Laboratory-confirmed case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in Malaysia: preparedness and response, April 2014.

On 14 April 2014, the first laboratory-confirmed case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection was reported in Malaysia in a man in his mid-fifties, who developed pneumonia with respiratory distress, after returning from a pilgrimage to Saudi Arabia. The case succumbed to his illness three days after admission at a local hospital. The follow-up of 199 close contacts identified through contact tracing and vigilant surveillance did not result in detecting any other confirmed cases of MERS-CoV infection.

Smoking behaviours and attitudes toward tobacco control among assistant environmental health officer trainees.

Assistant environmental health officers (AEHO) are health care providers (HCPs) who act as enforcers, educators and trusted role models for the public. This is the first study to explore smoking behaviour and attitudes toward tobacco control among future HCPs. Almost 30% of AEHO trainees did not know the role of AEHOs in counselling smokers to stop smoking, but 91% agreed they should not smoke before advising others not to do so. The majority agreed that tobacco control regulations may be used as a means of reducing the prevalence of smoking. Future AEHOs had positive attitudes toward tobacco regulations but lacked understanding of their responsibility in tobacco control measures.

Risk factors for typhoid outbreak in Sungai Congkak Recreational Park, Selangor 2009.

Typhoid fever continues to pose public health problems in Selangor where cases are found sporadically with occasional outbreaks reported. In February 2009, Hospital Tengku Ampuan Rahimah (HTAR) reported a cluster of typhoid fever among four children in the pediatric ward. We investigated the source of the outbreak, risk factors for the infection to propose control measures. We conducted a case-control study to identify the risk factors for the outbreak. A case was defined as a person with S. typhi isolated from blood, urine or stool and had visited Sungai Congkak recreational park on 27th January 2010. Controls were healthy household members of cases who have similar exposure but no isolation of S. typhi in blood, urine or stool. Cases were identified from routine surveillance system, medical record searching from the nearest clinic and contact tracing other than family members including food handlers and construction workers in the recreational park. Immediate control measures were initiated and followed up. Twelve (12) cases were identified from routine surveillance with 75 household controls. The Case-control study showed cases were 17 times more likely to be 12 years or younger (95% CI: 2.10, 137.86) and 13 times more likely to have ingested river water accidentally during swimming (95% CI: 3.07, 58.71). River water was found contaminated with sewage disposal from two public toilets which effluent grew salmonella spp. The typhoid outbreak in Sungai Congkak recreational park resulted from contaminated river water due to poor sanitation. Children who accidentally ingested river water were highly susceptible. Immediate closure and upgrading of public toilet has stopped the outbreak.

Poliomyelitis vaccination status among children in the Federal Territory of Kuala Lumpur 2007.

INTRODUCTION: Polio vaccination rates remain low in certain regions of Malaysia. The Federal Territory of Kuala Lumpur (FTKL) reported coverage of only 29.3% in 2005 and 61.2% in 2006, despite a Department of Health campaign to provide free three-round immunizations. The estimated numbers of live births used to calculate these rates may have artificially lowered the reported coverage percentages. METHODS: A descriptive, cross-sectional household survey was conducted throughout the FTKL in 2007 to assess the actual polio vaccination status of children aged 9 to 24 months. Minimum sample size was calculated and proportionately divided among the 11 FTKL parliamentary constituencies. Residential areas were then randomly selected for in-person interviews. We used the gathered information, verified by medical records, to calculate the actual vaccination coverage and to compare the rates determined by using estimated or registered live births for the region. RESULTS: Of the 1713 study participants, 98.3% had completed their polio vaccination schedule. Only 21 children had been partially vaccinated, and nine children were completely unvaccinated. FTKL residents had 20 431 live births registered for 2006, as opposed to the official estimate of 28 400. When the registered value of live births was used to calculate vaccination coverage, the 2006 coverage increased (to 85.1%). CONCLUSION: Actual vaccination coverage in Kuala Lumpur was much higher than the estimated coverage previously reported, reflecting the expected success of the Department of Health immunization campaign. Estimated values of live births are insufficient to accurately determine vaccine status and should be avoided.