MyMedR

Socio-cultural aspects of a cholera epidemic in Trengganu, Malaysia

Chen PC

Trop Geogr Med, 1971 Sep;23(3):296-303.

PMID: 5099001

Matched MeSH terms: Cholera/epidemiology*

A study of two cholera epidemics in the district of Tawau, Sabah (1989-1991)

Khoo A

Southeast Asian J. Trop. Med. Public Health, 1994 Mar;25(1):208-10.

PMID: 7825016

Matched MeSH terms: Cholera/epidemiology*

An update on diarrhoeal diseases in Malaysia

Ismail A

Southeast Asian J. Trop. Med. Public Health, 1988 Sep;19(3):397-400.

PMID: 3217821

Analysis of diarrhoeal disease patterns in Malaysia from 1981-1986 suggested that infectious hepatitis ranked as the most predominant diarrhoeal disease followed by typhoid, food poisoning, dysentery and cholera. Although these five major food and water-borne diseases are still endemic in this country, diarrhoeal diseases per se no longer become an important public health problem in Malaysia. Enforcement of the cholera control program brought the incidence of the disease to a minimal. Unfortunately, this fatal form of diarrhoeal disease caused the greatest mortality compared to the others. Seasonal influence also played a part in controlling the occurrence of the disease. There was a preponderance of diarrhoeal diseases during the rainy season implicating contaminated water as a source of transmission. Although greater than half of the population has been supplied with piped water and sanitary latrines, a lot more has to be done before diarrhoeal diseases could be eliminated from this country.

Matched MeSH terms: Cholera/epidemiology

Fulltext Review of the trends and causes of food borne outbreaks in Malaysia from 1988 to 1997

Meftahuddin T

Med J Malaysia, 2002 Mar;57(1):70-9.

PMID: 14569721 MyJurnal

This paper examines the trend and possible contributing factors for the occurrence of the food borne diseases outbreaks in Malaysia. These diseases mainly are cholera, typhoid fever, hepatitis A, dysentery and food poisoning. The outbreaks still occur sporadically in certain high risk areas throughout the country. The incidence rate of all the other three major food borne diseases steadily declined from the year 1988 to 1997 except for food poisoning and cholera. Statistic of food poisoning from the year 1996 to 1997 showed that 66.5% of the outbreak occurred in schools whereas only 0.4% originated from the contaminated food sold at various public food outlets. The school age group is always more affected than the general population. Amongst the contributing factors identified are related to unhygienic food handling practices followed by inadequate safe water supply and poor environmental sanitation. A multisectoral approach between Ministry of Health and other government agencies or private agents needs to be undertaken in the management of the food borne diseases in order to curb the incidences of food borne diseases in Malaysia.

Matched MeSH terms: Cholera/epidemiology*

Fulltext Cholera: a re-emerging infection

Lim VKE

Med J Malaysia, 2001 Mar;56(1):1-3.

PMID: 11503284

Matched MeSH terms: Cholera/epidemiology*

Fulltext Cholera--still a major health problem

Lim VKE

Med J Malaysia, 1993 Mar;48(1):1-2.

PMID: 8341166

Matched MeSH terms: Cholera/epidemiology*

Fulltext Cholera in Sarawak: a historical perspective (1873-1989)

Yadav H, Chee CM

Med J Malaysia, 1990 Sep;45(3):194-201.

PMID: 2152080

Cholera has been in existence in Sarawak for many years and since 1873 many major epidemics have occurred. The epidemics usually occur during the dry months of May, June and July and the population affected are those in coastal areas. As in other outbreaks the areas affected were those which had poor environmental sanitation, poor water supply, poor refuse disposal and indiscriminate disposal of faeces. Malays are more affected as in Peninsular Malaysia outbreaks. The classical biotype was common prior to 1961. In later years the El Tor (biotype) has been responsible for most outbreaks.

Matched MeSH terms: Cholera/epidemiology

Fulltext Cholera outbreak in Tumpat, Kelantan-1990

Isa AR, Othman WM, Ishak A

Med J Malaysia, 1990 Sep;45(3):187-93.

PMID: 2152079

Two episodes of El Tor cholera outbreak occurred in Tumpat, Kelantan between the 13th of January and the 16th of May 1990. Every case and carrier reported were investigated to determine the source and mode of transmission and to identify specific preventive measures to break the chain of transmission. There were 109 cases and 85 carriers involved in this study. The first episode of one case only was of Inaba serotype while the second episode was caused by the imported Ogawa serotype. Two foci of spread were identified from cluster occurrence but the majority of infection had no discernible link between them. The outbreak became both explosive and protracted indicating poor basic sanitation and personal hygiene. Person-to-person transmission via food and water was the main mode of spread. The Kelantan river water and river clams were confirmed sources of reservoir during the outbreak. Recommendations for prevention are intensified surveillance throughout the year,urgent upgrading of potable water supply and concerted effort in public health education especially against the use of river water and the consumption of raw food.

Matched MeSH terms: Cholera/epidemiology*

Fulltext The 1978 cholera outbreak in Krian district

Yadav H

Med J Malaysia, 1981 Sep;36(3):129-35.

PMID: 7329369

The findings of a cholera epidemic in Krian district is reported. There were 77 cases and 92 carriers in the epidemic. Although the three main ethnic groups of Malays, Chinese and Indians were involved in the epidemic, the Malays constituted majority of the cases and carriers. The overall infection rate and case attack rate was higher among the younger population. The case: carrier ratio was also higher among the younger population especially among Indians. Various reasons and probable causes of the epidemic have been described briefly.

Matched MeSH terms: Cholera/epidemiology*

An appraisal of El Tor carrier state in Kelantan

Dutt AK, Tan Hock Joo

Med J Malaya, 1971 Mar;25(3):205-7.

PMID: 4253247

Matched MeSH terms: Cholera/epidemiology*

A cholera epidemic without a hospital death

Hart PL

Med J Malaya, 1966 Jun;20(4):281-3.

PMID: 4224335

Matched MeSH terms: Cholera/epidemiology*

Cholera in the Kedah River area

Chen PC

Med J Malaya, 1970 Jun;24(4):247-56.

PMID: 4248344

Matched MeSH terms: Cholera/epidemiology*

Cholera epidemic in the State of Kedah (1963-1964) with administrative, preventive measures, treatment and laboratory investigations

Subrahmanyam C

Med J Malaya, 1966 Sep;21(1):41-8.

PMID: 4224877

Matched MeSH terms: Cholera/epidemiology*

Comparative PCR-based fingerprinting of Vibrio cholerae isolated in Malaysia

Shuan Ju Teh C, Thong KL, Osawa R, Heng Chua K

J Gen Appl Microbiol, 2011;57(1):19-26.

PMID: 21478644

Vibrio cholerae, the causative agent of cholera, is endemic in many parts of the world, especially in countries poor in resources. Molecular subtyping of V. cholerae is useful to trace the regional spread of a clone or multidrug-resistant strains during outbreaks of cholera. Current available PCR-based fingerprinting methods such as Random Amplified Polymorphic DNA (RAPD)-PCR, Enterobacterial Repetitive Intergenic Consensus Sequence (ERIC)-PCR, and Repetitive Extragenic Palindromic (REP)-PCR were used to subtype V. cholerae. However, there are problems for inter-laboratory comparison as these PCR methods have their own limitations especially when different PCR methods have been used for molecular typing. In this study, a Vibrio cholerae Repeats-PCR (VCR-PCR) approach which targets the genetic polymorphism of the integron island of Vibrios was used and compared with other PCR-based fingerprinting methods in subtyping. Forty-three V. cholerae of different serogroups from various sources were tested. The PCR-fingerprinting approaches were evaluated on typeability, reproducibility, stability and discriminatory power. Overall, Malaysian non-O1/non-O139 V. cholerae were more diverse than O1 strains. Four non-O1/non-O139 strains were closely related with O1 strains. The O139 strain in this study shared similarity with strains of both O1 and non-O1/non-O139 serogroups. ERIC-PCR was the most discriminative approach (D value = 0.996). VCR-PCR was useful in discriminating non-O1/non-O139 strains. RAPD-PCR and REP-PCR were less suitable for efficient subtyping purposes as they were not reproducible and lacked stability. The combination of the ERIC-PCR and VCR-PCR may overcome the inadequacy of any one approach and hence provide more informative data.

Matched MeSH terms: Cholera/epidemiology*

A review of potential factors contributing to epidemic cholera in Yemen

Al-Gheethi A, Noman E, Jeremiah David B, Mohamed R, Abdullah AH, Nagapan S, et al.

J Water Health, 2018 Oct;16(5):667-680.

PMID: 30285950 DOI: 10.2166/wh.2018.113

The menace of cholera epidemic occurrence in Yemen was reported in early 2017. Recent reports revealed that an estimated 500,000 people are infected with cholera whereas 2,000 deaths have been reported in Yemen. Cholera is transmitted through contaminated water and food. Yemen is the least developed country among the Middle East countries in terms of wastewater and solid waste management. The population of Yemen is about 24.5 million and generates about 70-100 million m3 of sewage. An estimated 7% of the population has sewerage systems. It has been revealed that 31.2 million m3 of untreated sewage is used for irrigation purposes especially for vegetables and Khat trees. In addition, more than 70% of the population in Yemen has no potable water. They depend on water wells as a water source which are located close to sewage disposal sites. The present review focuses on the current status of water, wastewater as well as solid waste management in Yemen and their roles in the outbreak of cholera. Future prospects for waste management have been proposed.

Matched MeSH terms: Cholera/epidemiology*

Molecular epidemiologic analysis of Vibrio cholerae O1 isolates by pulsed-field gel electrophoresis

Mahalingam S, Cheong YM, Kan S, Yassin RM, Vadivelu J, Pang T

J Clin Microbiol, 1994 Dec;32(12):2975-9.

PMID: 7883885

Isolates of Vibrio cholerae O1 El Tor from two well-defined cholera outbreaks in Malaysia were analyzed by using pulsed-field gel electrophoresis (PFGE). Isolates from sporadic cases occurring during the same time period were also studied. Digestion of chromosomal DNA from these isolates of V. cholerae O1 with restriction endonucleases NotI (5'-GCGGCCGC-3') and SfiI (5'-GGCCNNNN-3'), followed by PFGE, produced restriction endonuclease analysis (REA) patterns consisting of 13 to 24 bands (ranging in size from 46 to 398 kbp). Analysis of the REA patterns generated by PFGE after digestion with NotI and SfiI suggested the clonal nature and close genetic identity of the isolates obtained during each of the two outbreaks (Dice coefficient, 0.93 to 1.0). Although they had very similar REA patterns, the two outbreak clones were not identical. Isolates of V. cholerae O1 from sporadic cases, on the other hand, appeared to be much more heterogeneous (five different REA patterns detected in the five isolates tested; Dice coefficient, 0.31 to 0.81) than those obtained during the two outbreaks. We conclude that PFGE of V. cholerae O1 chromosomal DNA digested with infrequently cutting restriction endonucleases is a useful method for molecular typing of V. cholerae isolates for epidemiological purposes.

Matched MeSH terms: Cholera/epidemiology

Fulltext Molecular evidence of cholera outbreak caused by a toxigenic Vibrio cholerae O1 El tor variant strain in Kelantan, Malaysia

Ang GY, Yu CY, Balqis K, Elina HT, Azura H, Hani MH, et al.

J Clin Microbiol, 2010 Nov;48(11):3963-9.

PMID: 20826646 DOI: 10.1128/JCM.01086-10

A total of 20 Vibrio cholerae isolates were recovered for investigation from a cholera outbreak in Kelantan, Malaysia, that occurred between November and December 2009. All isolates were biochemically characterized as V. cholerae serogroup O1 Ogawa of the El Tor biotype. They were found to be resistant to multiple antibiotics, including tetracycline, erythromycin, sulfamethoxazole-trimethoprim, streptomycin, penicillin G, and polymyxin B, with 35% of the isolates being resistant to ampicillin. All isolates were sensitive to ciprofloxacin, norfloxacin, chloramphenicol, gentamicin, and kanamycin. Multiplex PCR analysis confirmed the biochemical identification and revealed the presence of virulence genes, viz., ace, zot, and ctxA, in all of the isolates. Interestingly, the sequencing of the ctxB gene showed that the outbreak strain harbored the classical cholera toxin gene and therefore belongs to the newly assigned El Tor variant biotype. Clonal analysis by pulsed-field gel electrophoresis demonstrated that a single clone of a V. cholerae strain was responsible for this outbreak. Thus, we present the first molecular evidence that the toxigenic V. cholerae O1 El Tor variant has invaded Malaysia, highlighting the need for continuous monitoring to facilitate early interventions against any potential epidemic by this biotype.

Matched MeSH terms: Cholera/epidemiology

Fulltext Cholera outbreak by Sea Gypsies in Sabah, Malaysia: A challenge in North Borneo

Jikal M, Riduan T, Aarifin R, Jeffree MS, Ahmed K

Int J Infect Dis, 2019 Jun;83:83-85.

PMID: 30986543 DOI: 10.1016/j.ijid.2019.04.008

OBJECTIVES: In this study we investigated an outbreak of Vibrio cholera O1 Ogawa serotype, occurred during December 2014 in Kudat district, situated in Sabah state of the Malaysian part of Borneo.

METHODS: Active case detection and contact tracing were done at respective localities by house to house survey. Passive case detection was done among acute gastroenteritis patients attended at various health facilities. To determine the source, samples from food, water and environment were taken. A case control study was also done to determine the risk factors.

RESULTS: A total of 44 symptomatic and 34 asymptomatic cases from 19 localities were investigated. 39 cases were detected through passive case detection. Median age of cases was 23 years. All cases belonged to serogroup O1 and Ogawa serotype. The epidemiological investigation of time, place, and person identified that V. cholerae cross-transmission might have occurred in two fish markets and the fish-loading port. Circumstantial evidences indicated that cholera was possibly transmitted through contaminated sea foods.

CONCLUSIONS: We concluded that the life-style of Sea Gypsies is a challenge in cholera control; therefore vaccination might be an effective way to mitigate cholera in an outbreak prone area like Kudat.

Matched MeSH terms: Cholera/epidemiology*

Detection of virulence associated genes, haemolysin and protease amongst Vibrio cholerae isolated in Malaysia

Iyer L, Vadivelu J, Puthucheary SD

Epidemiol Infect, 2000 Aug;125(1):27-34.

PMID: 11057956

Eighty-four strains of Vibrio cholerae O1, O139 and non-O1/non-O139 from clinical and environmental sources were investigated for the presence of the toxin co-regulated pilus gene, tcpA, the virulence cassette genes ctxA, zot, ace and cep and also for their ability to elaborate haemolysin and protease. The ctxA and zot genes were detected using DNA-DNA hybridization while the ace, cep and tcpA genes were detected using PCR. Production of haemolysin and protease was detected using mammalian erythrocytes and an agar diffusion assay respectively. Analysis of their virulence profiles showed six different groups designated Type I to Type VI and the major distinguishing factor among these profiles was in the in vitro production of haemolysin and/or protease. Clinical O1, O139 and environmental O1 strains were similar with regard to presence of the virulence cassette genes. All environmental O1 strains with the exception of one were found to possess ctxA, zot and ace giving rise to the probability that these strains may actually be of clinical origin. One strain which had only cep but none of the toxin genes may be a true environmental isolate. The virulence cassette and colonization factor genes were absent in all non-O1/non-O139 environmental strains but production of both the haemolysin and protease was present, indicating that these may be putative virulence factors. These findings suggest that with regard to its pathogenic potential, only strains of the O1 and O139 serogroup that possess the tcpA gene which encodes the phage receptor, have the potential to acquire the CTX genetic element and become choleragenic.

Matched MeSH terms: Cholera/epidemiology

Molecular evidence of clonality amongst Vibrio cholerae O1 biotype El Tor during an outbreak in Malaysia

Vadivelu J, Iyer L, Kshatriya BM, Puthucheary SD

Epidemiol Infect, 2000 Feb;124(1):25-30.

PMID: 10722126

Forty-three clinical strains of V. cholerae O1 biotype E1 Tor were isolated between 3 May and 10 June 1998 during an outbreak in the metropolitan area of Kuala Lumpur and its suburbs. With the exception of three Inaba strains that were restricted to three members of a family, all the others belonged to the Ogawa serotype. The strains were analysed for clonality using ribotyping and pulsed-field gel electrophoresis (PFGE). Two ribotypes, V/B21a and B27, were identified among 40 Ogawa isolates using BglI restriction endonuclease. Ribotype V/B21a has been described previously from Taiwan and Colombia and several Asian countries while B27 has been reported among isolates from Senegal. The three Inaba strains belonged to one ribotype, designated type A, not previously reported. PFGE analysis using NotI revealed that all isolates within a ribotype had identical profiles demonstrating clonality amongst the strains. Dice coefficient analysis of the two Ogawa genotypes revealed 89% similarity on ribotype patterns and 91.3% on PFGE profiles. Ribotype V/B21a isolates were associated with cases from dispersed areas of Kuala Lumpur and its suburbs while ribotype B27 was restricted to cases from one particular area suggesting a common-source outbreak.

Matched MeSH terms: Cholera/epidemiology

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