Posts tagged ‘Malaysia’
The World Health Organisation has recorded 238 cases of the disease and 92 deaths related to the MERS-CoV globally to date.
Eight more H7N9 influenza cases have been reported from four of China’s provinces over the past 3 days, signaling that cases may be leveling off from a burst of infections that appeared to coincide with Lunar New Year activity.
The cases are from four Chinese provinces, according to official notices from Hong Kong’s Centre for Health Protection (CHP) and provincial health department notices translated and posted by the FluTrackers infectious disease news message board.
Provincial health ministry reports
Three of the newly confirmed infections involve patients from Guangdong province, one of the main H7N9 hot spots during the second wave of infections. They include a 4-year-old girl, a 79-year-old man, and a 44-year-old man.
Hunan and Anhui provinces each reported two cases. Hunan’s two case-patients include a 46-year-old man whose infection was first reported on Feb 15 and a 64-year-old man whose illness was reported today. The patients from Anhui are a 14-year-old girl whose infection was reported on Feb 15 and a 63-year-old man whose positive H7N9 test was reported the following day.
The eighth case-patient is an 84-year-old man from Jiangsu province whose infection was reported yesterday.
The CHP, which issued statements today and yesterday announcing seven of the new cases, said the patients are receiving treatment in hospitals.
Reports of eight more cases from China lift the number of cases reported in the outbreak’s second wave to 221, compared with 136 reported during the first wave. Also, the new reports boost the overall outbreak total to 357, according to FluTrackers’ running total.
WHO details latest confirmations
In other developments, the World Health Organization (WHO) today posted two updates on H7N9 cases in China, one on seven reports it received from the country on Feb 13 and one on an infection in a Chinese traveler to Malaysia, the first to be detected outside China.
In the report on the seven cases on the mainland, the WHO said all of the patients are male, ranging in age from 8 to 84 years. All of them have a history of exposure to live poultry. Three are hospitalized in critical condition, three are listed as severe, and one patient—an 8-year-old boy—has a mild infection.
Illness onset dates ranged from Jan 28 to Feb 6, according to the WHO.
The WHO’s report on the visitor to Malaysia contained some new details but confirmed other reports. Based on information it received from Malaysia’s health ministry, the WHO said the 67-year-old woman was treated in Guangdong for fever, cough, flu, fatigue, and joint pain 4 days before she traveled to Malaysia. The timing of symptom onset and her travel dates suggest that she was probably exposed to the virus before she arrived in Malaysia.
She and her tour group, which included family members, stayed overnight in Kuala Lumpur upon their Feb 3 arrival in Malaysia and then visited Sabah from Feb 4 to 6.
Malaysia’s health ministry is investigating the woman’s illness, tracing her contacts, and sharing information with Chinese health officials, the report said.
The WHO reiterated its assessment that community spread of the virus from exported H7N9 cases in travelers is unlikely, given that H7N9 so far doesn’t transmit easily among humans. It said more sporadic cases are expected in China and possibly neighboring countries, and it urged travelers to countries with known outbreaks to avoid live poultry settings.
Officials institute more poultry controls
In poultry developments, Guangzhou, capital of Guangdong province, on Feb 15 temporarily closed poultry markets for 2 weeks to control the spread of H7N9, according to a Feb 14 Associated Press (AP) report. The announcement appeared on provincial government microblog.
The province, along with Zhejiang province, has been among the hardest-hit areas, especially in the second wave of infections.
In other developments, Vietnam’s government is stepping up efforts to prevent the spread of the virus to its poultry, according to recent media reports. The country’s agriculture ministry, after a meeting with officials on Feb 13, announced a ban on Chinese poultry, Than Nien News, a Vietnamese media outlet, reported on Feb 14. During the meeting authorities aired concerns about H7N9 detections in people and poultry in China’s Guangxi province, which borders northern Vietnam.
Local officials have been ordered to boost surveillance and test birds in poultry markets in Vietnam’s northern region, according to the report.
Health officials announced an H7N9 avian flu infection in Malaysia today, the first case detected outside of China, along with eight other newly confirmed cases—one in Hong Kong and seven more from the mainland.
The patients who are sick with H7N9 infections in Hong Kong and Malaysia had travel links to China’s Guangdong province, one of the main hotspots of disease activity in the outbreak’s second wave.
Today’s new cases lift the number of H7N9 cases reported in the second wave, which began in October, to 211, compared with 136 reported during the first wave last spring. For both waves, the total is 347, according to a list of confirmed cases kept by FluTrackers. The unofficial death count remains at 72.
CDC: Malaysia case underscores surveillance priority
Malaysia’s patient is a 67-year-old woman who was part of a tour group from Guangdong province, according to a report today from Bernama, Malaysia’s national news agency. The group was visiting Sabah. The woman is being treated in the intensive care unit at a private hospital in Kota Kinabalu.
The country’s health minister, Datuk Seri Dr. S. Subramaniam said it was the first H7N9 case reported in the country and that health officials are taking steps to limit contact with the patient.
The US Centers for Disease Control and Prevention (CDC) today issued a statement on the Malaysian H7N9 case, which said the agency has been expecting the detection of H7N9 cases exported from China, including the scenario of an infected traveler. It said the illness in a traveler to Malaysia doesn’t change its risk assessment for the H7N9 virus.
The CDC said the most important element in gauging the public health threat is transmissibility, and so far there is no evidence of sustained, ongoing person-to-person spread of H7N9. It emphasized, however, that the case underscores how important international surveillance is for H7N9 and other viruses that have pandemic potential.
Human infections in China linked to poultry exposure are likely to continue, the CDC said, and the virus could spread to neighboring countries, where it could infect people who are exposed to poultry. The most worrisome development would be if the virus gained the ability to spread easily among people, a possibility that the CDC said it and other international health partners are closely monitoring.
Hong Kong’s travel-linked case
Meanwhile, Hong Kong’s Centre for Health Protection (CHP) said it has detected an H7N9 infection in a 65-year-old resident who started having symptoms while visiting the city of Kaiping in Guangdong province. The case is the fifth H7N9 infection detected so far in Hong Kong, and all have had travel links to China’s mainland.
During the patient’s stay in Kaiping between Jan 24 and Feb 9, his family bought a slaughtered chicken in the village on Jan 29. Upon his return to Hong Kong on Feb 9 he saw a doctor, and yesterday the man was hospitalized and is now in critical condition in an isolation unit, according to a CHP statement.
Seven of the man’s family members in Hong Kong are asymptomatic, and five of them that are close contacts will be admitted to the hospital for observation and testing, the CHP said. Further investigations are under way into the man’s travel and exposure history, and the CHP is working with mainland authorities to identify the man’s contacts during his stay in Kaiping.
Seven new H7N9 cases from the mainland
The seven latest H7N9 cases reported on the mainland include three from Guangdong province, three from Zhejiang, and one from Hunan, according to provincial health ministry reports in Chinese translated and posted by Avian Flu Diary (AFD), an infectious disease news blog, and FluTrackers, an infectious disease news message board.
Guangdong province’s patients include an 8-year-old boy who is hospitalized in stable condition, a 46-year-old male farmer who is in critical condition, and a 65-year-old male farmer, also in critical condition.
In Zhejiang province, newly confirmed case-patients are all adult men who work as farmers, including an 84-year-old who is in critical condition, a 58-year-old who is in severe condition, and a 46-year-old who is also in severe condition.
The patient from Hunan province is a 19-year-old man who is hospitalized, according to AFD and FluTrackers.
Five more markets yield positive samples
In other developments, China’s agriculture ministry yesterday reported five more detections of H7N9 in poultry and their environments, according to report to the World Organization for Animal Health (OIE).
One was at a livestock market in Guangxi province, an area that recently reported two human cases and shares a border with Vietnam, fueling worries that porous borders and frequent poultry trade could spread the virus beyond the China.
Tests on 261 samples from the market in the Guangxi city of Guigang yielded four positive samples, all from chickens, according to the OIE report.
Elsewhere, surveillance activities in a live-bird market in the Zhejiang province city of Zhuji found 1 positive environmental sample among 19 that were tested, and tests on 42 chicken samples from a live-bird market in the Guangdong province city of Meizhou also found 1 positive. At a wholesale market in Zhuhai in Guangdong, officials took 360 samples and found 2 positives from chickens.
The fifth detection was in from a live-bird market in the Hunan province city of Yueyang. Of 137 specimens collected, officials detected H7N9 in 2 chicken samples and 1 duck sample.
Deaths from dengue fever have nearly tripled in Malaysia this year compared to the same period in 2013, sparking a stepped-up campaign to control the mosquitoes that spread the virus.
Health Minister S. Subramaniam says as of this week, 22 people had died from dengue in 2014 – compared to eight deaths over the same stretch last year.
While still early in the year, at the current pace the numbers would surpass 2010 – the deadliest year on record, when 134 people died from the illness.
A total of 11,879 cases had been reported as of Monday, up nearly four-fold from the same period in 2013.
“I think the number of cases will increase,” Mr Subramaniam said.
“We urge the public to play their role. The spike in cases is putting a strain on our medical services.”
More than 43,000 cases were reported in 2013, with 92 deaths, up from 35 dead the year before.
“Every three to four years, we witness a peak in the cycle,” Mr Subramaniam said.
Dengue fever is a flu-like illness marked by symptoms including nausea, headache, and severe muscle and joint pain that gives rise to its nickname “break-bone fever”.
In severe cases, it can cause internal bleeding, organ impairment, respiratory distress and death.
Dengue is transmitted by the Aedes aegypti mosquito, which can pick up the virus from an infected human and transmit it to the next person it bites.
According to the World Health Organisation, which has labelled dengue one of the fastest-growing viral threats globally, the disease may be infecting up to 50-100 million people each year.
There is no vaccine, so prevention focuses on mosquito control.
Malaysian authorities have stepped up a nationwide campaign to fumigate or eliminate mosquito breeding hotbeds in standing water, garbage dumps and construction sites.
This includes what authorities have called the first large-scale use in Malaysia of the biological agent bacillus thuringiensis israelensis, or BTI, a naturally-occurring bacterium used in insect control.
The government also has ordered local clinics in dengue “hot spot” areas – which have been concentrated in and around the capital Kuala Lumpur – to extend their operating hours to accommodate the roughly 2,000 new cases emerging weekly.
“Hot spot” residents also are being advised to wear long sleeves and use mosquito repellent.
Researchers estimate around three billion people live in regions of the world susceptible to dengue.
Prof Dr Awang Bulgiba Awang Mahmud.
KUALA LUMPUR: Doctors should be rewarded for promoting good health and keeping people out of hospital, in addition to treating those who are already sick.
A public health expert said any new healthcare model should consider this as preventive care is more cost effective than curative care.
Universiti Malaya deputy vice-chancellor (Research and Innovation) Prof Dr Awang Bulgiba Awang Mahmud noted that under Britain’s National Health Service, general practitioners are rewarded for keeping patients out of hospital.
“I hope a Malaysian model will be less likely to reward the use of (health services) but more likely to reward doctors for keeping their patients healthy and out of hospitals.”
In Britain, GPs are paid cash incentives to improve healthcare. The “pay-for-performance” scheme is designed to pay work by doctors that previously wasn’t funded, such as managing conditions like hypertension as well as monitoring smokers and obese patients.
Prof Awang Bulgiba said there were three grand challenges facing the healthcare system – the rise in lifestyle diseases, an ageing population and rapidly spreading infectious diseases. He said any new healthcare model must address these factors.
“The rise in lifestyle diseases such as cardiovascular conditions, cancer and diabetes is due to our sedentary lifestyles and environmental changes.
“The cost of statins and lipid lowering drugs is getting higher. Healthcare is getting more expensive because more people are affected by these non-communicable diseases,” said Prof Awang Bulgiba, adding that the private sector must play a role in preventive care, which until now has almost exclusively been the preserve of the Government.
He noted that the top cause of deaths in government hospitals was heart disease. The increase in the rate of diabetes prevalence is worrying too. In the National Health and Morbidity Surveys, it increased from 8% in 1996 to more than 14% in 2006. In the fourth survey in 2011, the rate of diabetes was an alarming 20.8%.
Other than the rise in lifestyle diseases, Prof Awang Bulgiba also noted Malaysia’s ageing population would put stress on the country’s healthcare.
“By 2035, more than 7% of Malaysia’s population will be 60 years or older. Healthcare must recognise this fact and take steps to prepare for it,” said Prof Awang Bulgiba, who was the first Malaysian doctor to gain a PhD in Medical Informatics.
He said that with cheap air travel, infectious diseases like SARS and H5N1 can spread faster than ever before.
“What used to take months, now takes days to spread,” he said, noting that Chikungunya, a viral disease from Africa, has been detected in Malaysia.
Prof Awang Bulgiba also highlighted the disparity in the allocation of resources between the public and private healthcare sectors.
In 2011, public healthcare providers had 41,616 beds compared to 13,568 in private facilities.
“Although government institutions provide 75% of beds, only 40% of doctors work in the public sector with the majority in private practice,” he noted.
Prof Awang Bulgiba said there was also an imbalance of resources in healthcare. For example, there are far too many MRIs (magnetic resonance imaging machines) in the Klang Valley, “probably more than in the whole of Australia.”
He was speaking at a lecture on The Evolution of Public Healthcare in Malaysia held at UM recently after his election as a fellow of the Academy of Sciences Malaysia (ASM).
Prof Awang Bulgiba also talked about the rapid growth of private healthcare in Malaysia.
There has been a proliferation of private healthcare facilities, from 174 in 1992 to 660 in 2011. In 1980, there were only 50 private hospitals but in 2011, the number had grown to 220.
The share of private healthcare expenditure has been rising and is almost on par with government spending, from 5.8% in 1981 to 45.4% in 2009.
Looking at the bigger picture, Malaysia’s total expenditure on health was RM33.7bil or 4.96% of Gross Domestic Product. This is below the World Health Organisation’s recommended level of not less than 5% of a country’s GDP.
“As a comparison, the United States spends 15% of its GDP on healthcare,” said Prof Awang Bulgiba.
He noted that although Malaysia has made great strides in healthcare, there is concern on whether the current model is sustainable.
Rising costs would eventually force the government to evaluate how a national healthcare financing scheme can be implemented. Previous attempts, including the 1Care for 1Malaysia plan, have failed to get off the ground following opposition from stakeholders.
“I hope the new model will integrate the public and private healthcare facilities to promote equitable access,” said Prof Awang Bulgiba.
KUALA LUMPUR: Malaysia and Singapore have signed the first health sector deal related to pharmaceutical regulatory matters in a move that hopes to see a boosting of healthcare services in both countries, government officials told Bikyamasr.com on Thursday.
Health Minister Datuk Seri Liow Tiong Lai said the agreement “was a new milestone” in cooperation as both Malaysia and Singapore faced similar challenges in the pharmaceutical field.
“With this collaboration, we will be able to achieve a win-win situation as we can combine resources to eventually save cost and time,” he said after the inking of the deal on Wednesday.
Liow said the agreement would enable both countries to share information on pharmaceutical regulatory matters and would include information related to safety issues.
“The sharing of information by both countries is vital to the public as this will include information on product recalls and other developments in the pharmaceutical sector.
“This will enable both countries to take appropriate and immediate action towards protecting and ensuring the safety of the people,” he said, adding that the health agreement would also allow for joint evaluation and audits which would reduce timelines for pharmaceutical product registration for both countries.
“We will also be able to cooperate by conducting mutual exchange of courses, seminars, attachment training, study visits and other related activities,” he said.
Liow said the deal would also help strengthen enforcement, especially against illicit drugs and contraband products in both countries.
“Through the cooperation, we will be able to share information, track down and trace illicit drugs to ensure that the people from both countries will not receive such materials,” he said.
Read More: Bikya Masr