An outbreak of an acute virus infection was detected in Sarawak,
Malaysia beginning from 14 April 1997. Up till today (2 June 1997), 15
children have died from this disease. Their ages ranged from 5 months to
3.5 years; nine were males and six were females. All the cases came
from different localities, but six were from within the same district.
All cases were very ill when admitted to hospital and died within 24
hours of admission. All presented with similar clinical features which
were as follows:-
Clinical features:
- fever of 2-3 days duration
- involvement of the nervouse system which manifested as fits and
paralysis of one side of the upper limbs
- poor systemic perfusion
- end stage : cardiogenic shock due to myocarditis. Echocardioram shows
poor contractability of left ventricle
Other significant findings,
Chest x-ray - pulmonary oedema
Cerebro-spinal fluid -suggestive of aseptic meningitis
the following have been excluded serologicay : Japanese
encephalitis Dengue
Yellow fever
Virus culture:
Serum and cerebro-spinal fluid cultured in:
1. baby hamster kidney cells medium MEM with 1% foetal bovine serum
2. pig kidney cells (PS) medium Leibovitz 15 with 1% foetal bovine
serum
3. mosquito cells C6/36 medium Leibovitz 15 with 1% foetal bovine serum
Cytopathic effect (CPE) noted in medium (3) for cerebrospinal fluid from
one patient
Throat and rectal swabs will be cultured in vero-primate cell line today
(2/5/1997)
As we have yet to come to a conclusive diagnosis of this condition, we
would bevery grateful if anyone could provide some information or
suggestion as to what organism we are dealing with. This is essential
for control purposes.
Please contact :
Sarawak Health Department
Email : JKNS2 at po.jaring.my
Tel: 60-82-256566 Fax: 60-82-424959
