Asia Times: Mysterious epidemic aided by poor sanitation



	April 01, 1999	atimes.com

Southeast Asia

Mysterious epidemic aided by poor sanitation
By Anil Netto

PENANG - A deadly epidemic caused by amysterious virus in Malaysia has exposed serious flaws in theinspection, management and sanitation of pig farms, and thecontrol of infectious diseases in the country.

Malaysia is racing against time in its all-out war against thevirus - suspected to be carried by pigs and now transmitted tohumans - that has killed 76 people so far.

Officials and health experts at first attributed the outbreakto Japanese encephalitis, a virus that normally affects pigs and,in unusual circumstances, humans. But now there is evidence ofanother virus that they have yet to identify.

To try to control the virus's spread, the government hasdispatched 52 culling squads that have destroyed some 150,000 pigson the Malay peninsula. About a million, or a third, of thepeninsula's 2.7 million pigs are to be shot in the massive cullingoperation.

Medical experts are racing to identify the virus that hasvirtually wiped out the pig farming industry, brought loss oflivelihood among pig farm owners and spread fear among manycommunities.

But beyond the search to identify and control the virus,experts say it appears that unsanitary conditions and poorregulation of pig farms, a sensitive issue in this mainly Muslimcountry, may have facilitated the spread of the virus.

''It's horrible,'' retired senior health inspector Noel Thangamsays of sanitary conditions on the farms. ''Effluent is just letloose."

Asked at a recent press conference if he was satisfied with the state of hygiene on pigfarms, Health Minister Chua Jui Mengpointedly refused to comment.

''The sanitation aspect is lacking.,'' agrees Thangam. ''If youreally go into the farms, you will see they are in a deplorablestate. It's really terrible, especially in the new villages. Noone cared about the sanitation aspect: it's a fact."

Almost three-quarters of the peninsula's 2,000-odd farms aremedium-sized operations with 100 to 2,000 pigs each. The remainderare more professionally managed, larger farms with morethat 5,000 pigs each.

It is largely the medium-sized farms that are in bad shape,says the official. ''Everything boils down to sanitation,'' hesays.''The authorities should have used their powers to pounce onthe culprits."

''The fault lies with the local authorities and the farmers,''says Thangam.

Local town councils, which have veterinary, health and licensingsections, are responsible for inspecting and issuing licenses forpig farms.

But in reality they do little more than check Biological OxygenDemand - which measures to what extent organisms have to fightfor available oxygen - in the effluents to make sure it does notexceed acceptable standards.

But even in this area, control is lax. ''The pig farms were notreally inspected as long as they paid their annual licenses fees,''says Thangam. ''The authorities have to be very strict."

The problem, says another health inspector working with a towncouncil who spoke on condition of anonymity, is the lack ofpolitical will to crack down on unhygienic pig farms.

''Effluent goes into a pond and it is stagnant; you can see theculex mosquito breeding,'' he says, referring to the mosquito thatspreads Japanese encephalitis among pigs.

''Pig rearing is in a mess, slaughtering is in a mess. But noone wants to make decisions,'' he laments.

Some theorize the reason for the lack of political will couldstem from sensitivities in Malaysian society.

For the ethnic Chinese, who make up about 30 percent ofMalaysia's 21 million people, pork comprises a key part of theirdiet. But it is taboo to the Muslims who make up more than halfthe population. (Only non-Muslims take part in thepig culling operation.)

So officials turn a blind eye to the pig industry and mostlypretend that unhygienic farms do not exist, some analysts say.

Many pig farmers did not invest in treatment plants to clearthe effluents, apart from the most rudimentary of earth ponds oraeration treatment (the pumping of air into the effluent).

All the rivers in mainland Penang, for instance, are heavilypolluted with pig waste, apart from industrial discharge. ''If[the pig farmers] had been more hygienic in the disposal ofwaste, it might have lessened the chance of transmission'' of themystery virus,'' Chan told IPS.

Meantime, an eight-member medical team from the Atlanta-basedCenters for Disease Control and Prevention have set up a speciallaboratory at the University Hospital near Kuala Lumpur toidentify the virus. Joining them are local experts and Australianscientists.

The human fatalities were at first all attributed to Japaneseencephalitis, which is transmitted to people from carrier pigs bythe culex mosquito.

After all, outbreaks of viral Japanese encephalitis have beenoccurring in Malaysia since October 1998. The current cases werealso all associated with pigs and piggeries - as was the case withprevious outbreaks of Japanese encephalitis.

Likewise, at least 18 of the deaths so far in the currentoutbreak are confirmed to have been due to Japaneseencephalitis, says the World Health Organisation's office for theWestern Pacific, based in Manila.

But Malaysia's health ministry backtracked on attributingthe outbreak to Japanese encephalitis, given evidence that it wasnot the sole virus involved.

For one thing, Japanese encephalitis usually affects children butmost of the cases at present have been young adult males, mostlyworkers in contact with piggeries, WHO said this week.

''New information indicates that both Japanese encephalitis anda second virus are circulating,'' the WHO statement said.

''We should be wary that even more harm might come aboutthrough misguided, clumsy attempts to manage 'the truth',''epidemiologist Chan Chee Khoon said on March 19, the day officialsfirst mentioned a new virus other than Japanese encephalitis.

That day, the director-general of health announced that anotherhitherto unknown virus had been isolated from the body fluids ortissue samples of five deceased patients.

These results were confirmed by the Centers for DiseaseControl, which classified it as a Hendra-type virus, a member ofthe paramyxoviridae family of viruses.

The Hendra-type virus appears most closely related - but notidentical - to the Hendra virus that first emerged in Australiain 1994/1995 in two separate locations.

In those episodes, a horse-breeder and a horse trainer who hadcome into close contact with sick horses died after falling illwith a combination of flu-like symptoms and encephalitis.

Since then, there had been no other reports of Hendra or Hendra-like virus outbreaks until the viral encephalitis fatalities inIpoh city, 200 kilometers north of Kuala Lumpur, and in Negri Sembilanstate, 70 kilometers south of the Malaysian capital.

Little is known of the virus's modes of transmission and itsincubation and latency periods in people and animals.

(Inter Press Service)

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