Although the CDC is reputed to have the best technology in the world for disease control and prevention, it seems to be equally stumped as local experts by the viral outbreak in Sarawak which had killed 31, and although loosely referred to as coxsackie virus B, its real identity is still unknown.
However, three questions persist in the public mind, first, whether the Health Minister, Datuk Chua Jui Meng has lost interest in the viral epidemic in Sarawak and had ceded the monopoly control of the crisis management to Datuk Dr. George Chan; secondly, why the three experts from Atlanta CDC came so late when they should have been in Sarawak at the height of the epidemic early last month; and thirdly, who are in real charge in the fight against the viral outbreak, the local experts or the Atlanta CDC experts.
The third question is particularly nagging, as Malaysians have been told that our local experts, whether virologist or epidemilogist, in tropical diseases are among the best in the world.
The grave problem of loss of public confidence in the authorities� public relations management of the viral epidemic crisis is obvious from the latest update on the University of Nebraska Medical Centre (UNMC) website, the only website in the world to closely monitor the deadly viral epidemic in Sarawak.
The latest UNMC update states:
"02. July:
"We have received a good number of requests for more information about these events by folks who state they are either confused about what is going on or do not completely trust the information in the official proclamations and news stories.
"We post here whatever we can and that which we think is verifiable. Therefore, we cannot offer any more information than that. We, like you the reader, are spectators of this event and though, as virologists, we can comment on specific aspects, we are not privy to what is happening.
"We are no longer following these events because of the potential of a CVB involved in these illnesses and deaths, but now are trying only to be a bulletin board, as it were, of useful information. Once these events really quiet down, hopefully soon, we will deactivate this page...
"An article in ASIAWEEK in late June called �Why are the infants dying?� by S.C.Chan Kuching, referenced in the informational website http://www.geocities.com/HotSprings/2188/outbreak.html contains some misleading information that is easily set straight.
"The most obvious is the acceptance of the official line that the deaths are due to CVB infection: there are no data to date to support this assumption.
"�.....Coxsackie B....is also called hand, foot and mouth disease...� HFM disease is, as discussed here before, primarily caused by coxsackie A viruses (CVAs) in the US or, recently in Sarawak, by EV71. CVB infections are not generally called HFM disease, nor are they common causes of HFM disease. HFM disease is a benign disease of childhood, irritating but certainly not generally considered life-threatening...
"�It is not known if the Coxsackie B virus grows in the respiratory tract or in the gut -- so no one is sure if it is passed through mucus or feces.� The CVBs, like other enteroviruses such as polioviruses, is spread by a route called fecal-oral. That is, virus in feces contaminates water, food, is aerosolized (say during a diaper change on a baby), or is on hands after using the WC, etc., and thus infects through the mouth. It is passed in feces, in urine, and likely during the initial phase of infection, through mucus (spit). This is why, in lieu of any virus having been isolated to date, that the health authorities have stressed good hygiene, something that is a worthwhile recommendation regardless."
It is most unfortunate that two-and-a-half months after the first death from the deadly viral outbreak on April 14, misleading information about the viral infection continue to be carried in the mass media, both printed and electronic, which is a sad reflection of the utter failure in the Health Ministry�s crisis management in the important area of public relations and education.
What is even more unfortunate is that the Health Minister is not prepared to admit that the entire public relations exercise in the viral epidemic crisis management had been one greater disaster from the beginning.
(3/7/97)