exudates and Pneumonia--Viral

The emergence of a novel human coronavirus, SARS-CoV-2, causing severe respiratory tract infections in humans, is affecting all countries of the world and has become a global health concern. Since the virus was first identified in December 2019, the number of deaths have been propagating exponentially, causing countries across the world, including Malaysia, to increase emergency measures to combat the virus. Due to the fact that the COVID-19 pandemic does not discriminate its victims, it is of paramount importance to construct a plan for management of the dead for all suspected or confirmed COVID-19 cases, including the unidentified deceased, as an essential portion of the humanitarian forensic action approach. This document provides an overview on ways to maximize the local collective capacity from various government agencies to manage the dead based on the prevailing regulations and legislation in the country, in preparation for possible large scale deaths from this pandemic. The National Institute of Forensic Medicine Malaysia has improvised procedures and guidelines for management of the dead within the existing regulations in order to achieve a balance between medicolegal requirements and the safety of personnel managing the bodies of the deceased with suspected or confirmed COVID-19 infection; at the site of death, during transport, during postmortem procedures, storage and preparation before and during burial or cremation as well as environmental cleaning and disinfection, involving various agencies in the country. A form of temporary controlled burial is as an option to allow the reinvestigation of a decedent to help formally identify victims of the pandemic such as undocumented migrants or refugees who were previously not identified. Due to the different legal requirements and mortality rates between countries, there is no one-size-fits-all approach to the management of the dead. Whenever possible, every opportunity and assistance must be given to families to mourn their loved ones, even in times of crisis or an outbreak, in order to sustain an appropriate level of dignity and respect.

Topics: Adult; Aged; Aged, 80 and over; Attitude to Death; Autopsy; Betacoronavirus; Burial; Cause of Death; Coronavirus Infections; COVID-19; Cremation; Female; Forensic Sciences; Funeral Rites; Hospital Mortality; Humans; Malaysia; Male; Middle Aged; Mortuary Practice; Pandemics; Pneumonia, Viral; SARS-CoV-2

As of mid-May 2020, it has been 5 months since the 1st case of coronavirus was detected in Malaysia. Thus far, 113 deaths have been reported. Several effective measures have been taken by the government under a partial lockdown or movement control order to contain the spread of the virus, which have led to the flattening of the curve. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Topics: Betacoronavirus; Coronavirus Infections; COVID-19; Health Policy; Humans; Malaysia; Pandemics; Pneumonia, Viral; Quarantine; SARS-CoV-2

Rapid evolution of pulmonary complications associated with severe COVID-19 pneumonia often pose a management challenge to clinicians especially in the critical care setting. Serial chest imaging enable clinicians to better monitor disease progression and identify potential complications early which may decrease the mortality and morbidity associated with COVID-19. We report a 69-year-old male patient with severe COVID-19 pneumonia who presented to a tertiary referral centre in Kuala Lumpur, Malaysia, in 2020 with multiple pulmonary complications including lung cavitation, bronchopleural fistula, pneumothorax, pneumomediastinum, subcutaneous emphysema and acute pulmonary embolism. Unfortunately, the patient died one month after admission. COVID-19 patients may develop pulmonary complications due to a combination of direct viral lung damage, hypoxaemia and high stress ventilation. Awareness of COVID-19 complications can prompt early diagnosis and timely management to reduce morbidity and mortality.

Topics: Aged; COVID-19; Humans; Lung; Malaysia; Male; Pneumonia, Viral; Thorax

Topics: Alphacoronavirus; Animals; Child; Coronavirus Infections; Deltacoronavirus; Dogs; Genome, Viral; Haiti; Humans; Malaysia; Pneumonia, Viral; Recombination, Genetic; Swine; Viral Zoonoses

An outbreak of coronavirus disease 2019 (COVID-19) caused by the 2019 novel coronavirus (SARS-CoV-2) began in the city of Wuhan in China and has widely spread worldwide. Currently, it is vital to explore potential intermediate hosts of SARS-CoV-2 to control COVID-19 spread. Therefore, we reinvestigated published data from pangolin lung samples from which SARS-CoV-like CoVs were detected by Liu et al. [1]. We found genomic and evolutionary evidence of the occurrence of a SARS-CoV-2-like CoV (named Pangolin-CoV) in dead Malayan pangolins. Pangolin-CoV is 91.02% and 90.55% identical to SARS-CoV-2 and BatCoV RaTG13, respectively, at the whole-genome level. Aside from RaTG13, Pangolin-CoV is the most closely related CoV to SARS-CoV-2. The S1 protein of Pangolin-CoV is much more closely related to SARS-CoV-2 than to RaTG13. Five key amino acid residues involved in the interaction with human ACE2 are completely consistent between Pangolin-CoV and SARS-CoV-2, but four amino acid mutations are present in RaTG13. Both Pangolin-CoV and RaTG13 lost the putative furin recognition sequence motif at S1/S2 cleavage site that can be observed in the SARS-CoV-2. Conclusively, this study suggests that pangolin species are a natural reservoir of SARS-CoV-2-like CoVs.

Topics: Amino Acid Sequence; Animals; Betacoronavirus; Chiroptera; Coronavirus Infections; COVID-19; Disease Reservoirs; Eutheria; Genome, Viral; Malaysia; Pandemics; Phylogeny; Pneumonia, Viral; SARS-CoV-2; Sequence Alignment; Spike Glycoprotein, Coronavirus

The ongoing outbreak of viral pneumonia in China and across the world is associated with a new coronavirus, SARS-CoV-2

Topics: Amino Acid Sequence; Animals; Betacoronavirus; China; Chiroptera; Coronavirus Infections; COVID-19; Disease Reservoirs; Eutheria; Evolution, Molecular; Genome, Viral; Genomics; Humans; Malaysia; Pandemics; Phylogeny; Pneumonia, Viral; Recombination, Genetic; SARS-CoV-2; Sequence Alignment; Sequence Homology, Nucleic Acid; Spike Glycoprotein, Coronavirus; Zoonoses

Topics: China; Coronavirus Infections; Cough; COVID-19; Female; Fever; Humans; Malaysia; Middle Aged; Pandemics; Pneumonia, Viral; Tomography, X-Ray Computed; Travel

This is a brief report of 4 paediatric cases of COVID-19 infection in Malaysia BACKGROUND: COVID-19, a coronavirus, first detected in Wuhan, China has now spread rapidly to over 60 countries and territories around the world, infecting more than 85000 individuals. As the case count amongst children is low, there is need to report COVID-19 in children to better understand the virus and the disease.. In Malaysia, until end of February 2020, there were four COVID-19 paediatric cases with ages ranging from 20 months to 11 years. All four cases were likely to have contracted the virus in China. The children had no symptoms or mild flu-like illness. The cases were managed symptomatically. None required antiviral therapy.. There were 2 major issues regarding the care of infected children. Firstly, the quarantine of an infected child with a parent who tested negative was an ethical dilemma. Secondly, oropharyngeal and nasal swabs in children were at risk of false negative results. These issues have implications for infection control. Consequently, there is a need for clearer guidelines for child quarantine and testing methods in the management of COVID-19 in children.

Topics: Betacoronavirus; Child; Child, Preschool; Coronavirus Infections; COVID-19; Female; Humans; Infant; Malaysia; Male; Pandemics; Pneumonia, Viral; SARS-CoV-2

Topics: Coronavirus Infections; COVID-19; Crowding; Disease Outbreaks; Humans; Islam; Malaysia; Pandemics; Pneumonia, Viral; Travel

Topics: Betacoronavirus; Communicable Disease Control; Coronavirus Infections; COVID-19; Humans; Malaysia; Pandemics; Pneumonia, Viral; SARS-CoV-2; Social Isolation; Urology

An outbreak of respiratory illness which is proven to be infected by a 2019 novel coronavirus (2019-nCoV) officially named as Coronavirus Disease 2019 (COVID-19) was first detected in Wuhan, China and has spread rapidly in other parts of China as well as other countries around the world, including Malaysia. The first case in Malaysia was identified on 25 January 2020 and the number of cases continue to rise since March 2020. Therefore, 2020 Malaysia Movement Control Order (MCO) was implemented with the aim to isolate the source of the COVID-19 outbreak. As a result, there were fewer number of motor vehicles on the road and the operation of industries was suspended, ergo reducing emissions of hazardous air pollutants in the atmosphere. We had acquired the Air Pollutant Index (API) data from the Department of Environment Malaysia on hourly basis before and during the MCO with the aim to track the changes of fine particulate matter (PM

Topics: Air Pollution; Betacoronavirus; China; Coronavirus Infections; COVID-19; Humans; Malaysia; Pandemics; Pneumonia, Viral; SARS-CoV-2

Topics: Betacoronavirus; Borderline Personality Disorder; Coronavirus Infections; COVID-19; Disease Outbreaks; Female; Humans; Malaysia; Mentalization; Pandemics; Pneumonia, Viral; SARS-CoV-2

The current outbreak of coronavirus disease-2019 (COVID-19) poses unprecedented challenges to global health

Topics: Animals; Betacoronavirus; China; Chiroptera; Chlorocebus aethiops; Coronavirus Envelope Proteins; Coronavirus Infections; Coronavirus M Proteins; Coronavirus Nucleocapsid Proteins; COVID-19; Disease Reservoirs; Eutheria; Evolution, Molecular; Genome, Viral; Genomics; Host Specificity; Humans; Lung; Malaysia; Nucleocapsid Proteins; Pandemics; Phosphoproteins; Phylogeny; Pneumonia, Viral; Polymerase Chain Reaction; Recombination, Genetic; SARS-CoV-2; Sequence Alignment; Sequence Analysis, RNA; Sequence Homology, Nucleic Acid; Spike Glycoprotein, Coronavirus; Vero Cells; Viral Envelope Proteins; Viral Matrix Proteins; Zoonoses

In an effort to mitigate the outbreak of COVID-19, many countries have imposed drastic lockdown, movement control or shelter in place orders on their residents. The effectiveness of these mitigation measures is highly dependent on cooperation and compliance of all members of society. The knowledge, attitudes and practices people hold toward the disease play an integral role in determining a society's readiness to accept behavioural change measures from health authorities. The aim of this study was to determine the knowledge levels, attitudes and practices toward COVID-19 among the Malaysian public. A cross-sectional online survey of 4,850 Malaysian residents was conducted between 27th March and 3rd April 2020. The survey instrument consisted of demographic characteristics, 13 items on knowledge, 3 items on attitudes and 3 items on practices, modified from a previously published questionnaire on COVID-19. Descriptive statistics, chi-square tests, t-tests and one-way analysis of variance (ANOVA) were conducted. The overall correct rate of the knowledge questionnaire was 80.5%. Most participants held positive attitudes toward the successful control of COVID-19 (83.1%), the ability of Malaysia to conquer the disease (95.9%) and the way the Malaysian government was handling the crisis (89.9%). Most participants were also taking precautions such as avoiding crowds (83.4%) and practising proper hand hygiene (87.8%) in the week before the movement control order started. However, the wearing of face masks was less common (51.2%). This survey is among the first to assess knowledge, attitudes and practice in response to the COVID-19 pandemic in Malaysia. The results highlight the importance of consistent messaging from health authorities and the government as well as the need for tailored health education programs to improve levels of knowledge, attitudes and practices.

Topics: Adolescent; Adult; Aged; Betacoronavirus; Coronavirus Infections; COVID-19; Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; Humans; Malaysia; Male; Middle Aged; Pandemics; Pneumonia, Viral; SARS-CoV-2; Surveys and Questionnaires; Young Adult

No abstract provided.

Topics: Betacoronavirus; Coronavirus Infections; COVID-19; Humans; Malaysia; Pandemics; Pneumonia, Viral; SARS-CoV-2; Smoking; Tobacco Use Cessation

On the 18th of March 2020, the Malaysia government declared a movement control order (MCO) due to the unprecedented COVID-19 pandemic. Although the majority of patients presented with respiratory-related symptoms, COVID-19 patients may present atypically with neurological manifestations and may even have an increased risk of stroke. The Malaysia Stroke Council is concerned regarding the level of care given to stroke patients during this pandemic. During the recent National Stroke Workflow Steering Committee meeting, a guide was made based on the currently available evidences to assist Malaysian physicians providing acute stroke care in the hospital setting in order to provide the best stroke care while maintaining their own safety. The guide comprises of prehospital stroke awareness, hyperacute stroke care, stroke care unit and intensive care unit admission, post-stroke rehabilitation and secondary prevention practice. We urge continuous initiative to provide the best stroke care possible and ensure adequate safety for both patients and the stroke care team.

Topics: Betacoronavirus; Coronavirus Infections; COVID-19; Humans; Intensive Care Units; Malaysia; Pandemics; Pneumonia, Viral; Practice Guidelines as Topic; SARS-CoV-2; Stroke; Stroke Rehabilitation; Tomography, X-Ray Computed

Topics: Betacoronavirus; Burns; Clinical Laboratory Techniques; Coronavirus Infections; COVID-19; COVID-19 Testing; Delivery of Health Care; Disease Management; Elective Surgical Procedures; Emergencies; Humans; Malaysia; Operating Rooms; Pandemics; Pneumonia, Viral; Reverse Transcriptase Polymerase Chain Reaction; SARS-CoV-2; Surgical Procedures, Operative

Since its first appearance in Wuhan, China at the end of 2019, the new coronavirus (COVID-19) has evolved a global pandemic within three months, with more than 4.3 million confirmed cases worldwide until mid-May 2020. As many countries around the world, Malaysia and other southeast Asian (SEA) countries have also enforced lockdown at different degrees to contain the spread of the disease, which has brought some positive effects on natural environment. Therefore, evaluating the reduction in anthropogenic emissions due to COVID-19 and the related governmental measures to restrict its expansion is crucial to assess its impacts on air pollution and economic growth. In this study, we used aerosol optical depth (AOD) observations from Himawari-8 satellite, along with tropospheric NO

Topics: Air Pollution; Asia, Southeastern; Betacoronavirus; Carbon Monoxide; Coronavirus Infections; COVID-19; Environmental Monitoring; Humans; Malaysia; Nitrogen Dioxide; Oceans and Seas; Pandemics; Particulate Matter; Pneumonia, Viral; SARS-CoV-2; Sulfur Dioxide

Topics: Betacoronavirus; Clinical Laboratory Services; Coronavirus Infections; COVID-19; Humans; Malaysia; Pandemics; Pneumonia, Viral; Real-Time Polymerase Chain Reaction; SARS-CoV-2

Coronavirus disease 2019 (COVID-19), a novel pneumonia disease originating in Wuhan, was confirmed by the World Health Organization on January 12, 2020 before becoming an outbreak in all countries.. A stringent screening process at all airports in Malaysia was enforced after the first case outside China was reported in Thailand. Up to April 14, 2020, Malaysia had reported two waves of COVID-19 cases, with the first wave ending successfully within less than 2 months. In early March 2020, the second wave occurred, with worrying situations.. The Government of Malaysia enforced a Movement Control Order starting on March 18, 2020 to break the chain of COVID-19. The media actively spread the hashtag #stayhome. Non-governmental organizations, as well as prison inmates, started to produce personal protective equipment for frontliners. Various organizations hosted fundraising events to provide essentials mainly to hospitals. A provisional hospital was set up and collaborations with healthcare service providers were granted, while additional laboratories were assigned to enhance the capabilities of the Ministry of Health.. An initial financial stimulus amounting to RM 20.0 billion was released in February 2020, before the highlighted PRIHATIN Package, amounting to RM 250 billion, was announced. The PRIHATIN Package has provided governmental support to society, covering people of various backgrounds from students and families to business owners.

Topics: Airports; Betacoronavirus; Coronavirus Infections; COVID-19; Disease Outbreaks; Government; Humans; Malaysia; Middle Aged; Pandemics; Pneumonia, Viral; SARS-CoV-2; Young Adult

The coronavirus COVID-19 has recently started to spread rapidly in Malaysia. The number of total infected cases has increased to 3662 on 05 April 2020, leading to the country being placed under lockdown. As the main public concern is whether the current situation will continue for the next few months, this study aims to predict the epidemic peak using the Susceptible-Exposed-Infectious-Recovered (SEIR) model, with incorporation of the mortality cases. The infection rate was estimated using the Genetic Algorithm (GA), while the Adaptive Neuro-Fuzzy Inference System (ANFIS) model was used to provide short-time forecasting of the number of infected cases. The results show that the estimated infection rate is 0.228 ± 0.013, while the basic reproductive number is 2.28 ± 0.13. The epidemic peak of COVID-19 in Malaysia could be reached on 26 July 2020, with an uncertain period of 30 days (12 July-11 August). Possible interventions by the government to reduce the infection rate by 25% over two or three months would delay the epidemic peak by 30 and 46 days, respectively. The forecasting results using the ANFIS model show a low Normalized Root Mean Square Error (NRMSE) of 0.041; a low Mean Absolute Percentage Error (MAPE) of 2.45%; and a high coefficient of determination (R

Topics: Betacoronavirus; Coronavirus Infections; COVID-19; Forecasting; Health Surveys; Humans; Malaysia; Pandemics; Pneumonia, Viral; Public Health Administration; Quarantine; SARS-CoV-2

Topics: Betacoronavirus; Change Management; Communicable Disease Control; Coronavirus Infections; COVID-19; Disease Transmission, Infectious; Humans; Malaysia; Models, Statistical; Pandemics; Pneumonia, Viral; Prognosis; Risk Assessment; SARS-CoV-2

The COVID-19 pandemic has placed an unprecedented test on the delivery and management of healthcare services globally. This study describes the adaptive measures taken and evolving roles of the members of the paediatric surgery division in a developing country during this period.. We adopted multiple adaptive strategies including changes to stratification of surgeries, out-patient services by urgency and hospital alert status, policy writing involving multidisciplinary teams, and redeployment of manpower. Modifications were made to teaching activities and skills training to observe social distancing and mitigate reduced operative learning opportunities. Roles of academic staff were expanded to include non-surgical duties.. The planned strategies and changes to pre COVID-19 practices were successful in ensuring minimal disruption to the delivery of essential paediatric surgical services and training. Despite the lack of established guidelines and literature outlining strategies to address the impact of this pandemic on surgical services, most of the initial measures employed were consistent with that of other surgical centres.. Changes to delivery of surgical services and surgical training warrant a holistic approach and a constant re-evaluation of practices with emergence of new experiences and guidelines.

Topics: Ambulatory Care Facilities; Betacoronavirus; Child; Coronavirus Infections; COVID-19; Humans; Malaysia; Pandemics; Pediatrics; Pneumonia, Viral; Practice Guidelines as Topic; SARS-CoV-2; Surgical Procedures, Operative

We report on the suspected case reports filed for SARS-CoV-2 infections and COVID-19 illnesses among health and social welfare workers in Germany. In addition, we report about COVID-19 in health workers in Malaysia. Claims for occupational diseases caused by SARS-CoV-2 are recorded separately in a database of the Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW). This database is analyzed according to its content as of May 22, 2020. In addition, the notifiable cases of SARS-CoV-2 infections from personnel in medical institutions (e.g., clinics and doctor's office) and social welfare institutions (e.g., nursing homes, shelters and refugee camps) following the German Infection Protection Act are analyzed. The report from Malaysia is based on personal experience and publications of the government. In Germany at present, 4398 suspected case reports for the diagnosis of SARS-CoV-2 infections among health and social workers have been filed. This figure is four times the number of all reported infections normally received per year. The majority of claims, regardless of being a confirmed infection, concerned nurses (n = 6927, 63.9%). The mortality rate for workers infected with SARS-CoV-2 is 0.2% to 0.5%. Doctors are affected by severe illness more frequently than other occupational groups (8.1% vs. 4.1%). In Malaysia, work-related infection of health workers (HW) occurred mainly when COVID-19 was not suspected in patients and no adequate personal protective equipment (PPE) was worn. Although knowledge on the spread of SARS-CoV-2 infections among workers remains limited, the impact appears to be substantial. This is supported by the mortality rate among infected workers. Occupational health check-ups carried out at the present time should be systematically analyzed in order to gain more information on the epidemiology of COVID-19 among HW. Since the supply and use of PPE improved, the infection risk of HW in Malaysia seems to have decreased.

Topics: Adult; Betacoronavirus; Coronavirus Infections; COVID-19; Female; Germany; Health Personnel; Health Workforce; Humans; Malaysia; Male; Occupational Health; Pandemics; Personal Protective Equipment; Pneumonia, Viral; SARS-CoV-2

Topics: Betacoronavirus; Coronavirus Infections; COVID-19; Humans; Malaysia; Medical Tourism; Pandemics; Pneumonia, Viral; SARS-CoV-2

Malaysia has one of the highest total numbers of COVID-19 infections amongst the Southeast Asian nations, which led to the enforcements of the Malaysian "Movement Control Order" to prohibit disease transmission. The overwhelming increasing amount of infections has led to a major strain on major healthcare services. This leads to shortages in hospital beds, ventilators and critical personnel protective equipment. This article focuses on the critical adaptations from a general surgery department in Malaysia which is part of a Malaysian tertiary hospital that treats COVID-19 cases. The core highlights of these strategies enforced during this pandemic are: (1) surgery ward and clinic decongestions; (2) deferment of elective surgeries; (3) restructuring of medical personnel work force; (4) utilization of online applications for tele-communication; (5) operating room (OR) adjustments and patient screening; and (6) continuing medical education and updating practices in context to COVID-19. These adaptations were important for the continuation of emergency surgery services, preventing transmission of COVID-19 amongst healthcare workers and optimization of medical personnel work force in times of a global pandemic. In addition, an early analysis on the impact of COVID-19 pandemic and lockdown measures in Malaysia towards the reduction in total number of elective/emergent/trauma surgeries performed is described in this article.

Topics: Betacoronavirus; Coronavirus Infections; COVID-19; Elective Surgical Procedures; Emergency Treatment; Humans; Malaysia; Pandemics; Pneumonia, Viral; SARS-CoV-2; Wounds and Injuries

The COVID-19 pandemic caught the world by surprise, causing millions of confirmed cases and hundreds of thousands of deaths. Hence, the Malaysian government announced a Movement Control Order at the start of the containment phase to flatten the epidemiological curve. Universiti Malaysia Sabah (UMS), a public university in Borneo, was accelerated into alert phase because of high risk of case importation from more than 400 China incoming undergraduates. Measures to mitigate the potential COVID-19 outbreaks in its population were taken by using conventional public health measures with special attention to task-shifting and widespread community mental health interventions. A Preparedness and Response Centre was established to overseer the mitigating measures happening inside the university. Measures taken included empowerment of frontline staff, strengthening of restrictions, strengthening university health center, vigorous contact tracing, widespread health education, maintaining cultural sensitivity, and establishment of early standard operating procedures and university continuity plans. Hence, UMS was able to ensure no importation of cases into its campus during both acute and containment phases at the nationwide level.

Topics: Betacoronavirus; Coronavirus Infections; COVID-19; Humans; Malaysia; Mental Health; Pandemics; Pneumonia, Viral; SARS-CoV-2; Universities

The development of a vaccine against SARS-CoV-2 infection is on the way. To prepare for public availability, the acceptability of a hypothetical COVID-19 vaccine and willingness to pay (WTP) were assessed to provide insights into future demand forecasts and pricing considerations.. A cross-sectional survey was conducted from 3 to 12 April 2020. The health belief model (HBM) was used to assess predictors of the intent to receive the vaccine and the WTP.. A total of 1,159 complete responses was received. The majority reported a definite intent to receive the vaccine (48.2%), followed by a probable intent (29.8%) and a possible intent (16.3%). Both items under the perceived benefits construct in the HBM, namely believe the vaccination decreases the chance of infection (OR = 2.51, 95% CI 1.19-5.26) and the vaccination makes them feel less worry (OR = 2.19, 95% CI 1.03-4.65), were found to have the highest significant odds of a definite intention to take the vaccine. The mean ± standard deviation (SD) for the amount that participants were willing to pay for a dose of COVID-19 vaccine was MYR$134.0 (SD±79.2) [US$30.66 ± 18.12]. Most of the participants were willing to pay an amount of MYR$100 [US$23] (28.9%) and MYR$50 [US$11.5] (27.2%) for the vaccine. The higher marginal WTP for the vaccine was influenced by no affordability barriers as well as by socio-economic factors, such as higher education levels, professional and managerial occupations and higher incomes.. The findings demonstrate the utility of HBM constructs in understanding COVID-19 vaccination intention and WTP.

Topics: Adolescent; Adult; Aged; Betacoronavirus; Coronavirus Infections; COVID-19; COVID-19 Vaccines; Cross-Sectional Studies; Female; Health Care Surveys; Health Expenditures; Humans; Malaysia; Male; Middle Aged; Models, Psychological; Pandemics; Patient Acceptance of Health Care; Pneumonia, Viral; SARS-CoV-2; Socioeconomic Factors; Vaccination; Viral Vaccines; Young Adult

Research identifying adults' mental health during the coronavirus disease 2019 (COVID-19) pandemic relies solely on demographic predictors without examining adults' health condition as a potential predictor. This study aims to examine individuals' perception of health conditions and test availability as potential predictors of mental health-insomnia, anxiety, depression, and distress-during the COVID-19 pandemic. An online survey of 669 adults in Malaysia was conducted during 2-8 May 2020, six weeks after the Movement Control Order (MCO) was issued. We found adults' perception of health conditions had curvilinear relationships (horizontally reversed J-shaped) with insomnia, anxiety, depression, and distress. Perceived test availability for COVID-19 also had curvilinear relationships (horizontally reversed J-shaped) with anxiety and depression. Younger adults reported worse mental health, but people from various religions and ethnic groups did not differ significantly in reported mental health. The results indicated that adults with worse health conditions had more mental health problems, and the worse degree deepened for unhealthy people. Perceived test availability negatively predicted anxiety and depression, especially for adults perceiving COVID-19 test unavailability. The significant predictions of perceived health condition and perceived COVID-19 test availability suggest a new direction for the literature to identify the psychiatric risk factors directly from health-related variables during a pandemic.

Topics: Adult; Anxiety; Betacoronavirus; Coronavirus Infections; COVID-19; Depression; Female; Health Services Accessibility; Humans; Malaysia; Male; Mental Health; Pandemics; Pneumonia, Viral; SARS-CoV-2; Sleep Initiation and Maintenance Disorders; Surveys and Questionnaires; Young Adult

Malaysia is currently facing an outbreak of COVID-19. We aim to present the first study in Malaysia to report the reproduction numbers and develop a mathematical model forecasting COVID-19 transmission by including isolation, quarantine, and movement control measures. We utilized a susceptible, exposed, infectious, and recovered (SEIR) model by incorporating isolation, quarantine, and movement control order (MCO) taken in Malaysia. The simulations were fitted into the Malaysian COVID-19 active case numbers, allowing approximation of parameters consisting of probability of transmission per contact (

Topics: Betacoronavirus; Coronavirus Infections; COVID-19; Disease Outbreaks; Disease Susceptibility; Forecasting; Humans; Malaysia; Models, Theoretical; Pandemics; Pneumonia, Viral; Quarantine; SARS-CoV-2

To explore whether the climate has played a role in the COVID-19 outbreak, we compared virus lethality in countries closer to the Equator with others. Lethality in European territories and in territories of some nations with a non-temperate climate was also compared.. Lethality was calculated as the rate of deaths in a determinate moment from the outbreak of the pandemic out of the total of identified positives for COVID-19 in a given area/nation, based on the COVID-John Hopkins University website. Lethality of countries located within the 5th parallels North/South on 6 April and 6 May 2020, was compared with that of all the other countries. Lethality in the European areas of The Netherlands, France and the United Kingdom was also compared to the territories of the same nations in areas with a non-temperate climate.. A lower lethality rate of COVID-19 was found in Equatorial countries both on April 6 (OR=0.72 CI 95% 0.66-0.80) and on May 6 (OR=0.48, CI 95% 0.47-0.51), with a strengthening over time of the protective effect. A trend of higher risk in European vs. non-temperate areas was found on April 6, but a clear difference was evident one month later: France (OR=0.13, CI 95% 0.10-0.18), The Netherlands (OR=0.5, CI 95% 0.3-0.9) and the UK (OR=0.2, CI 95% 0.01-0.51). This result does not seem to be totally related to the differences in age distribution of different sites.. The study does not seem to exclude that the lethality of COVID-19 may be climate sensitive. Future studies will have to confirm these clues, due to potential confounding factors, such as pollution, population age, and exposure to malaria.

Topics: Betacoronavirus; Brunei; Burundi; Climate; Congo; Coronavirus Infections; COVID-19; Ecuador; Equatorial Guinea; Europe; France; Gabon; Humans; Indian Ocean Islands; Indonesia; Kenya; Malaysia; Melanesia; Micronesia; Netherlands; Pandemics; Papua New Guinea; Pneumonia, Viral; Rwanda; Samoa; Sao Tome and Principe; SARS-CoV-2; Seasons; Seychelles; Singapore; Somalia; Timor-Leste; Tropical Climate; Uganda; United Kingdom; Weather

The Covid-19 pandemic has caused changes in the surgical treatment of non-Covid patients, especially in thoracic surgery because most procedures are aerosol generating. Hospital Kuala Lumpur, where thoracic procedures are performed, was badly affected. We describe our experience in performing aerosol generating procedures safely in thoracic surgery during the Covid-19 era.. Medical records of patients who underwent thoracic surgery from March 18, 2020 to May 17, 2020 were reviewed retrospectively. All patients undergoing thoracic surgery were tested for Covid-19 using the reverse transcriptase polymerase chain reaction method. Patients with malignancy were observed for 10 to 14 days in the ward after testing negative. The healthcare workers donned personal protective equipment for all the cases, and the number of healthcare workers in the operating room was limited to the minimum required.. A total of 44 procedures were performed in 26 thoracic surgeries. All of these procedures were classified as aerosol generating, and the mean duration of the surgery was 130 ± 43 minutes. None of the healthcare workers involved in the surgery were exposed or infected by Covid-19.. Covid-19 will be a threat for a long time and thoracic surgeons must continue to provide their services, despite having to deal with aerosol generating procedures, in the new normal. Covid-19 testing of all surgical candidates, using the reverse transcriptase polymerase chain reaction, donning full personal protective equipment for healthcare workers, and carefully planned procedures are among the measures suggested to prevent unnecessary Covid-19 exposure in thoracic surgery.

Topics: Adult; Aerosols; Betacoronavirus; Clinical Laboratory Techniques; Coronavirus Infections; COVID-19; COVID-19 Testing; Diagnostic Imaging; Female; Humans; Malaysia; Male; Middle Aged; Operating Rooms; Pandemics; Personal Protective Equipment; Pneumonia, Viral; Retrospective Studies; SARS-CoV-2; Thoracic Surgery, Video-Assisted; Thoracic Surgical Procedures

The rapid global spread of the coronavirus disease (COVID-19) has inflicted significant health and socioeconomic burden on affected countries. As positive cases continued to rise in Malaysia, public health laboratories experienced an overwhelming demand for COVID-19 screening. The confirmation of positive cases of COVID-19 has solely been based on the detection of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) using real-time reverse transcription polymerase chain reaction (qRT-PCR). In efforts to increase the cost-effectiveness and efficiency of COVID-19 screening, we evaluated the feasibility of pooling clinical Nasopharyngeal/Oropharyngeal (NP/OP) swab specimens during nucleic acid extraction without a reduction in sensitivity of qRT-PCR. Pools of 10 specimens were extracted and subsequently tested by qRT-PCR according to the WHO-Charité protocol. We demonstrated that the sample pooling method showed no loss of sensitivity. The effectiveness of the pooled testing strategy was evaluated on both retrospective and prospective samples, and the results showed a similar detection sensitivity compared to testing individual sample alone. This study demonstrates the feasibility of using a pooled testing strategy to increase testing capacity and conserve resources, especially when there is a high demand for disease testing.

Topics: Betacoronavirus; Coronavirus Infections; COVID-19; Humans; Malaysia; Mass Screening; Nasopharynx; Oropharynx; Pandemics; Pneumonia, Viral; Real-Time Polymerase Chain Reaction; SARS-CoV-2; Sensitivity and Specificity; Specimen Handling

The COVID-19 pandemic and the lockdown has taken the world by storm. This study examines its impact on the anxiety level of university students in Malaysia during the peak of the crisis and the pertinent characteristics affecting their anxiety. A cross-sectional online survey, using Zung's self-rating anxiety questionnaire was conducted during the COVID-19 pandemic and lockdown. Out of the 983 respondents, 20.4%, 6.6%, and 2.8% experienced minimal to moderate, marked to severe, and most extreme levels of anxiety. Female gender (OR = 21.456, 95% CI = 1.061, 1.998,

Topics: Anxiety; Betacoronavirus; Coronavirus Infections; COVID-19; Cross-Sectional Studies; Female; Humans; Malaysia; Male; Pandemics; Pneumonia, Viral; SARS-CoV-2; Stress, Psychological; Students; Universities

The COVID-19 is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study aims to describe the clinical characteristics of COVID-19 patients admitted to Hospital Tengku Ampuan Afzan (HTAA), Pahang, Malaysia and to identify the clinical and laboratory markers for severe disease, complications and virologic clearance according to clinical staging.. This was a single-centre, retrospective, descriptive study. All COVID-19 patients admitted to HTAA from March 9 to April 15, 2020, were included in the study. Patients were categorised according to clinical staging. Data obtained from the medical report includes baseline characteristics of patients, comorbidities, presenting symptoms, laboratory findings, treatments, complications, and outcomes.. Of the total of 247 patients hospitalised, the majority consisted at clinical-stage 1 (43%) and stage 2 (39%) disease. Older patients, diabetes mellitus, hypertension, cardiovascular diseases, and chronic kidney disease were found more common among patients with severe disease. Fever was uncommon and the majority had normal haemoglobin levels, white cell counts, and platelet counts. C-reactive protein (CRP) was found statistically significant to predict pneumonia or hypoxia at a cut-off value of 14mg/L (sensitivity 73.8%, specificity 91.3%) and 50mg/L (sensitivity 100%, specificity 96.4%) respectively. Pneumonia was mostly diagnosed radiologically using chest radiography, especially among clinical stage 3. Acute kidney injury (AKI) was a significant complication, with 31% of clinical stage 3 and above developed AKI and 44% of them requiring haemodialysis. Median virologic clearance time was 15 days from onset of illness, and asymptomatic patients had longer clearance time.. COVID-19 presented with a wide spectrum of clinical patterns. CRP was a valuable predictor of severe disease. In this study risk and severity of acute kidney injury were found to be higher. A longer duration of virologic clearance was observed among the asymptomatic patients.

Topics: Adolescent; Adult; Aged; Betacoronavirus; Coronavirus Infections; COVID-19; Female; Hospitalization; Humans; Malaysia; Male; Middle Aged; Pandemics; Pneumonia, Viral; Retrospective Studies; SARS-CoV-2; Severity of Illness Index; Symptom Assessment; Treatment Outcome; Young Adult

COVID-19 has the potential to affect the mental health of health care workers (HCWs). It is known that HCWs who serve as front-liners during the COVID-19 pandemic experience stress and have the fear of contracting the infection. Little is known of how being a positive contact affects HCWs.. We examined the experience of HCWs who were quarantined following a close unprotected contact with a COVID-19 positive colleague and explore the psychological impact especially as the timing of the quarantine coincided with the Eid (annual Muslim festival) celebration in Malaysia.. This was a cross-sectional on-line questionnaire study, involving HCWs exposed to a COVID-19 positive colleague in Universiti Kebangsaan Malaysia Medical Centre, a teaching hospital. Data on demographics, levels of depression, anxiety and stress using a validated depression, anxiety, and stress scale (DASS-21) questionnaire, aspects of quarantine, wearing of masks, hand hygiene practice and swab experience were collected.. Twenty-two HCWs participated. Eighteen (81.8%) were between 30-39 years and 17 (77.3%) were women. Majority 19 (86.3%) were Malays. There were twelve (54.5%) medical officers, 5 (22.7%) specialists and 5(22.7%) allied health staff. Eighteen out of 22 (81.8%) felt they were able to do home quarantine adequately. All tested negative with a mean (Standard Deviation) hour of contact of 2.56±2.38 hours. Eighteen reported their biggest concern was infecting their families.. HCWs undergoing contact swabbing and quarantine are vulnerable to depression, anxiety and stress. The ability of the HCW to adequately home quarantine should not be taken for granted. Psychological support should be offered to HCWs who are positive contacts.

Topics: Adult; Attitude of Health Personnel; Betacoronavirus; Coronavirus Infections; COVID-19; Cross-Sectional Studies; Female; Humans; Malaysia; Male; Middle Aged; Occupational Exposure; Pandemics; Pneumonia, Viral; Quarantine; SARS-CoV-2; Surveys and Questionnaires

The world feels strange as we face what is for most of us our first ever pandemic. The number of newly diagnosed cases rises daily in many parts of the world, and we are faced with the reality that there are still many things to learn about this new disease. We share here our experience of treating our first 199 COVID-19 patients in the Hospital Canselor Tuanku Muhriz, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM).

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Betacoronavirus; Child; Contact Tracing; Coronavirus Infections; COVID-19; Female; Humans; Malaysia; Male; Middle Aged; Pandemics; Pneumonia, Viral; Retrospective Studies; Risk Factors; SARS-CoV-2; Symptom Assessment; Virus Shedding; Young Adult

No abstract provided.

Topics: Betacoronavirus; Coronavirus Infections; COVID-19; Emergency Service, Hospital; Humans; Infection Control; Malaysia; Pandemics; Pneumonia, Viral; SARS-CoV-2

No abstract provided.

Topics: Betacoronavirus; Child; Child Health; Communicable Disease Control; Coronavirus Infections; COVID-19; Humans; Malaysia; Mental Health; Pandemics; Pneumonia, Viral; SARS-CoV-2

The novel coronavirus infection has become a global threat affecting almost every country in the world. As a result, it has become important to understand the disease trends in order to mitigate its effects. The aim of this study is firstly to develop a prediction model for daily confirmed COVID-19 cases based on several covariates, and secondly, to select the best prediction model based on a subset of these covariates.. This study was conducted using daily confirmed cases of COVID-19 collected from the official Ministry of Health, Malaysia (MOH) and John Hopkins University websites. An Autoregressive Integrated Moving Average (ARIMA) model was fitted to the training data of observed cases from 22 January to 31 March 2020, and subsequently validated using data on cases from 1 April to 17 April 2020. The ARIMA model satisfactorily forecasted the daily confirmed COVID-19 cases from 18 April 2020 to 1 May 2020 (the testing phase).. The ARIMA (0,1,0) model produced the best fit to the observed data with a Mean Absolute Percentage Error (MAPE) value of 16.01 and a Bayes Information Criteria (BIC) value of 4.170. The forecasted values showed a downward trend of COVID-19 cases until 1 May 2020. Observed cases during the forecast period were accurately predicted and were placed within the prediction intervals generated by the fitted model.. This study finds that ARIMA models with optimally selected covariates are useful tools for monitoring and predicting trends of COVID-19 cases in Malaysia.

Topics: Bayes Theorem; Betacoronavirus; Clinical Laboratory Techniques; Coronavirus Infections; COVID-19; COVID-19 Testing; Forecasting; Humans; Malaysia; Models, Statistical; Pandemics; Pneumonia, Viral; Public Health Surveillance; SARS-CoV-2

We report the transmission dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) across different settings in Brunei. An initial cluster of SARS-CoV-2 cases arose from 19 persons who had attended the Tablighi Jama'at gathering in Malaysia, resulting in 52 locally transmitted cases. The highest nonprimary attack rates (14.8%) were observed from a subsequent religious gathering in Brunei and in households of attendees (10.6%). Household attack rates from symptomatic case-patients were higher (14.4%) than from asymptomatic (4.4%) or presymptomatic (6.1%) case-patients. Workplace and social settings had attack rates of <1%. Our analyses highlight that transmission of SARS-CoV-2 varies depending on environmental, behavioral, and host factors. We identify red flags for potential superspreading events, specifically densely populated gatherings with prolonged exposure in enclosed settings, persons with recent travel history to areas with active SARS-CoV-2 infections, and group behaviors. We propose differentiated testing strategies to account for differing transmission risk.

Topics: Adult; Aged; Betacoronavirus; Brunei; Clinical Laboratory Techniques; Cluster Analysis; Coronavirus Infections; COVID-19; COVID-19 Testing; Disease Transmission, Infectious; Female; Humans; Malaysia; Male; Middle Aged; Pandemics; Pneumonia, Viral; SARS-CoV-2; Travel-Related Illness

The COVID-19 pandemic potentially increases doctors' work demands and limits their recovery opportunity; this consequently puts them at a high risk of adverse mental health impacts. This study aims to estimate the level of doctors' fatigue, recovery, depression, anxiety, and stress, and exploring their association with work demands and recovery experiences. This was a cross-sectional study among all medical doctors working at all government health facilities in Selangor, Malaysia. Data were collected in May 2020 immediately following the COVID-19 contagion peak in Malaysia by using self-reported questionnaires through an online medium. The total participants were 1050 doctors. The majority of participants were non-resident non-specialist medical officers (55.7%) and work in the hospital setting (76.3%). The highest magnitude of work demands was mental demand (M = 7.54, SD = 1.998) while the lowest magnitude of recovery experiences was detachment (M = 9.22, SD = 5.043). Participants reported a higher acute fatigue level (M = 63.33, SD = 19.025) than chronic fatigue (M = 49.37, SD = 24.473) and intershift recovery (M = 49.97, SD = 19.480). The majority of them had no depression (69.0%), no anxiety (70.3%), and no stress (76.5%). Higher work demands and lower recovery experiences were generally associated with adverse mental health. For instance, emotional demands were positively associated with acute fatigue (adj.

Topics: Adaptation, Psychological; Coronavirus Infections; COVID-19; Cross-Sectional Studies; Humans; Malaysia; Mental Disorders; Pandemics; Physicians; Pneumonia, Viral; Workload

Although handwashing is an effective way to prevent infections, there is scarce evidence on predictors of handwashing during a pandemic. This paper aims to identify behavioural and demographic predictors of handwashing. The study surveyed 674 adults in Malaysia in May 2020 regarding whether the time spent on social media predicted handwashing contingent on gender and number of children. More time spent on social media was positively associated with handwashing for males with three or more children. However, for males without children, social media use was negatively associated with handwashing. The association was not significant for males with one or two children. For females, more time spent on social media was significantly linked to more handwashing only for females with one child. Gender, a traditional predictor of handwashing, was a useful predictor only for those who spent more than three hours per day on social media and had at most one child. Number of children was a novel negative predictor for males who did not use social media and who averaged one hour per day on social media, a positive predictor for males who spent lots of time on social media, but not a predictor for females. In sum, social media use predicts handwashing, and is thus a helpful variable for use in targeted health communication during a pandemic - particularly through social media. Further, more conventional predictors like gender and number of children exhibit contingency effects with social media use.

Topics: Adult; Betacoronavirus; Coronavirus Infections; COVID-19; Family Characteristics; Female; Hand Disinfection; Humans; Malaysia; Male; Middle Aged; Pandemics; Pneumonia, Viral; SARS-CoV-2; Social Media; Young Adult

Topics: Betacoronavirus; Communicable Disease Control; Communication; Community Participation; Coronavirus Infections; COVID-19; Humans; Malaysia; Pandemics; Pneumonia, Viral; SARS-CoV-2

An estimated 105 million dengue infections occur per year across 120 countries, where traditional vector control is the primary control strategy to reduce contact between mosquito vectors and people. The ongoing sars-cov-2 pandemic has resulted in dramatic reductions in human mobility due to social distancing measures; the effects on vector-borne illnesses are not known. Here we examine the pre and post differences of dengue case counts in Malaysia, Singapore and Thailand, and estimate the effects of social distancing as a treatment effect whilst adjusting for temporal confounders. We found that social distancing is expected to lead to 4.32 additional cases per 100,000 individuals in Thailand per month, which equates to 170 more cases per month in the Bangkok province (95% CI: 100-242) and 2008 cases in the country as a whole (95% CI: 1170-2846). Social distancing policy estimates for Thailand were also found to be robust to model misspecification, and variable addition and omission. Conversely, no significant impact on dengue transmission was found in Singapore or Malaysia. Across country disparities in social distancing policy effects on reported dengue cases are reasoned to be driven by differences in workplace-residence structure, with an increase in transmission risk of arboviruses from social distancing primarily through heightened exposure to vectors in elevated time spent at residences, demonstrating the need to understand the effects of location on dengue transmission risk under novel population mixing conditions such as those under social distancing policies.

Topics: Animals; Betacoronavirus; Communicable Disease Control; Coronavirus Infections; COVID-19; Dengue; Humans; Malaysia; Mosquito Vectors; Pandemics; Pneumonia, Viral; SARS-CoV-2; Singapore; Social Isolation; Thailand

The pandemic has affected all walks of life and businesses, including education at all levels. Movement controls have forced the schools and universities to migrate the teaching and learning to be fully online. Some universities in large cities in Malyasia had already implemented blended learning and thus, were better prepared to adjust to the current situation. However, the universities, which practiced mainly traditional didactic courses, were struggling to suddenly change the mode of delivery. Many relied on the creativity of the lecturers and students.

Topics: Betacoronavirus; Coronavirus Infections; COVID-19; Education, Pharmacy; Humans; Indonesia; Malaysia; Pandemics; Pneumonia, Viral; SARS-CoV-2

The COVID-19 pandemic has resulted in a Movement Control Order (MCO) in Malaysia and the subsequent closure of all educational institutions. We aimed to examine the psychological impact of the MCO among clinical undergraduates. A cross-sectional study was conducted using self-reported questionnaires that were distributed online using the Depression, Anxiety and Stress Scale-21 (DASS 21), Short Warwick Edinburgh Mental Well-Being Scale (SWEMWBS), and the newly designed MCO effect questionnaire. Seven hundred seventy-two students completed the survey. The prevalence of psychological distress was 52.8%, with around 60% of respondents reporting disruption to their daily lives. Older (

Topics: Anxiety; Betacoronavirus; Coronavirus Infections; COVID-19; Cross-Sectional Studies; Humans; Malaysia; Mental Health; Pandemics; Pneumonia, Viral; Quarantine; SARS-CoV-2; Stress, Psychological; Students

Respiratory syncytial virus (RSV) and parainfluenza virus (PIV) are frequent causes of pneumonia and death among children at Sibu and Kapit Hospitals in Sarawak, Malaysia.. To determine the prevalence and risk factors for RSV subtypes A and B and PIV types 1-4 among patients hospitalized with pneumonia.. In a cross-sectional, pilot study nasopharyngeal swabs were studied with real-time reverse transcription polymerase chain reaction assays. Concurrently, we helped Sibu and Kapit Hospitals adapt their first molecular diagnostics for RSV and PIV.. Of 129 specimens collected (June to July 2017), 39 tested positive for RSV-A (30.2%), two were positive for RSV B (1.6%), one was positive for PIV-3 (0.8%) and one was positive for PIV-4 (0.8%). No samples were positive for PIV-1 or PIV-2. Of the 39 RSV-A positive specimens, 46.2% were collected from children under one year of age and only 5.1% were from patients over the age of 18. A multivariable analysis found the odds of children <1 year of age testing positive for RSV-A were 32.7 (95% CI: 3.9, 276.2) times larger than >18 years of age, and the odds of patients hospitalized at Kapit Hospital testing positive for RSV-A were 3.2 (95% CI: 1.3, 7.8) times larger than patients hospitalized at Sibu Hospital.. This study found an unusually high prevalence of RSV-A among pneumonia patients admitted to the two hospitals. Subsequently, Sibu Hospital adapted the molecular assays with the goal of providing more directed care for such pneumonia patients.

Topics: Adolescent; Child; Child, Preschool; Cross-Sectional Studies; Female; Hospitalization; Humans; Infant; Infant, Newborn; Malaysia; Male; Odds Ratio; Paramyxoviridae Infections; Pneumonia, Viral; Prevalence; Public Health Surveillance; Respiratory Syncytial Virus Infections; Respiratory Syncytial Virus, Human; Risk Factors; Young Adult

To describe the severity, human adenovirus (HAdV) type and respiratory morbidity following adenovirus pneumonia in children.. Retrospective review of children under 12 years of age, admitted with HAdV pneumonia, between January 2011 and July 2013, in a single centre in Malaysia. HAdV isolated from nasopharyngeal secretions were typed by sequencing hypervariable regions 1-6 of the hexon gene. Patients were reviewed for respiratory complications.. HAdV was detected in 131 children of whom 92 fulfilled inclusion criteria. Median (range) age was 1.1 (0.1-8.0) years with 80% under 2 years. Twenty percent had severe disease with a case-fatality rate of 5.4%. Duration of admission (p = 0.02) was independently associated with severe illness. Twenty-two percent developed respiratory complications, the commonest being bronchiolitis obliterans (15.2%) and recurrent wheeze (5.4%). The predominant type shifted from HAdV1 and HAdV3 in 2011 to HAdV7 in 2013. The commonest types identified were types 7 (54.4%), 1(17.7%) and 3 (12.6%). Four out of the five patients who died were positive for HAdV7. Infection with type 7 (OR 8.90, 95% CI 1.32, 59.89), family history of asthma (OR 14.80, 95% CI 2.12-103.21) and need for invasive or non-invasive ventilation (OR 151.84, 95% CI 9.93-2.32E) were independent predictors of respiratory complications.. One in five children admitted with HAdV pneumonia had severe disease and 22% developed respiratory complications. Type 7 was commonly isolated in children with severe disease. Family history of asthma need for invasive or non-invasive ventilation and HAdV 7 were independent predictors of respiratory complications.

Topics: Adenoviridae; Adenoviridae Infections; Bronchiolitis Obliterans; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Malaysia; Male; Phylogeny; Pneumonia, Viral; Respiratory Sounds; Retrospective Studies

Between 2005 and 2013 six severe pneumonia cases (all requiring mechanical ventilation, two fatal outcomes) caused by human adenovirus type 21 (HAdV-B21) were observed in Germany. So far, HAdV-B21 was mainly associated with non-severe upper and lower respiratory tract infections. However, a few highly virulent HAdV types, e.g. HAdV-B14p1, were previously associated with severe, fatal pneumonia. Complete genomic sequences of the German HAdV-B21 pneumonia isolates formed a single phylogenetic cluster with very high sequence identity (≥ 99.897%). Compared to the HAdV-B21 prototype (only 99.319% identity), all isolates had a unique 15 amino acid deletion and a 2 amino acid insertion in the RGD loop of the penton base which may affect binding to the secondary receptor on the host cells. Moreover, a recombinant E4 gene region derived of HAdV-B3 was identified by bootscan analysis. Thus, the highly virulent, pneumotropic HAdV-B21 was denominated as subtype 21a. Surprisingly, there was 99.963% identity with agent Y/SIBU97 (only 13.4 kb available in GenBank of the 35.4 kb genome) which was associated with 10 fatalities due to cardiopulmonary failure in Sarawak, Malaysia, in 1997. In conclusion, a HAdV-B21 subtype (21a) associated with severe pneumonia in Germany was phylogenetically linked to an adenovirus isolated in Malaysia.

Topics: Adenoviruses, Human; Adult; Amino Acid Sequence; Child, Preschool; DNA, Viral; Female; Germany; Humans; Malaysia; Male; Middle Aged; Molecular Sequence Data; Phylogeny; Pneumonia, Viral; Respiratory Tract Infections; Viral Proteins

Human bocavirus (HBoV) is a newly discovered parvovirus associated with respiratory disease in children. There are many reports worldwide on the endemicity of this virus. Since it is relatively new, detection in clinical laboratories is not routinely performed. We describe the first detection of HBoV in Malaysia in a 13-month-old boy with pneumonia and underlying asthma. The infective agent was confirmed by molecular methods.

Topics: Asthma; Bocavirus; Humans; Infant; Malaysia; Male; Parvoviridae Infections; Pneumonia, Viral

Topics: Animals; Antibodies, Viral; Arecaceae; Bangladesh; Chiroptera; Disease Outbreaks; Disease Reservoirs; Encephalitis, Viral; Henipavirus Infections; Humans; Livestock; Malaysia; Nipah Virus; Pneumonia, Viral

Topics: Bronchiolitis; Humans; Infant; Malaysia; Pneumonia, Viral; Respiratory Syncytial Virus Infections

During 10-19 March 1999, 11 workers in 1 of 2 Singaporean abattoirs developed Nipah-virus associated encephalitis or pneumonia, resulting in 1 fatality. A case-control study was conducted to determine occupational risk factors for infection. Case patients were abattoir A workers who had anti-Nipah IgM antibodies; control subjects were randomly selected abattoir A workers who tested negative for anti-Nipah IgM. All 13 case patients versus 26 (63%) of 41 control subjects reported contact with live pigs (P=.01). Swine importation from Malaysian states concurrently experiencing a Nipah virus outbreak was banned on 3 March 1999; on 19 March 1999, importation of Malaysian pigs was banned, and abattoirs were closed. No unusual illnesses among pigs processed during February-March were reported. Contact with live pigs appeared to be the most important risk factor for human Nipah virus infection. Direct contact with live, potentially infected pigs should be minimized to prevent transmission of this potentially fatal zoonosis to humans.

Topics: Abattoirs; Adult; Animals; Antibodies, Viral; Case-Control Studies; Disease Outbreaks; Encephalitis, Viral; Female; Humans; Immunoglobulin M; Malaysia; Male; Occupational Diseases; Paramyxoviridae Infections; Pneumonia, Viral; Risk Factors; Singapore; Swine; Swine Diseases; Zoonoses

To study the viral aetiology of lower respiratory tract infection (LRTI) in young Malaysian children.. A retrospective review was performed of LRTI patients aged less than 24 months who were admitted to the University Malaya Medical Centre between 1982 and 1997. Respiratory viruses in their nasopharyngeal secretion were identified by indirect immunofluorescence, viral culture, or both.. A total of 5691 children were included in the study. The mean age was 8.6 +/- 6.6 months and the M:F ratio was 1.6:1. The most common diagnosis was pneumonia (52%) followed by bronchiolitis (45%) and croup (2%). Positive viral isolation rate was 22.0%. Respiratory syncytial virus (RSV) was the commonest virus isolated (84%), followed by parainfluenza virus (8%), influenza virus (6%) and adenovirus (2%). Patients with positive virus isolation were younger (7.8 +/- 6.2 vs 8.7 +/- 6.7 months, P = 0.0001) and were more likely to have bronchiolitis.. Young Malaysian children admitted with LRTI had a 22% viral isolation rate and RSV was the commonest virus isolated.

Topics: Bronchiolitis; Croup; Female; Humans; Infant; Infant, Newborn; Malaysia; Male; Pneumonia, Viral; Retrospective Studies