Viral Aetiology of Acute Flaccid Paralysis Surveillance Cases, before and after Vaccine Policy Change from Oral Polio Vaccine to Inactivated Polio Vaccine

Since 1992, surveillance for acute flaccid paralysis (AFP) cases was introduced in Malaysia along with the establishment of the National Poliovirus Laboratory at the Institute for Medical Research. In 2008, the Ministry of Health, Malaysia, approved a vaccine policy change from oral polio vaccine to inactivated polio vaccine (IPV). Eight states started using IPV in the Expanded Immunization Programme, followed by the remaining states in January 2010. The objective of this study was to determine the viral aetiology of AFP cases below 15 years of age, before and after vaccine policy change from oral polio vaccine to inactivated polio vaccine. One hundred and seventy-nine enteroviruses were isolated from the 3394 stool specimens investigated between 1992 and December 2012. Fifty-six out of 107 virus isolates were polioviruses and the remaining were non-polio enteroviruses. Since 2009 after the sequential introduction of IPV in the childhood immunization programme, no Sabin polioviruses were isolated from AFP cases. In 2012, the laboratory AFP surveillance was supplemented with environmental surveillance with sewage sampling. Thirteen Sabin polioviruses were also isolated from sewage in the same year, but no vaccine-derived poliovirus was detected during this period

Use of the Reverse Transcriptase Polymerase Chain Reaction for Diagnosis on Dengue Virus Infection Compared to IgM-ELISA

Applicability of the reverse transcriptase polymerase chain reaction (RT-PCR) was evaluated as a routine rapid diagnostic test for dengue virus infection. A total of 160 acute phase sera from patients with clinical diagnosis of dengue fever was examined both by the RT-PCR and IgM-ELISA. Of these, 9 (6%) were positive for both RT-PCR and IgM-ELISA, 61 were positive for IgM-ELISA only and 31 (19%) for RT-PCR only. Both techniques gave negative results in the remaining 59 (37%) specimens. The diagnostic efficiency of IgM-ELISA was statistically better than the RT-PCR even when the specimens were collected on the 3rd or 5th days of the disease. Considering the operational cost in the tests, the acute serum specimens should first be tested by the IgM-ELISA, followed by the RT-PCR on the negative specimens in order to increase the diagnostic efficiency with reasonable cost

Avian Influenza (H7N9) Virus Infection in Chinese Tourist in Malaysia, 2014

Of the ≈400 cases of avian influenza (H7N9) diagnosed in China since 2003, the only travel-related cases have been in Hong Kong and Taiwan. Detection of a case in a Chinese tourist in Sabah, Malaysia, highlights the ease with which emerging viral respiratory infections can travel globally

A Virological Study of Enterovirus Infections in Peninsular Malaysia

Background: Hand, foot, and mouth disease (HFMD) is a common illness in infants and children. It can be caused by many different human enteroviruses. Of these human enteroviruses, human enterovirus 71 (EV71) infection is more frequently associated with serious neurological complications and fatalities. The emergence of this virus emphasized the need for surveillance study and identification of EV71 to provide early warning of potential EV71 encephalitis outbreaks and assist in directing public health interventions as well as inform clinical decisions. This surveillance study was aimed to examine the prevalence of enteroviruses and EV71 in suspected clinical specimens. Methods: Samples preparation: Specimens with the clinical and epidemiological data were received from various hospitals in West Malaysia from January to December 2007. The samples were analyzed immediately upon arrival in our laboratory otherwise stored at −80 ◦C. RNA extraction: The RNA from the specimens were extracted using High Pure Viral Nucleic Acid Kit. PCR analysis and primer sequences: One step RT-PCR was employed with primers EVPCR1 (5�-ACA-CGG-ACA-CCCAAA-GTA-GTC-GGT-TCC-3�) and EVPCR2 (5�-TCC-GGC-CCCTGA-ATG-CGG-CTA-ATC-C-3�) for enteroviruses and MAS01S (5�-ATA-ATA-GCA-YTR-GCG-GCA-GCC-CA-3�) and MAS02A (5�-AGA-GGG-AGR-TCT-ATC-TCY-CC-3�) for EV71. Results: A total number of 2,381 clinical specimens were analyzed for the presence of enteroviruses and EV71 by RTPCR analysis. Out of all of the specimens analyzed, 531 (22.3%) were positive for enteroviruses and 21 (0.04%) of these were positive for EV71. These results showed that EV71 is less prevalent than other enteroviruses in the clinical specimens analyzed. Conclusion: The outcomes of the present surveillance study suggested that the EV71 which is more frequently associated with serious neurological and complications and fatalities is less prevalent than other enteroviruses. The results obtained also confirmed the usefulness of the PCR as a simple and rapid method for the detection of enteroviruses and discrimination of EV71 from other enteroviruses in clinical specimens

Epidemiology Study of Human Metapneumovirus in Malaysia among Paediatric Children below 4 years of age, 2012

We have done a specific study on the molecular epidemiology of Human Metapneumovirus cases which was found in Malaysia among paediatric children below 48 months of age from January till December 2012. These paediatric cases were isolated from the rest of those entire positive below 48 months of age. The total number of the positive cases below 48 months of age is 53 cases out of the general population of 438 positive cases. We performed phylogenetic analysis on these patients and a seasonal prevalence hMPV incidence was observed in the month of November. A high level of sequence identity was observed in the A2 subgroup and no amino acid substitution was found compared to the strains observed in Malaysia and other countries. The pairwise distance among the strains belonging to the predominant subgroup A2was0.0925 suggesting highly homologous with seasonal epidemics. Keyword: Molecular epidemiology, human metapneumovirus, polymerase chain reaction (PCR), paediatric, phylogenetic analysis

Epidemiology and molecular characterization of chikungunya virus involved in the 2008 to 2009 outbreak in Malaysia

International audienceThe 2008 to 2009 outbreak of chikungunya was considered as the huge and worst outbreak of CHIKV (Chikungunya virus) infections in history of the country affecting all states in both Peninsular and East Malaysia. This was unlike the first outbreak in late 1998, which was only restricted to Klang district in Selangor and six years later the second outbreak which only involved the state of Perak. The objective of the study was to detect the presence of chikungunya antibody and antigen by immunofluorescence technique and RT-PCR from the sera samples. A total of 2,692 sera samples were received in 2008, in which 19.2% were positive by antibody detection and 42.6% were positive by RT-PCR. The following year in 2009, the samples size increased to 3,592, only 16.3% sample were positive by antibody detection and 31.7% were positive by RT-PCR. Majority of the hospitalized cases were adults between 30 to 60 years of age and the highest incidence rate was amongst patients' age between 40 to 49 year old. In 2008, most of the confirmed CHIKV infection cases were female but the opposite was seen in 2009, where more male cases were reported. In this outbreak, the prominent ethnic group affected was the Malays. CHIKV involved in the 2008 to 2009 outbreaks was the new Central/East African genotype which was found to be similar with strains causing the outbreaks in the India Ocean and main CHIKV genotype circulating in the European countries from 2006 to 2009

Epidemiology and molecular characterization of chikungunya virus involved in the 2008 to 2009 outbreak in Malaysia

International audienceThe 2008 to 2009 outbreak of chikungunya was considered as the huge and worst outbreak of CHIKV (Chikungunya virus) infections in history of the country affecting all states in both Peninsular and East Malaysia. This was unlike the first outbreak in late 1998, which was only restricted to Klang district in Selangor and six years later the second outbreak which only involved the state of Perak. The objective of the study was to detect the presence of chikungunya antibody and antigen by immunofluorescence technique and RT-PCR from the sera samples. A total of 2,692 sera samples were received in 2008, in which 19.2% were positive by antibody detection and 42.6% were positive by RT-PCR. The following year in 2009, the samples size increased to 3,592, only 16.3% sample were positive by antibody detection and 31.7% were positive by RT-PCR. Majority of the hospitalized cases were adults between 30 to 60 years of age and the highest incidence rate was amongst patients' age between 40 to 49 year old. In 2008, most of the confirmed CHIKV infection cases were female but the opposite was seen in 2009, where more male cases were reported. In this outbreak, the prominent ethnic group affected was the Malays. CHIKV involved in the 2008 to 2009 outbreaks was the new Central/East African genotype which was found to be similar with strains causing the outbreaks in the India Ocean and main CHIKV genotype circulating in the European countries from 2006 to 2009

RESEARCH NOTE MONITORING OF THE H275Y MUTATION IN PANDEMIC INFLUENZA A(H1N1) 2009 STRAINS ISOLATED IN MALAYSIA

Abstract. The 2009 pandemic influenza A(H1N1) infection in Malaysia was first reported in May 2009 and oseltamivir was advocated for confirmed cases in postexposure prophylaxis. However, there are cases of oseltamivir-resistance reported among H1N1-positive patients in other countries. Resistance is due to substitution of histidine by tyrosine at residue 275 (H275Y) of neuraminidase (NA). In this study, we have employed Sanger sequencing method to investigate the occurrence of mutations in NA segments of 67 pandemic 2009 A(H1N1) viral isolates from Malaysian patients that could lead to probable oseltamivir resistance. The sequencing analysis did not yield mutation at residue 275 for all 67 isolates indicating that our viral isolates belong to the wild type and do not confer resistance to oseltamivir

Avian Influenza (H7N9) Virus Infection in Chinese Tourist in Malaysia, 2014

Of the ≈400 cases of avian influenza (H7N9) diagnosed in China since 2003, the only travel-related cases have been in Hong Kong and Taiwan. Detection of a case in a Chinese tourist in Sabah, Malaysia, highlights the ease with which emerging viral respiratory infections can travel globally