ABOUT 20 years ago, there was an outbreak of severe febrile encephalitis among pig farmers in Malaysia. Initially, it was thought to be Japanese encephalitis (JE) despite the fact that its clinical characteristic and epidemiologic features were distinct from JE. That wrong assumption led to an ineffective mosquito control and JE virus vaccination programme to stem the spread.
Six months later, the outbreak spread southward to Bukit Pelanduk, Nipah, Negri Sembilan. Sadly, the whole outbreak took nine months to control and resulted in a total of 265 cases of Nipah encephalitis with 105 deaths. It was one of the most severe outbreaks of any disease in Malaysia.
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