KUALA LUMPUR: Malaysia has received praises from global citizens and leaders for its efficient and swift response to the Covid-19 pandemic.
This is, however, not the first time the country has emerged stronger in the eyes of the world by becoming a leader in taming viral and deadly diseases.
Malaysia has battled many outbreaks, from the H1N1 form of swine flu to the enterovirus encephalitis (hand, foot and mouth disease) outbreak in Kuching in 1998, and the Polyarthritis outbreak in Port Klang from December 1998 to April 1999, which led to important lessons in disease management.
Malaysia was instrumental in bringing to light one of the world's deadliest pathogens, the Nipah virus (NiV), a paramyxovirus related to the Hendra virus, which spread from September 1998 to May 1999, causing 265 cases of acute encephalitis and 105 deaths.
Unlike Ebola, NiV attacks the brain. It almost destroyed the billion-ringgit pig farming industry in Perak, Selangor and Negri Sembilan, the three affected states.
NiV, which inspired the 2011 movie Contagion, first struck pig farms in Ipoh, starting with respiratory illness and encephalitis among pigs, which transferred to humans. It was initially attributed to Japanese encephalitis, hence early control measures were ineffective, and the outbreak spread to other parts of Malaysia and Singapore.
Virologist Dr Chua Kaw Bing from Universiti Malaya (UM) (now a senior principal investigator at Temasek Lifesciences Laboratory, Singapore) was central to the discovery of the NiV.
In an interview with United States media outlet NPR in 2017, Chua shared how he sneaked virus samples into the Centres for Disease Control in the US after his professors ignored his findings.
The findings — that the infection was caused by a new agent named NiV — led to military deployment in a widespread culling of pigs. The last human fatality in Malaysia was on May 27, 1999.
A decade later, it was found that bats infected the pigs through contamination of pig swill by bat excretions.
NiV can be transmitted to humans from animals or contaminated food and can also be transmitted from human to human.
Chua and Professor Datuk Dr Looi Lai Meng of UM's Pathology Department, in an article published in the Malaysian Journal of Pathology (2007), wrote that the migration of fruit bats driven by the fruiting failure of forest trees during the El Nino-related drought and anthropogenic fires in Indonesia in 1997 and 1998 could have sparked the outbreak.
The outbreak, they said, emphasised the need to share information of unusual illnesses in animals and humans and an open-minded approach and close collaboration and coordination between the medical profession, veterinarians and wildlife specialists in the investigation of such diseases.
"Environmental mismanagement has far-reaching effects, including encroachment of wildlife on human habitats and the introduction of zoonotic infections into domestic animals and humans," they wrote.
In 2009, Malaysia was hit by a new strain of the H1N1 swine flu, a subtype of the influenza A virus that causes symptoms similar to the regular flu.
The highly contagious disease originated in pigs, but is spread primarily from person to person through saliva and mucus.
The World Health Organisation declared the H1N1 pandemic over in August 2010.
Many lessons were learnt in the fight against these emerging infectious diseases that have stood Malaysia in good stead, especially in addressing the Covid-19 pandemic.
Academician and virologist Emeritus Professor Datuk Dr Lam Sai Kit said the flu outbreak taught Malaysia to be prepared and ensure that an adequate surveillance programme was in place once it was known that the virus was spreading outside the epicentre.
There is also now a National Influenza Pandemic Preparedness Plan, which provides a framework for a multi-sector response.
Lam, an Academy of Sciences Malaysia senior fellow who was instrumental in managing the NiV, said it was crucial to handle an investigation thoroughly and not rush to conclusions.
"During an epidemic or pandemic, especially one that is suspected to be infectious by nature, the government should get all experts nationwide involved.
"In the early days, the help of medical schools was not even considered in the investigation. The situation has changed.
"To investigate zoonotic infections, it is necessary to involve the Veterinary Services Department under the Agriculture and Agro-based Industry Ministry.
"With Covid-19, the Health Ministry, National Security Council, and other ministries and agencies worked closely together to control the pandemic. An important lesson we learnt from Nipah."
Lam said more than 60 per cent of emerging diseases nowadays involved bats, camels, pangolins and animals sold at wildlife markets.
He said it was important to trace the source or reservoir of the virus to prevent it from spreading to the human population.
He said as emerging infectious diseases could appear at any time, it was important to be on the alert.
He said surveillance should include looking out for unusual rises in cases with certain symptoms, such as flu-like, neurological or gastrointestinal symptoms, as well as body rashes.
He stressed the importance of having a single, regular source of information to prevent the spread fake news, citing the daily briefings by the Health director-general and defence minister as good examples.
"The media plays a vital role in disseminating accurate information from reliable sources. I have found the local media to be responsible in providing accurate reporting."