2019 Kuala Koh Measles Outbreak
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The 2019 Kuala Koh measles outbreak was a
measles Measles (probably from Middle Dutch or Middle High German ''masel(e)'', meaning "blemish, blood blister") is a highly contagious, Vaccine-preventable diseases, vaccine-preventable infectious disease caused by Measles morbillivirus, measles v ...
outbreak that occurred among the
Orang Asli The Orang Asli are a Homogeneity and heterogeneity, heterogeneous Indigenous peoples, indigenous population forming a national minority in Malaysia. They are the oldest inhabitants of Peninsular Malaysia. As of 2017, the Orang Asli accounted f ...
sub-group of
Batek people The Batek (or Bateq) people are an indigenous Orang Asli people (numbering about 1,519 in 2000) belonging to the Semang group, who live in the rainforest of peninsular Malaysia. As a result of encroachment, they now primarily inhabit the Taman N ...
in Kuala Koh Village in the state of
Kelantan Kelantan (; Kelantan-Pattani Malay, Kelantanese Malay: ''Klate''; ) is a state in Malaysia. The capital, Kota Bharu, includes the royal seat of Kubang Kerian. The honorific, honorific name of the state is ''Darul Naim'' ("The Blissful Abode"). ...
,
Malaysia Malaysia is a country in Southeast Asia. Featuring the Tanjung Piai, southernmost point of continental Eurasia, it is a federation, federal constitutional monarchy consisting of States and federal territories of Malaysia, 13 states and thre ...
, from May until July. Following the sudden deaths of several villagers, the disease became a mystery among the villagers and public for nearly a month until it was identified by the Malaysian Health Ministry in mid-June as measles.


Background of the disease

The sudden deaths of 14
Orang Asli The Orang Asli are a Homogeneity and heterogeneity, heterogeneous Indigenous peoples, indigenous population forming a national minority in Malaysia. They are the oldest inhabitants of Peninsular Malaysia. As of 2017, the Orang Asli accounted f ...
villagers in Kuala Koh Village was at first considered a mystery with two people dying from
pneumonia Pneumonia is an Inflammation, inflammatory condition of the lung primarily affecting the small air sacs known as Pulmonary alveolus, alveoli. Symptoms typically include some combination of Cough#Classification, productive or dry cough, ches ...
complications between 2 May and 7 June, while the remaining people's causes of death remain unknown as their bodies were buried by locals prior to reports of the outbreak. On 8 June, a further 83 villagers presented pneumonia with two of them, a 36-year-old woman and three-year-old baby, in critical condition. Thirty-seven of the villagers received outpatient treatment with 32 treated at Gua Musang Hospital, 11 at Kuala Krai Hospital, and another three at the Orang Asli Health Homestay. Another died on 16 June, bringing the total death toll to 15.


Villager claims

One of the villagers claimed that the deaths are caused by
mining Mining is the Resource extraction, extraction of valuable geological materials and minerals from the surface of the Earth. Mining is required to obtain most materials that cannot be grown through agriculture, agricultural processes, or feasib ...
activity that is situated near the village. He revealed that his two daughters have been experiencing breathing difficulty for days and could not sleep at night; some of his neighbours died of the same disease. Despite knowing the nearby mining activities causing pollution to their
water source Water is an inorganic compound with the chemical formula . It is a transparent, tasteless, odorless, and Color of water, nearly colorless chemical substance. It is the main constituent of Earth's hydrosphere and the fluids of all known liv ...
, another villager claimed they have no other choice than to use the water for their daily activities.


Official response, investigation, and conclusion

On 9 June, the Malaysian
federal government A federation (also called a federal state) is an entity characterized by a political union, union of partially federated state, self-governing provinces, states, or other regions under a #Federal governments, federal government (federalism) ...
through Deputy Prime Minister
Wan Azizah Wan Ismail Wan Azizah binti Wan Ismail ( Jawi: وان عزيزة بنت وان إسماعيل; born 3 December 1952) is a Malaysian politician who has served as Spouse of the Prime Minister of Malaysia as the wife of Anwar Ibrahim, Member of Parliamen ...
said they are investigating the cause as well the allegations of
water pollution Water pollution (or aquatic pollution) is the contamination of Body of water, water bodies, with a negative impact on their uses. It is usually a result of human activities. Water bodies include lakes, rivers, oceans, aquifers, reservoirs and ...
and promised stern action will be taken against the culprits if it is indeed found the deaths were caused by contamination on their water source. A similar statement was echoed by Water, Land and Natural Resources Minister
Tengku Zulpuri Shah Raja Puji Tengku Zulpuri Shah bin Raja Puji ( Jawi: تڠكو ذوالڤوري شاه بن راج ڤوجي) (born 15 July 1964) is a Malaysian politician who has served as Member of the Pahang State Legislative Assembly (MLA) for Tras since November 20 ...
during his visit to the affected community. On 11 June, Deputy Prime Minister Wan Azizah called an emergency meeting for the unexplained deaths which was attended by a minister in the Prime Minister's Department,
Waytha Moorthy Ponnusamy Waytha Moorthy Ponnusamy, sometimes spelled Waythamoorthy (; born 16 July 1966), is a Malaysian people, Malaysian politician and lawyer who served as the Minister in the Prime Minister's Department in charge of National Unity and Social Wellbe ...
, Health Minister
Dzulkefly Ahmad Dzulkefly bin Ahmad ( Jawi: ذوالكفل بن أحمد; born 1 January 1956) is a Malaysian politician who has served as the Minister of Health for the second term in the Unity Government administration under Prime Minister Anwar Ibrahim si ...
and Energy, Technology, Science, Climatic Change and Environment Minister Yeo Bee Yin. Based on samples taken by the Environment Department from the
manganese Manganese is a chemical element; it has Symbol (chemistry), symbol Mn and atomic number 25. It is a hard, brittle, silvery metal, often found in minerals in combination with iron. Manganese was first isolated in the 1770s. It is a transition m ...
mine and water catchment areas close to the villagers settlement, the results on 12 June showed the water is free of hazardous contaminants and meet the standards for
raw water Raw water is water found in the environment that has not been water treatment, treated and does not have any of its minerals, ions, particles, bacteria, or parasites removed. Raw water includes rainwater, ground water, water from infiltration wells ...
. On the same day, the affected area was declared by
police The police are Law enforcement organization, a constituted body of Law enforcement officer, people empowered by a State (polity), state with the aim of Law enforcement, enforcing the law and protecting the Public order policing, public order ...
as a "red zone". Through further laboratory tests on 37 villagers in the area with similar symptoms of illness, the disease was finally confirmed to be measles on 15 June. Until 20 June, a further 43 measles cases are confirmed among the community with three more respiratory illnesses also being reported in the area. The Malaysian Health Ministry said the cause of the spread among the Orang Asli community is due to low coverage of MMR immunisation which is attributed to the relatively low immunisation rate among the community with their nomadic lifestyle. Health Minister
Dzulkefly Ahmad Dzulkefly bin Ahmad ( Jawi: ذوالكفل بن أحمد; born 1 January 1956) is a Malaysian politician who has served as the Minister of Health for the second term in the Unity Government administration under Prime Minister Anwar Ibrahim si ...
explained that although 61.5% of the villagers received their first measles,
mumps MUMPS ("Massachusetts General Hospital Utility Multi-Programming System"), or M, is an imperative, high-level programming language with an integrated transaction processing key–value database. It was originally developed at Massachusetts Gen ...
, and
rubella Rubella, also known as German measles or three-day measles, is an infection caused by the rubella virus. This disease is often mild, with half of people not realizing that they are infected. A rash may start around two weeks after exposure and ...
(MMR) shots, only 30% of them had their follow-up shots. Since the outbreak was announced, 113 cases has been reported in the affected area with a total 43 confirmed cases. Despite the relatively low deaths reported by the findings of Health Ministry, the latter was unable to confirm the post-mortems results on the skeletal remains of several more cases. The "red zone" declaration was lifted on 8 July after the area was declared safe for the public.


See also

* Epidemiology of measles


Notes


References


Further reading

* * {{Epidemics Health disasters in Malaysia Kuala Koh 2019 in Malaysia 2019 disasters in Malaysia History of Kelantan Gua Musang District