘it became even more difficult to admit there was an error.’ Lam too says ‘it was quite obvious to us right from the beginning that not all the cases were due to JE.’ But not being involved in the official investigation, he didn't look for other possible culprits.
"David Quek, editor of the journal of the Malaysian Med. Assoc., says the episode reminds him of a heart infection outbreak in Sarawak in 1997, in which more than 20 children died. Health authorities blamed that epidemic on the Coxsackie virus--and kept doing so long after scientists had ruled it out as the culprit. This time, says Quek, ‘we hope that the authorities can be more enlightened. Sometimes it's all right to admit an error.’
With this report and revelation that as far back as November, the Health Ministry had been alerted to look for another killer virus apart from the JE virus, it is clear that all the 85 deaths in Negri Sembilan could have been avoided if this warning had been heeded, as the first case of viral encephalitis in Bukit Pelanduk started only in the last week of February and even the first case of viral encephalitis in Sikamat was only reported in early January.
After Chua Jui Meng’s misdiagnosis and mishandling of the so-called Coxsackie B Virus epidemic in Sarawak (which killed 41 people and not 20 as mentioned by David Quek in the Science article), it is most tragic that there should be another misdiagnosis, mistreatment and mishandling of another viral outbreak disaster costing 100 lives and the collapse of the RM2.5 billion pig rearing and pork industry.
It is most unsatisfactory and disgraceful that Malaysians had to depend on foreign sources to get information about what is happening in their own country, including about the viral encephalitis disaster. For instance, last Wednesday, 21st April, 1999, the World Health Organisation Regional Office for the Western Pacific in Manila gave the following statistics about the viral encephalitis outbreak in Malaysia:
"Since the beginning of the outbreak in October 1998 until 19 April 1999, there have been a total of 256 cases and 98 deaths. Of the deaths for which tests have been completed, 40 were due to Nipah virus, 8 to Japanese encephalitis (JE) and 17 had a dual infection of JE and Nipah virus."
Chua Jui Meng has refused up to now to admit that the JE is a marginal problem in the viral encephalitis outbreak which had killed 100 people, and that it is primarily caused by the Nipah virus.
I call on the Health Minister, Datuk Chua Jui Meng to make amends for his shocking Ministerial bungling and incompetence in allowing the viral encephalitis outbreak in Perak last month, which had already claimed the lives of some 15 people, to get out of control until one hundred lives were sacrified and the RM2.5 billion pig rearing and pork industry virtually collapsed.
As a first step, the Cabinet should increase from RM50 to RM200 as compensation for each pig destroyed. The government should fully understand and sympathise with the pig farmers who are dissatisfied with the financial aid for the destruction of their animals, especially as it is now clear that they are the victims of gross government negligence and incompetence in refusing to heed warnings as far back as last November that it was not the JE virus which was the killer virus.
(25/4/99)