Sunday, September 16, 2007

rubella outbreak in klang valley?!?.. another serious incident swept under the carpet?!?...

saw this news in lks's blog... i thought this a very serious matter, which swept under the carpet due to the 50th anniversary?!?...

if the email from um is proven to be true, then the authorites have a lot to answer!...

did they choose to proclaim merdeka instead of asking people to becareful with this issue?!?...

p/s ; transparency is a history?!?...

An email from CL that there is a rubella outbreak in the Klang Valley which has been blacked out so as not to spoil the Merdeka anniversary celebrations.

Can the authorities in particular the Health Minister and the University of Malaya Vice Chancellor respond?

CL’s email:

There is an outbreak of rubella in the Klang Valley and possibly nationwide as well. Apparently this had been going on for the past two months but the power-that-be has chose to keep the news blacked out because of the impending 50th anniversary Merdeka celebration. The outbreak also occurred in the UM campus and the recently concluded convocation was almost marred. News of the outbreak in the campus only came out lately, in fact only a few days back.(see circular appended below). It is not immediately known how many students had been infected to date. However, official news of the outbreak has caused anger and anxiety among the “warga kampus”.

Rubella in the adults and adolescents is mild with nothing more than a flu-like illness with fever lasting a few days and associated with muscle aches and joint pains. Its mild nature cannot be said if an expectant mother who has no immunity, contracts rubella in the first 3 months of her pregnancy. The unborn foetus has a high risk of developing various abnormalities : small brain, cataracts, deafness, heart defects, mental retardation, etc.

Because of the non-specific symptoms, most cases of rubella are diagnosed as a viral illness. The rash over the body and enlarged lymph glands behind the ears are typical but can be easily missed if not specifically looked for. The rash is very faint and lasts no more than 48 hours and often missed in the dark skinned. Hence many infected persons are not aware that that they are infected. This is a highly infectious disease and an infected person can transmit the infection (airborne spread) from one week before till at least 4 days after onset of the rash. This implies that by the time the index case is diagnosed, he/she would have transmitted to susceptible persons in contact with him/her. This is the reason why outbreaks usually occur in hostels, schools, army barracks. This was probably what caused the outbreak among UM students staying in the residential colleges.

The illness is effectively preventable by giving rubella vaccine, which the government gave as a routine for female students in secondary three since 1986. However, this strategy has obviously failed to prevent one from getting the diseases because the immunization program selectively immunized females only. Transmission can still occur among males who in turn pass it on to susceptible females. This explains the reason for the current outbreak.

In 2002 the government started the routine MMR (mumps, measles, rubella) immunization of children at 1 year and again on entering primary one. This strategy is more effective and would stamp out rubella infection in the adolescents and adults. Students entering universities (at age 20 years) from now till 2022 will still be susceptible to the 3 diseases. To effectively control the outbreak now will require mass immunization with the vaccine of both male and female students. MMR is the ideal vaccine as it ensures that the vaccinee is also protected against measles. The vaccine costs less than RM20 if purchased in bulk. There had been instances of reports of measles outbreak in the past.

Events happening over the last two months have indicated that the current outbreak has not been handled in the proper manner. Firstly there is news blackout of the rubella outbreak. This was done so as not to spoil the merdeka celebration. By so doing, pregnant women are been exposed unnecessarily to risk of getting infected and subsequently delivery of an affected baby. Secondly the government, till date has not advised the public who had not have rubella vaccination in the past to go for vaccination. The vaccine is very cheap (about RM 2 per dose) but of course there is a shortage of the vaccine now. Thirdly during the fasting month there will be lots of mingling of people and those “balik kampung” setting the stage for mass transmission of the illness. From what is happening in the UM campus, the management has decided to vaccinate only the females first and then the males at a later date. Only rubella vaccine is used (about 3000 doses from MOH, a gross inadequate) not the MMR vaccine. This is an exercise in futility for two reasons: The males can still be infected and will continue to transmit the virus. The outbreak can never be controlled if only females are vaccinated. This is a golden opportunity to give everyone the MMR vaccine to protect against measles too. Otherwise it will be a matter of time before an outbreak of measles occur in the campus and nationwide. Measles is a very much more severe illness compared to rubella with many complications.

In short the government has attempted to cover up an outbreak of rubella in the country at the expense of risks to unborn foetuses. By not taking quick and proper measures it has allowed the illness to spread to a stage that the government is now in a helpless state.

Date: Sun, 09 Sep 2007 13:03:23 +0800
From: International & Corporate Relations Office
Subject: [Uminfo] RUBELLA ON CAMPUS
YBhg. Dato’/Datuk/Datin/Profesor/Tuan/Puan,

Please be informed that a number of students had been infected with Rubella, an infectious disease caused by a virus. A main concern with the rubella disease is the effect it has on pregnant ladies as it can be very harmful to the foetus. Therefore, it is imperative for staff and students who are pregnant to seek consultation at the Obstetrics and Gynaecology Clinic at the University Malaya Medical Centre (UMMC).

The symptoms of Rubella are fever and rashes. Apart from that, there may also be:

1. Conjunctivitis
2. Sore throat
3. Headache
4. Nausea
5. Tenderlymphadenopathy (particularly behind the ear areas - posterior auricular and suboccipital lymph nodes)

The University Management has taken several steps to address this issue and would like to seek lecturers’ assistance to inform and advise students of the above.

Thank you.

International & Corporate Relations Office (ICR)
Level 1, Chancellery Building
University of Malaya
50603 Kuala Lumpur
Tel: 603-7967 3273 / 3423 / 3575 / 3334
Fax: 7956 0027


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