Displaying publications 101 - 120 of 684 in total

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  1. Alyousefi TA, Abdul-Ghani R, Mahdy MA, Al-Eryani SM, Al-Mekhlafi AM, Raja YA, et al.
    BMC Infect Dis, 2016 Oct 7;16(1):543.
    PMID: 27717333
    Yemen has witnessed several dengue fever outbreaks coincident with the social unrest and war in the country. The aim of the present study was to describe the knowledge, attitudes and practices (KAPs) of at-risk urban populations residing in Taiz, southwest of Yemen. In addition, factors possibly associated with poor preventive practices were investigated.
    Matched MeSH terms: Disease Outbreaks
  2. 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: Disease Outbreaks
  3. Appannan JS, Maheswaran L, Raimee N, Lim WL, Amran FH
    Work, 2022;73(4):1135-1145.
    PMID: 36057808 DOI: 10.3233/WOR-211467
    BACKGROUND: Millions of employees were laid off during the COVID-19 pandemic. The hospitality industry has been gravely hit by this crisis.

    OBJECTIVE: Drawing from the theory of conservation of resources (COR), our study aims to examine possible factors that influence turnover intention among hotel employees.

    METHODS: The hypotheses were tested on 141 hotel employees from Klang Valley, Malaysia. Data were collected by means of questionnaires, purposive sampling was employed, and PLS-SEM was used in performing the data analyses.

    RESULTS: Job insecurity and psychological distress were found to be the potent antecedent of turnover intention. In contrast, the role of perceived supervisor support did not significantly moderate the effects of both job insecurity and psychological distress on the quitting intention.

    CONCLUSION: Re-looking at existing policies and leadership styles may be fruitful in ensuring the sustainability path of an organization. This is pivotal in growing back the entire hospitality industry that has gravely affected by COVID-19.

    Matched MeSH terms: Disease Outbreaks
  4. Fischer K, Pickering B, Diederich S
    Methods Mol Biol, 2023;2610:17-29.
    PMID: 36534278 DOI: 10.1007/978-1-0716-2895-9_2
    Nipah virus (NiV) is an emerging, zoonotic paramyxovirus that is among the most pathogenic of viruses in humans. During the first reported outbreak of NiV in Malaysia and Singapore in the late 1990s, pigs served as an intermediate host, which enabled the transmission to humans. Although subsequent outbreaks in Asia only reported direct bat-to-human and human-to-human transmission, pigs are still considered a potential source for viral dissemination in the epidemiology of the disease. Thus, serological assays such as Enzyme-linked immunosorbent assay (ELISA) or virus neutralization test (VNT) represent powerful tools to characterize the serum antibody responses in NiV-infected pigs as well as to perform seroepidemiological surveillance studies on the potential circulation of NiV or NiV-related viruses among pig populations worldwide. This chapter describes both methods in detail. Furthermore, we discuss some of the major pitfalls and indicate how to avoid them.
    Matched MeSH terms: Disease Outbreaks
  5. Muhaimin M, Habibi A, Riady Y, Alqahtani TM, Chaerunisaa AY, Wijaya TT, et al.
    BMC Med Educ, 2023 May 23;23(1):367.
    PMID: 37221539 DOI: 10.1186/s12909-023-04346-6
    The Covid-19 outbreak necessitated the implementation of social distancing mechanisms, such as the enforcement of lockdowns in numerous nations. The lockdown has disrupted many parts of everyday life, but this unusual event has particularly affected education. The temporary closure of educational institutions ushered in dozens of new reforms, including a shift into the distance and online learning. This study investigates the transition from traditional education in physical classrooms to online and distance and online learning in pharmacy education during Covid-19, especially about the challenges and benefits of distance and online learning. We did Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) for literature sources between 2020 and 2022 (n.14). The study elaborates on how the transition has influenced teachers and students of pharmacy education. The research also summarizes several recommendations, which may assist in minimizing the adverse impacts of lockdown and encourage streamlined processes to distance and online learning, particularly in pharmacy education.
    Matched MeSH terms: Disease Outbreaks
  6. Mallhi TH, Khan YH, Khan AH, Tanveer N, Qadir MI
    New Microbes New Infect, 2017 Sep;19:13-14.
    PMID: 28663798 DOI: 10.1016/j.nmni.2017.05.008
    Despite explicit warning from the National Institute of Health, Pakistan experienced its first chikungunya outbreak in the metropolis of Karachi. We underscore the attention of health authorities and healthcare professionals towards contributing factors associated with this outbreak and the measures required to combat this viral disease.
    Matched MeSH terms: Disease Outbreaks
  7. Murugaiah C
    Crit Rev Microbiol, 2011 Nov;37(4):337-48.
    PMID: 21823927 DOI: 10.3109/1040841X.2011.603288
    Cholera is an acute secretory diarrheal disease that is perceived by World Health Organization (WHO) to be a highly contagious threat. Firstly discovered by an Italian physician, Filippo Pacini, the disease gains a reputation as the most feared epidemic diarrheal disease encountered in developing countries. Despite effort taken by WHO to reduce the incidence rate, cholera-endemic prevail in certain regions. Factors that contribute to the disease transmission and ongoing spreading in cholera-prone areas remain as elusive. Should an awareness and knowledge of cholera be developed, it is the residents of developing nation that stand to benefit the most. This review gives insight into the disease prevalence, pandemic, epidemiology, pathogenesis, disease transmission, major strategies and steps to be pursued toward controlling cholera.
    Matched MeSH terms: Disease Outbreaks
  8. Lani R, Thariq IM, Suhaimi NS, Hassandarvish P, Abu Bakar S
    Hum Vaccin Immunother, 2024 Dec 31;20(1):2306675.
    PMID: 38263674 DOI: 10.1080/21645515.2024.2306675
    Arboviruses are a significant threat to global public health, with outbreaks occurring worldwide. Toll-like receptors (TLRs) play a crucial role in the innate immune response against these viruses by recognizing pathogen-associated molecular patterns and initiating an inflammatory response. Significantly, TLRs commonly implicated in the immune response against viral infections include TLR2, TLR4, TLR6, TLR3, TLR7, and TLR8; limiting or allowing them to replicate and spread within the host. Modulating TLRs has emerged as a promising approach to combat arbovirus infections. This review summarizes recent advances in TLR modulation as a therapeutic target in arbovirus infections. Studies have shown that the activation of TLRs can enhance the immune response against arbovirus infections, leading to increased viral clearance and protection against disease. Conversely, inhibition of TLRs can reduce the excessive inflammation and tissue damage associated with arbovirus infection. Modulating TLRs represents a potential therapeutic strategy to combat arbovirus infections.
    Matched MeSH terms: Disease Outbreaks
  9. Taleb S, Vahedian-Azimi A, Karimi L, Salim S, Mohammad F, Samhadaneh D, et al.
    BMC Psychiatry, 2024 Jan 22;24(1):61.
    PMID: 38254016 DOI: 10.1186/s12888-023-05088-x
    BACKGROUND: In light of several recent studies, there is evidence that the coronavirus disease 2019 (COVID-19) pandemic has caused various mental health concerns in the general population, as well as among healthcare workers (HCWs). The main aim of this study was to assess the psychological distress, burnout and structural empowerment status of HCWs during the COVID-19 outbreak, and to evaluate its predictors.

    METHODS: This multi-center, cross-sectional web-based questionnaire survey was conducted on HCWs during the outbreak of COVID-19 from August 2020 to January 2021. HCWs working in hospitals from 48 different countries were invited to participate in an online anonymous survey that investigated sociodemographic data, psychological distress, burnout and structural empowerment (SE) based on Depression Anxiety and Stress Scale 21 (DASS-21), Maslach Burnout Inventory (MBI) and Conditions for work effectiveness questionnaire (CWEQ_II), respectively. Predictors of the total scores of DASS-21, MBI and CWEQ-II were assessed using unadjusted and adjusted binary logistic regression analysis.

    RESULTS: Out of the 1030 HCWs enrolled in this survey, all completed the sociodemographic section (response rate 100%) A total of 730 (70.9%) HCWs completed the DASS-21 questionnaire, 852 (82.6%) completed the MBI questionnaire, and 712 (69.1%) completed the CWEQ-II questionnaire. The results indicate that 360 out of 730 responders (49.3%) reported severe or extremely severe levels of stress, anxiety, and depression. Additionally, 422 out of 851 responders (49.6%) reported a high level of burnout, while 268 out of 712 responders (37.6%) reported a high level of structural empowerment based on the DASS-21, MBI, and CWEQ-II scales, respectively. In addition, the analysis showed that HCWs working in the COVID-19 areas experienced significantly higher symptoms of severe stress, anxiety, depression and higher levels of burnout compared to those working in other areas. The results also revealed that direct work with COVID-19 patients, lower work experience, and high workload during the outbreak of COVID-19 increase the risks of negative psychological consequences.

    CONCLUSION: Health professionals had high levels of burnout and psychological symptoms during the COVID-19 emergency. Monitoring and timely treatment of these conditions is needed.

    Matched MeSH terms: Disease Outbreaks
  10. Eagles D, Siregar ES, Dung DH, Weaver J, Wong F, Daniels P
    Rev. - Off. Int. Epizoot., 2009 Apr;28(1):341-8.
    PMID: 19618637
    Since the first H5N1 highly pathogenic avian influenza virus (HPAIV) infection in the region in August 2003, Cambodia, Laos, Malaysia, Myanmar, Indonesia, Thailand and Vietnam have all recorded outbreaks of the disease. The HPAIV continues to occur in some countries in Southeast Asia despite control programmes encompassing surveillance, vaccination and stamping out strategies. A number of strains have been circulating in the region since the first outbreaks in 2003, and although the source of the initial outbreaks in domestic poultry is not known, the continuing propagation of disease in the region is primarily the result of the movement of domestic poultry and poultry products, and people. A comprehensive approach using all the strategies available to break the chain of transmission of the virus in poultry will be needed to achieve lasting disease control.
    Matched MeSH terms: Disease Outbreaks/prevention & control; Disease Outbreaks/veterinary*
  11. Edwards JR
    Dev Biol (Basel), 2004;119:423-31.
    PMID: 15742655
    The OIE Southeast Asia Foot-and-Mouth Disease Campaign (SEAFMD) involves the coordinated control of foot-and-mouth disease by eight of the ASEAN countries. A long term vision for SEAFMD has been developed and the core element is a progressive zoning approach to the control and eradication of FMD in the region. This paper describes the current status of FMD in Southeast Asia and progress towards achievement of OIE free zone status for FMD in parts of the Philippines and Malaysia and the initiation of the Malaysia-Thailand-Myanmar (MTM) Peninsular Campaign for FMD Freedom. In mainland Southeast Asia, the progressive zoning approach involves several sub-regional groups working in parallel to oversee the epidemiological and economic studies required to determine the feasibility of the approach. Areas involved include the Lower Mekong Basin, Upper Mekong Basin, parts of Myanmar and the Red River Delta of Vietnam. The paper describes the current usage of vaccines for FMD in Southeast Asia and provides recommendations for their supply and use in the new regional initiatives.
    Matched MeSH terms: Disease Outbreaks/prevention & control; Disease Outbreaks/veterinary*
  12. Chong NS, Dionne B, Smith R
    J Math Biol, 2016 09;73(3):751-84.
    PMID: 26865385 DOI: 10.1007/s00285-016-0971-y
    Depopulation of birds has always been an effective method not only to control the transmission of avian influenza in bird populations but also to eliminate influenza viruses. We introduce a Filippov avian-only model with culling of susceptible and/or infected birds. For each susceptible threshold level [Formula: see text], we derive the phase portrait for the dynamical system as we vary the infected threshold level [Formula: see text], focusing on the existence of endemic states; the endemic states are represented by real equilibria, pseudoequilibria and pseudo-attractors. We show generically that all solutions of this model will approach one of the endemic states. Our results suggest that the spread of avian influenza in bird populations is tolerable if the trajectories converge to the equilibrium point that lies in the region below the threshold level [Formula: see text] or if they converge to one of the pseudoequilibria or a pseudo-attractor on the surface of discontinuity. However, we have to cull birds whenever the solution of this model converges to an equilibrium point that lies in the region above the threshold level [Formula: see text] in order to control the outbreak. Hence a good threshold policy is required to combat bird flu successfully and to prevent overkilling birds.
    Matched MeSH terms: Disease Outbreaks/prevention & control*; Disease Outbreaks/statistics & numerical data
  13. Hashim HD
    Rev. - Off. Int. Epizoot., 1999 Apr;18(1):47-51.
    PMID: 10190203
    Besides response and recovery, prevention and preparedness are the two critical components of any contingency plan. The author discusses the various elements which must be present in the prevention and preparedness plan of countries in Asia. As the continent has such diverse peoples and veterinary infrastructures, the actual plan may vary from one country to another, but must incorporate those elements which are crucial to ensure the success of the preparedness plan.
    Matched MeSH terms: Disease Outbreaks/prevention & control; Disease Outbreaks/veterinary*
  14. Bell IG, Nicholls PJ, Norman C, Ideris A, Cross GM
    Aust. Vet. J., 1991 Mar;68(3):97-101.
    PMID: 2043098
    Meat chickens housed on a commercial broiler farm in Australia were vaccinated once at 10 to 11 days-of-age by aerosol with live V4 Newcastle disease virus (NDV) vaccine. Groups of vaccinated and unvaccinated birds were flown to Malaysia, where they were challenged with a virulent strain of NDV. Survival rates in vaccinated chickens challenged 7, 14, 21 or 31 d after vaccination were 0.47, 0.77, 0.97 and 0.92, respectively. All unvaccinated chickens died due to Newcastle disease (ND) following challenge. Chickens in Australia and Malaysia were bled and the serums tested for haemagglutination-inhibiting (HI) antibody to NDV. Many vaccinated birds with no detectable antibody, and all birds with a log2 titre of 2 or greater, survived challenge. The results showed that this V4 vaccine induced protective immunity in a significant proportion of chickens within 7 d of mass aerosol vaccination. This early immunity occurred in the absence of detectable circulating HI antibody. Non-HI antibody mediated immunity continued to provide protection up to 31 d after vaccination. Almost all vaccinated birds were protected within 3 w of vaccination. It is concluded that the V4 vaccine is efficacious and could be useful during an outbreak of virulent ND in Australia.
    Matched MeSH terms: Disease Outbreaks/prevention & control; Disease Outbreaks/veterinary
  15. Shearer FM, Longbottom J, Browne AJ, Pigott DM, Brady OJ, Kraemer MUG, et al.
    Lancet Glob Health, 2018 03;6(3):e270-e278.
    PMID: 29398634 DOI: 10.1016/S2214-109X(18)30024-X
    BACKGROUND: Yellow fever cases are under-reported and the exact distribution of the disease is unknown. An effective vaccine is available but more information is needed about which populations within risk zones should be targeted to implement interventions. Substantial outbreaks of yellow fever in Angola, Democratic Republic of the Congo, and Brazil, coupled with the global expansion of the range of its main urban vector, Aedes aegypti, suggest that yellow fever has the propensity to spread further internationally. The aim of this study was to estimate the disease's contemporary distribution and potential for spread into new areas to help inform optimal control and prevention strategies.

    METHODS: We assembled 1155 geographical records of yellow fever virus infection in people from 1970 to 2016. We used a Poisson point process boosted regression tree model that explicitly incorporated environmental and biological explanatory covariates, vaccination coverage, and spatial variability in disease reporting rates to predict the relative risk of apparent yellow fever virus infection at a 5 × 5 km resolution across all risk zones (47 countries across the Americas and Africa). We also used the fitted model to predict the receptivity of areas outside at-risk zones to the introduction or reintroduction of yellow fever transmission. By use of previously published estimates of annual national case numbers, we used the model to map subnational variation in incidence of yellow fever across at-risk countries and to estimate the number of cases averted by vaccination worldwide.

    FINDINGS: Substantial international and subnational spatial variation exists in relative risk and incidence of yellow fever as well as varied success of vaccination in reducing incidence in several high-risk regions, including Brazil, Cameroon, and Togo. Areas with the highest predicted average annual case numbers include large parts of Nigeria, the Democratic Republic of the Congo, and South Sudan, where vaccination coverage in 2016 was estimated to be substantially less than the recommended threshold to prevent outbreaks. Overall, we estimated that vaccination coverage levels achieved by 2016 avert between 94 336 and 118 500 cases of yellow fever annually within risk zones, on the basis of conservative and optimistic vaccination scenarios. The areas outside at-risk regions with predicted high receptivity to yellow fever transmission (eg, parts of Malaysia, Indonesia, and Thailand) were less extensive than the distribution of the main urban vector, A aegypti, with low receptivity to yellow fever transmission in southern China, where A aegypti is known to occur.

    INTERPRETATION: Our results provide the evidence base for targeting vaccination campaigns within risk zones, as well as emphasising their high effectiveness. Our study highlights areas where public health authorities should be most vigilant for potential spread or importation events.

    FUNDING: Bill & Melinda Gates Foundation.

    Matched MeSH terms: Disease Outbreaks/prevention & control; Disease Outbreaks/statistics & numerical data*
  16. Gleeson LJ
    Rev. - Off. Int. Epizoot., 2002 Dec;21(3):465-75.
    PMID: 12530354
    The author presents reports of foot and mouth disease (FMD) submitted between 1996 and 2001 to the Office International des Epizooties (OIE: World organisation for animal health) Sub-Commission for FMD in South-East Asia. Of the ten countries in South-East Asia, FMD is endemic in seven (Cambodia, Laos, Malaysia, Myanmar, the Philippines, Thailand and Vietnam) and three are free of the disease (Brunei, Indonesia and Singapore). Part of the Philippines is also recognised internationally as being free of FMD. From 1996 to 2001, serotype O viruses caused outbreaks in all seven of the endemically infected countries. On the mainland, three different type O lineages have been recorded, namely: the South-East Asian (SEA) topotype, the pig-adapted or Cathay topotype and the pan-Asian topotype. Prior to 1999, one group of SEA topotype viruses occurred in the eastern part of the region and another group in the western part. However, in 1999, the pan-Asian lineage was introduced to the region and has become widespread. The Cathay topotype was reported from Vietnam in 1997 and is the only FMD virus currently endemic in the Philippines. Type Asia 1 has never been reported from the Philippines but was reported from all countries on the mainland except Vietnam between 1996 and 2001. Type A virus has not been reported from east of the Mekong River in the past six years and seems to be mainly confined to Thailand with occasional spillover into Malaysia. The distribution and movement of FMD viruses in the region is a reflection of the trade-driven movement of livestock. There is great disparity across the region in the strength and resources of the animal health services and this has a direct impact on FMD control. Regulatory environments are not well developed and enforcement of regulations can be ineffectual. The management of animal movement is quite variable across the region and much market-driven transboundary movement of livestock is unregulated. Formal quarantine approaches are generally not supported by traders or are not available. Vaccination is not used widely as a control tool because of the expense. However, it is applied by the Veterinary Services in Malaysia to control incursions of the disease and there is a mass vaccination programme for large ruminants in Thailand where the Government produces and distributes vaccine. Vaccination is also used by the commercial pig sector, particularly in the Philippines and Thailand.
    Matched MeSH terms: Disease Outbreaks/prevention & control; Disease Outbreaks/veterinary
  17. Ambat AS, Zubair SM, Prasad N, Pundir P, Rajwar E, Patil DS, et al.
    J Infect Public Health, 2019 02 23;12(5):634-639.
    PMID: 30808593 DOI: 10.1016/j.jiph.2019.02.013
    The objectives of this review were to understand the epidemiology and outbreak of NiV infection and to discuss the preventive and control measures across different regions. We searched PubMed and Scopus for relevant articles from January 1999 to July 2018 and identified 927 articles which were screened for titles, abstracts and full texts by two review authors independently. The screening process resulted in 44 articles which were used to extract relevant information. Information on epidemiology of NiV, outbreaks in Malaysia, Singapore, Bangladesh, India and Philippines, including diagnosis, prevention, treatment, vaccines, control, surveillance and economic burden due to NiV were discussed. Interdisciplinary and multi sectoral approach is vital in preventing the emergence of NiV. It is necessary to undertake rigorous research for developing vaccines and medicines to prevent and treat NiV.
    Matched MeSH terms: Disease Outbreaks/prevention & control*; Disease Outbreaks/statistics & numerical data
  18. Kristmundsson Á, Erlingsdóttir Á, Freeman MA
    PLoS One, 2015;10(12):e0144685.
    PMID: 26684810 DOI: 10.1371/journal.pone.0144685
    Due to the total and unexpected collapse of the Iceland scallop, Chlamys islandica, stocks around Iceland during the 2000s, a commercial fishing ban has been imposed on this valuable resource since 2003. Following the initial identification of an apicomplexan parasite in the scallops, a long-term surveillance program was established to evaluate the effect of the parasite on the population. The infections were highly prevalent in all shell sizes throughout the study. However, the parasite only impacts mature scallops where they cause severe macroscopic changes, characterized by an extensively diminished and abnormally coloured adductor muscle. A highly significant relationship was observed between infection intensity and gonad and adductor muscle indices. The first four years of the study, were characterized by high infection intensity and very poor condition of the adductor muscle and gonads, whilst during subsequent years, infections gradually decreased and the condition of the scallops improved. Histopathological changes were restricted to the presence of apicomplexan zoites which were widely distributed, causing varying degrees of pathology in all organs. In heavy infections, muscular and connective tissues were totally necrotized, destroying significant parts of numerous organs, especially the adductor muscle, digestive gland and gonads. The progression of the disease was in good synchrony with the mortality rates and the subsequent decline observed in the scallop stock and recruitment indices. Our findings strongly suggest that the apicomplexan parasite played a major role in the collapse of the Iceland scallop stock in Breidafjordur. In addition to causing mortality, the infections significantly impact gonad development which contributes further to the collapse of the stock in the form of lower larval recruitment. Furthermore, compelling evidence exists that this apicomplexan pathogen is causing serious disease outbreaks in other scallop populations. Similar abnormal adductor muscles and the parasite itself have been identified or observed in association with other mass mortality events in several different scallop species and commercial stocks in the northern hemisphere.
    Matched MeSH terms: Disease Outbreaks
  19. Banu S, Hu W, Guo Y, Naish S, Tong S
    PLoS One, 2014;9(2):e89440.
    PMID: 24586780 DOI: 10.1371/journal.pone.0089440
    BACKGROUND: Dengue fever (DF) is one of the most important emerging arboviral human diseases. Globally, DF incidence has increased by 30-fold over the last fifty years, and the geographic range of the virus and its vectors has expanded. The disease is now endemic in more than 120 countries in tropical and subtropical parts of the world. This study examines the spatiotemporal trends of DF transmission in the Asia-Pacific region over a 50-year period, and identified the disease's cluster areas.

    METHODOLOGY AND FINDINGS: The World Health Organization's DengueNet provided the annual number of DF cases in 16 countries in the Asia-Pacific region for the period 1955 to 2004. This fifty-year dataset was divided into five ten-year periods as the basis for the investigation of DF transmission trends. Space-time cluster analyses were conducted using scan statistics to detect the disease clusters. This study shows an increasing trend in the spatiotemporal distribution of DF in the Asia-Pacific region over the study period. Thailand, Vietnam, Laos, Singapore and Malaysia are identified as the most likely clusters (relative risk = 13.02) of DF transmission in this region in the period studied (1995 to 2004). The study also indicates that, for the most part, DF transmission has expanded southwards in the region.

    CONCLUSIONS: This information will lead to the improvement of DF prevention and control strategies in the Asia-Pacific region by prioritizing control efforts and directing them where they are most needed.

    Matched MeSH terms: Disease Outbreaks
  20. Lim KG
    Med J Malaysia, 2010 Dec;65(4):255.
    PMID: 21901939
    In the last four years, Malaysia has had three outbreaks of chikungunya virus infection. The first two occurred in Perak in 2006.The third began in Johor in early 2008. The genome of the viruses suggests that on each occasion a different virus was introduced into the population. The first outbreak in Bagan Panchor was due to an Asian genotype virus. The second in the Kinta district of Perak in late 2006 was due to a Central/East African genotype virus. Contact tracing was even able to discover the patient who was the source of the virus from the Indian subcontinent. The third outbreak in Johor was also of a Central/East African strain of virus, but introduced independently. The epidemiology of that outbreak is described in this issue of the MJM.
    Matched MeSH terms: Disease Outbreaks
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