Umai Dish Preparation Practices and Food Safety Behaviors in Bintulu Locals on Borneo Island, Malaysia.

ABSTRACT: Umai is a popular, traditional, native dish of the Melanau ethnic group in Sarawak. It is prepared using thin slices of raw marine fish marinated with calamansi juice and seasoned with other ingredients. The local people believe that the acidity of the citrus juice, along with the use of salt and spice, can slightly cook the fish and remove the fishy smell. The aim of this study was to investigate (i) the different umai handling and preparation practices and (ii) the personal experience of umai consumption among respondents. A purposive sample of 100 umai makers, divided into two equal groups, professionals and nonprofessionals, participated in the study. We found that Spanish mackerel and hairfin anchovy were ranked first and second in the list of species chosen for making umai, with the former mostly preferred by the professional group, as opposed to the latter, which was preferred by the nonprofessional group. Black pomfret was ranked third, where it is equally preferred by both groups. About 20% of respondents would freeze the raw fish chunks prior to preparing umai, as opposed to 26% who would sun dry their fish. Other techniques, such as salting and marinating (using calamansi juice), were also used during the preparation of umai. Most of the respondents indicated that they would consider the umai ready to eat soon after marinating (with all ingredients) the raw fish. One-third of both respondent groups indicated that they would chill the umai dish at 4°C for 30 min before serving. The respondents could not provide any rationale behind these food preparation practices. Overall, this study provides evidence of the different preparation methods for umai. These practices can thus be considered important targets for public health education campaigns seeking to improve food safety surrounding this food group.

Melioidosis: an unusual cause of infective endocarditis: a case report.

INTRODUCTION: As a causal organism in infective endocarditis, Burkholderia pseudomallei is rare. Burkholderia pseudomallei is intrinsically resistant to aminoglycosides but a gentamicin-susceptible strain was discovered in Sarawak, Malaysian Borneo in 2010. We report the first occurrence of infective endocarditis due to the gentamicin-susceptible strain of B. pseudomallei. CASE PRESENTATION: A 29-year-old man presented with pneumonia and melioidosis septicaemia. His condition was complicated with infective endocarditis and septic emboli to the brain. Despite difficulties in reaching a diagnosis, the patient was successfully treated using intravenous gentamicin and ceftazidime and was discharged well. DISCUSSION: The role of gentamicin in the treatment of the gentamicin-susceptible strain of B. pseudomallei remains unclear.

Neurological melioidosis in East Malaysia: Case series and review of the literature

Melioidosis is an infectious disease caused by an aerobic, non-spore forming gram negative bacillus, Burkholderia pseudomallei. It is known to be of high incidence in parts of rural South East Asia, and in Northern Australia. Pneumonia is the commonest manifestation. We report here three cases of neurological melioidosis from the registry of 169 cases of melioidosis in Bintulu Hospital, Sarawak, East Malaysia, with a review of neurological melioidosis in the literature. The annual incidence of melioidosis is estimated to be 8 per 100,000 populations in the Bintulu district. Neurological melioidosis accounts for 1.8% of our melioidosis cases. A review of 76 cases of neurological melioidosis reported in the literature inclusive of our 3 cases shows that localized brain or spinal inflammation or abscess is the most common manifestation occurring in 80% of patients. Close to half (53%) have intra axial abscess (brain or spinal cord), a quarter (27%) have extra axial lesions only (epidural or subdural collection, osteomyelitis or scalp abscess), and another quarter (27%) have both intra and extra axial lesions. Thus, B. pseudomallei appears to be unique among the bacterial central nervous system infection to be able to affect the brain and its contiguous tissues, crossing the tissue plane particularly resulting in osteomyelitis, scalp abscess and vice versa. Two thirds of the neurologicalmelioidosis patients have only neurological disease with no evidence of disease elsewhere. Key words: Burkholderia pseudomallei; neurological melioidosis; Bintulu; Sarawak; Malaysia