Chua Jui Meng should stop making Malaysia a laughing stock and  publicly acknowledge that the outbreak in Bukit Pelanduk is due solely to the Hendra-like virus and not JE

Speech 2
- Royal Address 1999

by Lim Kit Siang  

(Dewan Rakyat, Thursday): I am shocked that the Royal Address makes no mention whatsoever to the worst virus epidemic disaster in the nation’s history, which has claimed 90 lives, destroyed the livelihood of 300,000 people in the pig-rearing industry, ruined the RM2.5 billion pig-rearing and pork industries, damaged other related and unrelated industries like animal-feed, transportation and tourism as well as delivering a body blow to national economic recovery efforts.

I was very frustrated, angry and outraged by the reply of the Health Minister, Datuk Chua Jui Meng and the Agriculture Minister, Datuk Dr. Sulaiman Daud to the questions on the worst virus outbreak in the nation’s history during the first day’s question time on Tuesday.

Chua Jui Meng’s reply was not to elucidate but to obfuscate the events and background of the worst virus outbreak.   It is now clear that the object of  Chua Jui Meng’s parliamentary reply was to drum home  two points in Parliament and to the country: one,  that Japanese encephalitis (JE) virus was the major cause of the worst viral outbreak in the nation’s history; and secondly, that there are two viruses involved in the viral outbreak disaster. Or as The Star highlighted yesterday’s report: "Both virus found in one area".

In actual fact, more and more people are convinced that there is only one killer virus which is wreaking havoc, the Hendra-like virus (which I have named CJM virus) and not the JE virus.

The following two postings yesterday morning on an Internet mailing list, responding to the newspaper report of Chua’s statement in Parliament, is very revealing:

A medical doctor posted the following:

"Is there a possibility that the Govt is still refusing to publicly acknowledge that the outbreak is due solely to the Hendra-like virus, but instead claiming that ‘there are two viruses’, in order to cover their … over the couple of hundred thousand doses of JE vaccine that has been ordered? 300,000 doses at RM30 per dose works out to RM9 million. Not to mention the few hundred thousand doses that have been allocated to vaccinate pigs in unaffected areas.  If it is shown that the Hendra-like virus is solely responsible for the outbreak, then the JE vaccinations are NOT going to help at all. Rather, an outbreak due solely to the new Hendra-like virus will only reflect poorly on the government.

"It is likely that they will only reveal the cause as solely due to Hendra-like virus only after the vaccination has been completed.   You may note that S'pore authorities have been quite quick in concluding that the one death which has occurred in an abattoir worker is NOT due to JE."

This posting elicited the following response: "I have a theory that the Malaysian govt was too arrogant and let pride get in the way when they didn't contact the Atlanta CDC earlier. After the recent US-bashing orgy, the last thing they wanted to do was to get help from the Americans. I reckon they preferred to save face, not lives."

I must say that there is a lot of sense in these two postings, which are probably closer to the truth than all the nonsense which have been spouted by the Health Minister, both inside and outside this House.

The statement made by Chua during question time is probably the most irresponsible and dishonest Ministerial statement  ever made in the Malaysian Parliament in the past 42 years,  full of misleading information, half-truths and even downright falsehoods.

For instance, Chua said that the first case of JE in Perak was reported by the Ipoh Hospital on 4th November, 1998  and the last case on 20th February 1999. Until 6th April 1999, there were 26 suspected JE cases, out of which 11 were confirmed JE cases.  There were 15 reported deaths out of which five were confirmed JE cases.  The JE outbreak in Perak was brought under control in 86 days.

This is most extraordinary information when Sin Chew Jit Poh on 22nd November 1998 quoted the Perak State Exco Member who head the state health and environment affairs committee, Datuk Lee Chee Leong as saying that there had been six  suspected JE deaths in the Perak state in 1997 and 1998 - one in 1997, one each in February and May 1998, two in October 1998 and another case earlier in the year but not recorded.

In fact, Chua himself, as reported by New Straits Times of November 25, 1998, mentioned about the JE outbreak in Perak which had killed five people between February and October 1998.

He said that the disease, which was initially regarded as "mysterious" was confirmed as Japanese encephalitis by the Institute for Medical Research after analysing fluid samples taken from four victims.

He said "so far this year", 18 cases were reported of which seven were treated at the Ipoh Hospital and the others at private hospitals. Out of these, five people died between February and October 1998.

He said out of the 18 cases, one was a pig buyer and the rest were pig farm workers, their family members or owners.

Why didn’t Chua inform Parliament that the so-called JE outbreak in Perak had gone as far back as February 1998, if not earlier in 1997?  Chua is guilty of trying to mislead Parliament and the country by not giving the full facts about the virus outbreak.

Furthermore, if as Chua claimed, the JE outbreak in Perak since the first case was reported by the Ipoh Hospital on 4th November 1998 was brought under control in 86 days, 28 January 1999, why is it necessary to presently  destroy 60,000 pigs in Perak?

 In this context, Parliament should note Chua’s announcement as reported by New Straits Times on December 24, 1998 that Kinta was already free of the JE virus for a week!   At that time, the number of deaths in Perak was mentioned as four.  Unfortunately the so-called JE virus did not hear or respect Chua’s declaration and the death toll in Perak mounted as in January it suddenly jumped to nine.  Chua had never explained how nine deaths in Perak  mentioned in January this year suddenly transformed into 15 deaths since the  outbreak last October - and Chua should explain to Malaysians why he should be so dishonest or prevaricating on straightforward matters like the number of JE  or suspected JE deaths?

Chua deliberately left vague as to whether the 15 who died in Perak dated from October 1998 or went all the way back to February last year - which is either an act of intellectual dishonesty or Ministerial irresponsibility.

In Sikamat, Negri Sembilan, Chua said the first suspected JE case was reported by the Seremban Hospital on 4th January 1999, and the outbreak was brought under control in nine days. There were seven suspected JE cases, three of which were confirmed.  Out of five reported deaths, one was confirmed JE.

In Bukit Pelanduk, Chua said that until 5th April 1999, there were 198 suspected JE cases, out of which 34 were confirmed as JE-positive.  Out of 68 deaths, 19 were confirmed JE.

Why didn’t Chua mention when was the first reported  JE case from Bukit Pelanduk?  Is it because it would highlight his indifference and disinterest about a viral outbreak in Bukit Pelanduk during its first  crucial first week?

Apart from imposing a gag order in early February forbidding state health officers from giving information on the so-called JE virus outbreak, Chua did not show any public concern about the viral outbreak in Bukit Pelanduk although eight people had died in a matter of six days.

On 27th March 1999, I flew to Sibu to attend a "Justice For All" campaign dinner organised by Sibu DAP to raise funds for Chinese Independent Secondary School and Chinese primary schools in Sibu, and on the flight, I read the front-page story in the  New Straits Times under the headline 'Bungling workers cause oil spill in Johore Straits', which reported:

"Pasir Gudang, Fri. - A mistake by shipyard workers carrying out repairs on a vessel at the Malaysian Shipyard and Engineering dry dock here, led to an estimated 52 tonnes of engine oil gushing into the Straits of Johore yesterday.

"The spill subsequently spread over an area of about one square kilometre, and initial findings by the Department of Environment indicate that some five kilometres of shoreline may have been stained by the black oil, used for working the ship's engine."

When I read this NST report, I wondered to myself when will Malaysia reach a stage where there could be a  report on the front page of the local newspapers  with a headline like: 'Bungling Minister cause more deaths in the worst virus epidemic in nation's history'.

That night, I told the people of Sibu that I was sure the people of Sarawak fully understood  the gamut of feelings I went through in the terrible viral outbreak disaster which had then  claimed 63 lives,  my feelings which ranged from anger, shock, outrage, desperation and even despair at seeing people dying like flies day by day, with the government and in particular the Health Minister, Datuk
Chua Jui Meng failing to show the proper seriousness or bungling day by day with people's lives and the economy of the nation.

When I first visited Bukit Pelanduk, the largest pig-rearing centre not only in Malaysia but in South East Asia and which had become the biggest centre for the most number of deaths of  pig farmers to fall victim to virus attacks, it was March 5, 1999.

At that time, there were eight deaths in that locality.  I visited Bukit Pelanduk five times in two weeks.

 I will not be honest if I say that when I visited Bukit Pelanduk, I was not worried at all about my personal  health and safety.  A victim of the virus attack who was a pig farmer in Bukit Pelanduk and who had died two days before my trip to Sibu, and the elder brother of a well-known local singing personality, had expressed his concern at my welfare at my frequest visits to Bukit Pelanduk.  Lim Guan Eng had also expressed many times his concerns at my visits to Bukit Pelanduk.

But I felt I had to go to Bukit Pelanduk  in order to force the Health Minister, Datuk Chua Jui Meng, and other Cabinet Ministers, particularly those from MCA and Gerakan, to visit Bukit Pelanduk, understand the magnitude of the crisis faced by the pig farmers whether in terms of public health or the life-and-death struggle faced by the pig industry, so that the government could urgently come out with an  integrated plan involving different Ministries  to address and end the crisis.

On March 3, 1999, I phoned up Chua Jui Meng immediately after the Cabinet meeting that day and asked him what was happening with the JE virus outbreak, as  more and more people were falling sick and dying.  He told me that the situation was under control. I told him he should rush to Bukit Pelanduk to restore calm and end the panic among the people.

But he did not go to Bukit Pelanduk. Instead he and the other MCA Ministers rushed to Sabah for the election campaign, to tell the voters of Api-Api in Kota Kinabalu that if they voted for the sole MCA candidate, Chau Teik Aun, the voters would get '1+12', i.e. in voting for one Sabah MCA Assemblyman,  they would also get the services of 12 MCA Ministers, Deputy Ministers and Parliamentary Secretaries.

The voters of Api-Api were very wise to reject the MCA's blandishments for they see that in Bukit Pelanduk, which was held by a MCA state assemblyman, the 12 MCA Ministers, Deputy Ministers and Parliamentary Secretaries did not bother to visit the constituency at all although people were dying day by day from what was then believed to be the JE virus outbreak! For Bukit Pelanduk, there was no ‘1+12’ but ‘1-12’, showing the gap between election promise and performance!

When I visited Bukit Pelanduk for the first time on March 5, there were eight deaths in the area. When I visited it the fifth time two weeks later on March 19, there were 36 deaths.  Two days ago, (April 6) at 6 p.m., just about a month later, there were 70 deaths - a shocking  900 per cent increase of deaths in a month!

Over 90 per cent of these deaths are unnecessary and avoidable - the result of criminal negligence and in particular Ministerial bungling in not putting in place an effective programme to contain  the viral outbreak when deaths begin to to mount  - at least by March 5, when there were already eight deaths in the Bukit Pelanduk area.

In 1997, where 41 children and babies died of the so-called Coxsackie B virus in Sarawak, the bereaved parents and close relatives were later told that the virus was not Coxsackie B virus after all.  The same is happening in the worst virus epidemic in the nation's history, what was for six months labelled as a JE virus  outbreak is now regarded as primarily a Hendra-type virus outbreak, the CJM virus.

Yesterday, during the winding up of the debate on the White Paper on the "Status fo the Malaysian economy", I asked the Deputy Prime Minister, Datuk Seri Abdullah Badawi why the government had not announced  any financial assistance to those in the  pig farming industry affected by the viral epidemic disaster as the government is providing  assistance to the small and medium
 scale industries.
 Abdullah, who heads the Cabinet Committee on JE, said any government financial assistance  to those in the pig farming industry and victims of the JE viral disease will be announced from time to time.  He said attention of the committee on JE was for now focussed on the JE  viral disease outbreak itself.

"The committee is discussing various issues  and it has not been able to announce the assistance to be provided," he said.

What I find sad and even tragic is that when the Deputy Prime Minister responded to my question, he was talking purely about the JE viral outbreak, when the Malaysian and international community know that the virus outbreak Malaysia is faced with is not the JE outbreak but the Hendra-type CJM virus.

The Cabinet Committee on JE is also wrongly named and is fighting the wrong virus, adopting a counter-measure which is aimed at a mistaken virus killer.  This means that all the measures taken by the government, whether on the mass vaccination of pigs and humans against JE, the  mass destruction of pigs, the entire focus of the entire government machinery as well as the Cabinet had been on the wrong track in fighting the wrong enemy!

Why is the Deputy Prime Minister, the Minister for Health, the Cabinet Committee, the Speaker of the House when rejecting my motion to adjourn the House to debate the Hendra-type CJM virus as a matter of  urgent, definite public importance all talking about JE when the whole medical community in Malaysia and internationally have stopped talking about JE as the viral outbreak in Malaysia and focussed its discussion and attention on the Hendra-type virus?

I do not know whether the Deputy Prime Minister, the Health Minister and all the other Cabinet Ministers are aware of the Internet website ProMED which has been tracking the worst virus outbreak disaster in Malaysian history, and if they are not aware, I would advise them to make mandatory daily visit to ProMED-mail  so that they could get properly briefed about the Hendra-type CJM virus killer which is wreaking all the havoc of deaths and financial ruin - and not JE.

If the ProMED postings concerning Malaysia have been made compulsory reading for Cabinet Ministers, Malaysia would have been spared the worst virus outbreak in history and not all 90 lives would have been lost or the RM2.5 billion pig-rearing and pork industries ruined.

ProMED which stands for The Program for Monitoring Emerging Diseases was proposed  by the Federation of American Scientists specifically to create a global system of early detection and timely response  to disease outbreaks as many experts, both within and outside government, have warned of the need to improve  capabilities for dealing with emerging infectious diseases such as the hemorrhagic fevers, and the  resurgence of old scourges like tuberculosis and cholera.

ProMED was inaugurated in September 1993 at a Geneva conference co-sponsored by sixty  prominent experts in human, animal and plant health and the  ProMED-mail electronic mail conference debuted in 1994.

ProMED-mail had also tracked the so-called Coxsackie B virus epidemic in 1997 which killed 41 people but which turned out later to be not caused by Coxsackie B virus after all.

The first posting of "Japanese encephalitis, suspected - Malaysia" on ProMED was on 24th November 1998 on the suspected JE outbreak among pig breeders in Perak, with 6 deaths and another 15 persons infected.

Even at that time, the moderator of ProMED commented: "So, without laboratory confirmation of the affected individuals' illnesses, vaccination with JE vaccine has been done.  We await further information as to the correct diagnosis, i.e., confirmation as JE or evidence for another disease."

The second posting was on 27th November 1998 which quoted the Health Minister, Datuk Chua Jui Meng, as announcing success in bringing the outbreak confined to  the vicinity of pig farms in Tambun, Ulu Piah and Ampang in the Kinta district in Perak under control.

The third posting on Nov. 30, 1998, however, showed the situation was far from under control.

The poster from Surrey, England said "he sell pedigree breeding pigs in Malaysia and was concerned to read of the possible link posted between JE and pig farms, and so e-mailed a customer near Penang who replied as follows" :

"The recent outbreak of Japanese encephalitis was a great concern to the pig farmers particularly in the affected places. Sad to tell you that 2 of my colleague's sons died from JE several months ago. Both were working on the farm.

"The state health department is monitoring the areas of outbreak and advises farm workers and the people living nearby to get vaccinated against JE virus. I hope that this outbreak does not necessitate the closing of the pig farms."

In retrospect, two members of a family dying is suspicious that it was probably not the mosquito-borne JE but another form of viral attack, as would be clearer as we track the development of the viral epidemic disaster.

The fourth posting on 18th December 1998 quoted Chua as saying that  some 70,000 people living near pig farms in seven states were  at risk if there was an outbreak of viral encephalitis in their areas. The fifth posting on 21st December 1999 quoted Chua as announcing for a second time that the so-called JE outbreak was over as "no new cases have been reported this month" despite knowing that the Prevention and Control of Infectious Diseases Act 1988 which makes it mandatory for all doctors including private practioners to report JE cases had broken down.

The seventh posting on 15th January 1999 carried three items.

The first item  reported the Agriculture Minister, Datuk Dr. Sulaiman Daud as announcing in Kuching that Universiti Malaysia Sarawak (Unimas), "which has vast experience" in dealing with the so-called Coxsackie B viral outbreak which killed 41 children and babies in 1997, "is helping to curb the outbreak of Japanese encephalitis (JE) in Peninsular Malaysia" and that the university had already sent an expert.

He said that his department would enforce strict regulations on pig farms, which were suspected to be the sources of JE in Peninsular Malaysia, and that a circular was issued on January 6, 1999 to pig breeders in Negri Sembilan, Perak and Malacca.

He also announced that the movement of pigs in JE-infected areas in Perak and Negri Sembilan had been further tightened, and pigs were only allowed to be transported from the pig farms to the abattoirs. The movement of sows and piglets in Peninsular Malaysia had also been banned.

The second item reported that four people, including a 13-year-old girl,  working in pig farms in Kampong Wong Seng Chow, died between January 2 and 5 - believed to be victims of JE.

In view of the importance of the  third item, which is a Bernama report from the Star Online of 14th January 1999, I would like to quote it in its original form:

"The results of the DNA (deoxyribonucleic acid) tests on blood samples of pigs in Negri Sembilan carrying the Japanese Encephalitis (JE) virus will be known in a week.

"The DNA tests, conducted at the Veterinary Research Institute here, were to determine the origin of the JE virus found in pigs in Sikamat, Negri Sembilan.

"The institute's director, Dr Abdul Aziz Jamaluddin, said the tests used DNA sequencing to determine the viral strain.

"So far, 120 blood samples of pigs from four farms in Sikamat were found to carry the JE virus but it has yet to be determined if the strain was the same as those found in pigs in Ulu Piah, Tambun and Ampang in Perak.

"Dr Abdul Aziz said yesterday that three strains of the JE virus had been identified in Malaysia.

"’The JE virus found in animals in Tambun, Ulu Piah and Ampang is unique.’

"An outbreak of the JE disease, which is transmitted to humans by mosquitoes, in Perak in October claimed nine lives, and four deaths were reported recently in Negri Sembilan."

A legitimate question to ask here is whether the "JE virus found in animals in Tambun, Ulu Piah and Ampang is unique" or that it was just not JE virus, but another new killer virus, now known as the Hendra-kind virus?

The fifth posting dated 17th January 1999 from one of the country’s top virologist from Unimas carried what in criminal  investigations would be tantamount to "the smoking gun", and bears reproduction in full:

"Date: Sat, 16 Jan 1999 10:24:02 +0800
From: Jane Cardosa <[email protected]>

"In the matter of the press release by the Minister of Agriculture, Dr Sulaiman Daud, I would like to clarify that Universiti Malaysia Sarawak (UNIMAS) has not been called in to assist in the investigation of the ‘JE’ outbreak referred to in your posting, and the university has not sent anyone to the peninsula. We are merely surprised that it is taking so long for the Ministry of Health to make a confirmatory diagnosis of JE (if in fact we are seeing a JE outbreak in the peninsula). We have offered to run confirmatory tests on human specimens if our assistance should be needed, but our offer has not been taken up.

"It might be worth pointing out to readers of ProMED-mail that JE is largely seasonal in Malaysia and normally occurs during the months of Nov/Dec/Jan. The fact that we are seeing an increase in JE cases during this period is therefore nothing new nor particularly unusual. What is unusual about the fatal cases in the peninsula is that they are young adults, and they are dying. Although they are mostly are pig farm workers, raising suspicion about JE, we must not forget to rule out other possible occupational causes. This is particularly relevant in view of the fact that there has not been a confirmatory laboratory result for most of these cases weeks later.
"In Sarawak (separated from the peninsula by an ocean), we are able to deliver a specific IgM result for JE with a 24 hour turnaround time. RT PCR is not terribly useful in cases already with encephalitis because virus is often undetectable by then. We are successfully using RT PCR to determine which febrile children with convulsions have JE. These children seroconvert for IgM a couple of days later, and then the RT PCR is normally negative.

"Jane Cardosa"

The important points here are that even as on January 16, some three months after the so-called JE outbreak in Kinta, Perak, there had been no "confirmatory diagnosis of JE" and that the offer of Unimas, which has the expertise and facility to to such confirmatory tests within in 24 hours was rejected by the authorities!

Jane Cardosa’s posting was commented on by Dr. Chan Yow Cheong, ProMED Regional Moderator for Asia, in the sixth posting on 18th January.

The eighth posting on 14th February reported the Health Minister had earlier in the month stopped all state health departments from making statements about the JE "which has claimed 14 lives in four months" so that the public would not be "unnecessarily alarmed".  Chua also reportedly told local editors not to overplay the issue as their reports could adversely affect the economy if picked up by foreign media.  The Malaysian Medical Association president  Dr. Lee Yan Sang was reported as supporting the gag order issued by Chua.

The moderator made this prescient comment:

"1. There is an urgent need for an official statement that there is nothing unusual about seeing cases of JE at this time of year, and no need for panic – a web page giving daily updates, such as Sarawak had during the Coxsackie B virus outbreak quoted would be a good idea.

"2. Bitter experience has taught many countries that reporting some diseases, such as cholera, has a bad effect on trade & tourism.  This is all the more reason why there should be frequent official updates of the situation, to curb rumors, put the outbreak in context, & explain what the country is doing to control the disease & prevent further cases.

"3. As our Regional Moderator for Asia, Dr Chan Yow Cheong, pointed out  in his comments on the posting referenced above, the epidemiology of this outbreak is different from the usual, since the cases reported are mainly in adults, and serological confirmation that most of them are due to JE virus is lacking.  Either JE virus has changed its characteristics this year, or there is a second virus involved. Malaysia has highly competent virologists who should be able to give an answer to this question soon."

Thus, on 14th February, the question of a "second virus" involved in the worst viral epidemic in Malaysian history was again raised in a direct and specific manner.

The ninth posting dated 24th February carried some information of the outbreak given by the Deputy Director-General (Public Health), Datuk Dr. Abdul Aziz Mahmood, saying among other things, that:

‘JE is endemic in Malaysia and cases occur sporadically throughout the year. Outbreaks of the disease occurred in 1974 in Langkawi (10 cases and two deaths), in 1978 in Penang (nine cases, four deaths) and in 1992 in Sarawak (10 cases and three deaths).

"The recent outbreak in Ipoh involved 25 cases and claimed 13 lives and in Seremban it claimed five lives out of seven cases."

The tenth posting of 26th February 1999 reported on a one-day regional conference in Ipoh on on latest advances in the diagnosis and control of JE, where University of Malaya senior virologist, Prof. Dr. Lam Sai Kit and Dr. Marina Abdul Hamid, a health officer from the Kinta District Health Office, were forced to rationalise the unusual behaviour of JE in the outbreak, or "change of scenario", affecting mainly adults who have been staying in the vicinity of pig farms for a period of time.

Lam  said based on the Ministry of Health's report, between 1989 and 1993, about 52% of the reported cases comprised children aged between seven and 15, 31% comprised children aged under four, 9% comprised those between 15 and 24 and only 8% were adults, aged above 25.  In the Kinta outbreak, however, all the 24 cases reported were adults except for a 10-year-old boy who stayed in one of the affected farms, with 87.5% males and the majority of them engaged directly in porcine-related activities.

In the eleventh posting of 1st March 1999, the moderator noted that on 16th January, Jane Cardozan had queried about the lack of confirmatory diagnosis of JE and unusual features of the fatal cases involving young adults; that on 14th February, the ProMED moderator raised the question of whether there is a second virus causing the deaths apart from JE and the data presented by Lam Sai Kit at the Ipoh Conference where 80 per cent of the patients in the Perak outbreak were adults when data between 1989 and 1993 show that only 8 per cent JE cases were in adults older than 25 years.

The ProMED moderator commented:

"This sounds to me as though it is an exceedingly complex situation.  Data are needed (and may already have been obtained, I simply do not know) regarding vaccine coverage of the human population, vaccine coverage of the pig population, prevalence of JEV in wild and domesticated birds in the area, laboratory confirmation of clinical suspicions, evidence that killing infected pigs (which do not have persistent infections) is a reasonable choice and tool for virus control, molecular data regarding sequence differences between the currently circulating strains and prototype/historic strains, infection rate in children and adults with a "history of vaccination against JEV", etc."

By March 1, 1999, fortunately, the Department of Medical Microbiology of the Faculty of Medicine, University of Malaya were on the fast track to discover the new killer virus, and this story is best told by Professor Lam Sai Kit in his posting to ProMed dated 3rd April 1999, as follows:


It has been a month since Dr. Chua Kaw Bing and I got involved with the viral  encephalitis outbreak in Negri Sembilan and we feel it is time to share our experience with ProMED-mail readers. There have been many postings already and I will not touch on issues already raised. We will try to update readers from time to time.

The outbreak in Negri Sembilan started in late February [1999] and we were requested to help by the Seremban Hospital, the closest referral hospital to the site of the outbreak. Clinically, the cases were viral encephalitis, mainly in male adults and with history of contact with pigs. This was similar to the earlier outbreak in Ipoh which started in October 1998 with 15 deaths, and [was] confirmed to be due to Japanese encephalitis by the Ministry of Health and the WHO Collaborating Center for Reference and Research on Tropical Virus Diseases, Nagasaki, Japan.

Since we too had several JE IgM serology positives [indicating recent infection], we assumed that the Negri Sembilan outbreak was a continuation of the Ipoh outbreak through movement of pigs. However, we were puzzled by the unusual epidemiology if it was JE alone.  Why were adults mainly affected and why only those in direct contact with pigs and not family members who also lived but not worked in the pig farms? Why were there cases among those who had received the full course of the Biken mouse brain-derived inactivated JE vaccines? Why were pigs dying and why were
there no seroconversions in well-timed paired serum samples [from pigs] to JE?

When we received the first few samples of [patient] blood and cerebrospinal fluid on 1 March  1999, we set out to do virus isolation using a number of cell lines, in addition to JE IgM serology. By day 5 post-inoculation (5 March), we noticed syncytial formation which rapidly spread to form large multinucleated giant cells. The isolate was passaged the next day (6 March) and slides of the infected cells made and stained for immuno-fluorescence with flavivirus and JE monoclonals [specific antibosies], herpes simplex and cytomegalovirus, respiratory viruses including paramyxoviruses, measles and panenterovirus. All were negative. However, IgM and IgG [antibodies] to the isolate were found in one CSF and three serum samples of patients.

Infected cells harvested on 8 March were also fixed in glutaraldehyde for electron microscopy and examined on 11 March. Pleomorphic viral-like particles measuring between 160 and 300 nm were observed. We felt we could not take the identification any further locally and when Duane Gubler from CDC, Fort Collins, offered to help, we decided to accept. Unfortunately we could not get a courier service to handle the consignment. Within 48 hours, Chua was on a flight to Fort Collins, arriving on 13 March. Since he had taken prepared slides and EM grids and blocks, along with clinical specimens and virus isolates, no time was wasted. Over the weekend and with the help of Nick Karabatsos and Duane, our earlier EM observation was confirmed, the virus was morphologically similar [to recognized] paramyxoviruses. All tests for arboviruses [i.e. JE virus & others] were negative.

Duane kindly arranged for Chua to go to CDC, Atlanta, on 17 March; duplicate clinical samples taken to Fort Collins from Malaysia had [already] been sent there 2 days earlier.  On arrival, further results on the samples were already available. The isolates reacted to Hendra antibodies and limited sequencing data on the P gene showed 10% divergence from Hendra virus. On 18 March, while Chua was still in Atlanta, I received a fax from Brian Mahy with the news that there was definite evidence for an association with a paramyxovirus related to Hendra virus.

The rest is history!

Ken Lam
1 April 1999

The rest is indeed history, except we do not know how many lives are going to be sacrificed, apart from the death toll of 91,  how many families ruined and how many  billions of ringgit lost as a result of the criminal negligence of the Minister of Health who till this day is still talking about the JE rather than the Hendra-kind CJM virus.

What weren’t Professor Jane Cardoza’s query whether it was indeed JE virus and her  offer to help identify the new killer virus in early January accepted, which would have spared the country from the worst virus epidemic disaster in history.

Is it because Jane Cardoza was involved in the analysis of the viral outbreak in 1997 which killed 41 people and in helping to establish that the Health Minister was wrong in pinning the outbreak on Coxsackie B virus? Or is it because Jane Cardoze is suspected of having Reformasi sympathies, to the extent that lives could be jeopardized and sacrificed?

The Health Minister had ignored the advice from one of the top virologist that another virus could be at work, as well as ignoring at least four unusual features of the so-called JE outbreak:

Even now, he is still telling Parliament and the nation about JE, when ProMED has stopped its thread on "Japanese encephalitis - Malaysia" since March 18, replacing it with  "Hendra-like Virus? - Malaysia".

Even as early as March 21, the ProMED moderator had expressed surprise at the fixation of the Malaysian Goverrnment with JE. He commented:

"Remarkably, the Malaysian Government is sticking to the story that this is a Japanese encephalitis (JE) epidemic with, possibly, some Hendra-like virus involvement. As our readers can tell from the change in headers,ProMED-mail is emphasizing the emerging nature of the Hendra-like virus and minimizing the JE factor. "

He said he did not know that "one measure to control a JE outbreak is to shoot the pigs".
DAP calls for a full inquiry to estabish whether there is a  conspiracy of deceit to blame the worst virus epidemic on two viruses and that  the Hendra-type virus is probably the sole cause of the 70 deaths in Bukit Pelanduk and of most if not all the 90 deaths since last October.

There should be a Royal Commission of Inquiry into the real causes of the worst virus epidemic disaster in history and whether all the deaths and financial losses could have been averted with proper crisis management. Such a Royal Commssion of Inquiry should inquire:

The Minister for Agriculture, Datuk Dr. Sulaiman Daud has just walked into the House and I regret that he could not stand up to confirm or deny, despite my repeated challenge,  as to whether horses had died in Kinta last year and what the Veterinary Services Department had done to investigate the link between the dead horses in Kinta with the spread of the Hendra-kind virus in Malaysia.

This is indeed the height of irresponsibility and incompetence.  Both the Health Minister and the Agriculture Minister have been most culpable for the national disaster caused by the worst viral epidemic in the nation’s history and both should resign from the Cabinet.  I know the MCA is going round asking why I was attacking the Health Minister and not the Agriculture Minister for the so-called JE scandal, as the Agriculture Minister should be more responsible than the Health Minister for the disaster, suggesting that I dare to criticise Ministers from the MCA but not from other parties.

I will hold a Minister responsible for any Ministerial bungling and criminal negligence in the discharge of his duties and I do not care whether he is from MCA, Gerakan, MIC or PBB - and this is why I am calling on both the Minister of Health and the Minister of Agriculture to resign for the way the national disaster they have created from their incompetence, where more than a hundred lives would be lost before the viral epidemic run its course, with the loss of billions of ringgit representing the hard-earned money of Malaysians and the country.

I find it most regrettable that the Health Minister, during question time, had to refer to 16 years to identify and confirm HIV virus, or four years in the case of the Hantan virus.  As the University of Malaya Department of Microbiology has demonstrated, all that  is needed is 11 days from March 1 to March 11 for the local experts to isolate the  new virus, which was taken to the CDC which confirmed in eight  days that it is not related to any known arboviruses and is  a new paramyxovirus related to the Hendra virus.

From Chua's reply in Parliament, he was more interested in wanting to challenge the DAP to raise donations for the victims of the worst virus disaster in the nation's history, which has reached 91 at 6 p.m. yesterday, and I have been informed that it has gone up to 92 already.

This is also the line which has been taken up by MCA MPs in this House as well as by other Barisan Nasional MPs at the instigation of MCA MPs.

I am amazed that the MCA Ministers and MPs  have no sense of shame and think that money can buy everything - to wash away their sins of Ministerial bungling and failure in crisis management which has resulted in 92 deaths and  the ruination of the pig-rearing and pork industries.

Let me tell the Health Minister that his job is to be a competent Minister to save lives and not to allow  a virus disaster from getting out of hand till there are over 91 deaths - and it looks unlikely that the virus epidemic would end before death toll crosses  the century mark-  and not to go round to raise donations after people have died from his Ministerial negligence and then challenging the DAP on how much money it is raising for the families of the dead, who should never have died at all

If this is all that MCA Ministers and leaders can do, using money to cover their political and Ministerial sins, then it is no wonder that MCA - previously been known as Money Collecting Association, has now another appellation -  Mati Chinese Association!  After Mati Chinese Association, the MCA becomes Money Collecting Association!  What a national shame a disgrace!

Now that it is clear that the killer virus is not the mosquito-borne JE virus, but the Hendra-type virus whose mode of transmission is unknown, I call on all quarters including the Minister and Deputy Minister of Agriculture and other Cabinet Ministers to stop  blaming the pig rearers for the virus outbreak, alleging that their refusal to heed government advice to maintain sanitary conditions of their pig farms have caused the Culex mosquitoes to breed in dirty and stagnant pools.

I regret that despite my repeated call  for support, no  MCA and Gerakan MP let alone other Barisan Nasional MP is prepared to express  support for my  proposal for a RM720 million government package to deal with the disaster, namely RM200 million compensation for a million pig destroyed at RM200 a pig, RM100 million financial assistance for people, whether Chinese, Malays or Indians, who are displaced from their homes and livelihoods, as a result of the mass destruction of pigs, and RM20 million as compensation for the families of the 92 who have died. Furthermore, a RM400 million credit facility to pu the pig-rearing industry back on its feet again.

I regret that not a single MCA MP has stood up although I have repeatedly said that I would give way to any MCA MP who is prepared to stand up now to declare his support for the proposal of a RM720 million government package to deal with the national crisis.  There is only silence.  There is a total absence of moral courage, a sense of outrage that there had been criminal negligence on the part of the Minister of Health and Minister of Agriculture causing unnecessary and avoidable deaths and destruction of the livelihoods of hundreds of thousands of Malaysians!  There are even MCA and Barisan Nasional UMNO MPs who want to "play politics" in the worst virus epidemic disaster in the country.  Let me tell them that those who do not feel anger and outrage at the criminal loss of lives and ruin of the pig-rearing industry are not fit to be human beings, let alone Members of Parliament!

I call on the government to  pay for the entire hospital fees incurred by victims of the virus outbreak disaster, whether public or private hospital. The Education Ministry should set up a special bureau to ensure that not a single student will suffrer in terms of having to discontinue his or her education, whether primary, secondary or tertiary, as a result of the disaster by providing special financial assistance to them.

At one time, the Health Minister said that the virus disaster is a natural disaster. It is not. It is an unnecessary, avoidable and man-made disaster which should have been contained when deaths started to occur.


*Lim Kit Siang - Malaysian Parliamentary Opposition Leader, Democratic Action Party Secretary-General & Member of Parliament for Tanjong