The 2009 flu outbreak in

Malaysia Malaysia ( ; ) is a country in Southeast Asia. The federation, federal constitutional monarchy consists of States and federal territories of Malaysia, thirteen states and three federal territories, separated by the South China Sea into two r ...

was part of a larger flu pandemic involving a new type of

influenza A virus subtype H1N1 In virology, influenza A virus subtype H1N1 (A/H1N1) is a subtype of influenza A virus. Major outbreaks of H1N1 strains in humans include the Spanish flu, the 1977 Russian flu pandemic and the 2009 swine flu pandemic. It is an orthomyxovirus ...

(A (H1N1)) virus. As of 11 August 2009, the country had over 2,253 cases, beginning with imported cases from affected countries, including the

United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territori ...

and Australia from 15 May 2009 onwards, and the first identified local transmission on 17 June 2009. From 12 August, the Malaysian Health Ministry said that it had discontinue officially updating the total number of H1N1 cases within Malaysia in line with guidelines issued by the

World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of ...

. As of 21 August 2009 the unofficial number of cases reported in the media is 5,876 so far. The first death related to the A(H1N1) virus was reported on 23 July 2009 and so far there have been 78 deaths reported. On 6 July 2009 Malaysia announced that it was shifting from containment to mitigation to tackle the spread of the virus. The federal government had declared a national health emergency in Malaysia because of the A(H1N1) outbreak and was considering imposing a health

curfew A curfew is a government order specifying a time during which certain regulations apply. Typically, curfews order all people affected by them to ''not'' be in public places or on roads within a certain time frame, typically in the evening and ...

similar to the week-long shutdown of non-essential services and industries in

Mexico Mexico (Spanish: México), officially the United Mexican States, is a country in the southern portion of North America. It is bordered to the north by the United States; to the south and west by the Pacific Ocean; to the southeast by Guatema ...

Government measures

Since the Nipah virus outbreak in 1999, the Malaysian Health Ministry have put in place processes to be better prepared to protect the Malaysian population from the threat of infectious diseases.

was fully prepared during the

Severe Acute Respiratory Syndrome (SARS) Severe acute respiratory syndrome (SARS) is a viral respiratory disease of zoonotic origin caused by the severe acute respiratory syndrome coronavirus (SARS-CoV or SARS-CoV-1), the first identified strain of the SARS coronavirus species, ''sev ...

situation (Malaysia was not a SARS affected country) and the episode of the H5N1 (bird flu) outbreak in 2004 The

Malaysian government The Government of Malaysia, officially the Federal Government of Malaysia ( ms, Kerajaan Persekutuan Malaysia), is based in the Federal Territory of Putrajaya with the exception of the legislative branch, which is located in Kuala Lumpur. Mala ...

has developed
National Influenza Pandemic Preparedness Plan (NIPPP)
which serves as a time bound guide for preparedness and response plan for influenza pandemic. It provides a policy and strategic framework for a multisectoral response and contains specific advice and actions to be undertaken by the Ministry of Health at the different levels, other governmental departments and agencies and non-governmental organisations to ensure that resources are mobilised and used most efficiently before, during and after a pandemic episode. According to the

n Ministry of Health, headed by

Liow Tiong Lai Tan Sri Dato' Sri Liow Tiong Lai (; born 13 October 1961) is a Malaysian politician who served as Minister of Transport, Minister of Health, Deputy Minister of Youth and Sports in the Barisan Nasional (BN) administration under former Pr ...

, health screenings were carried out on passengers travelling to and from Mexico via sea, air and land beginning 17 April 2009. The Health Ministry's disease control division has activated its operations room to monitor the swine flu situation and informed medical practitioners who are treating cases with symptoms of influenza-like illness or severe pneumonia and persons who had visited

California California is a state in the Western United States, located along the Pacific Coast. With nearly 39.2million residents across a total area of approximately , it is the most populous U.S. state and the 3rd largest by area. It is also the m ...

Texas Texas (, ; Spanish: ''Texas'', ''Tejas'') is a state in the South Central region of the United States. At 268,596 square miles (695,662 km2), and with more than 29.1 million residents in 2020, it is the second-largest U.S. state by ...

to inform the district health office immediately for preventive and control measures. As has several Asian countries, thermal scanners had been installed at entry points at the

Kuala Lumpur International Airport Kuala Lumpur International Airport (KLIA) is Malaysia's main international airport. It is located in the Sepang District of Selangor, approximately south of Kuala Lumpur and serves the city's greater conurbation. KLIA is the largest and ...

(KLIA) following the start of the global alert on the flu. Screenings were imposed in

Pengkalan Hulu Pengkalan Hulu ( Jawi: ڤڠكالن هولو; ), formerly known as Kroh or Keroh, is a town and a mukim in Hulu Perak District, Perak, Malaysia, bordering Thailand and Kedah. The nearest town on the Thailand side is Betong in Yala province ...

, at the border with Thailand, in late April. Quarantine rooms had been allocated in 28 hospitals, and the country has stockpiled more than 2 million doses of

Tamiflu Oseltamivir, sold under the brand name Tamiflu, is an antiviral medication used to treat and prevent influenza A and influenza B, viruses that cause the flu. Many medical organizations recommend it in people who have complications or are at hi ...

, as of May 2009. The Malaysian Health Ministry has warned Malaysians not to withhold health information to the authorities saying that those doing so could be fined RM10,000 or jailed two years or both if they are found guilty under the Disease Prevention Act 1988. On 18 June 2009 Malaysian Deputy Prime Minister Tan Sri

Muhyiddin Yassin Tan Sri Dato' Haji Mahiaddin bin Md Yasin (born 15 May 1947), commonly known as Muhyiddin bin Muhammad Yassin ( ms, محيي الدين بن محمد ياسين, label= Jawi, script=arab, italic=unset; ), is a Malaysian politician who serv ...

declared that all visitors and Malaysians returning from abroad will be required to fill the health declaration form following the influenza A (H1N1) pandemic around the world.

Mitigation of the Virus

On 17 August, The Government said that will consider declaring a health curfew if the mortality rate of Influenza A(H1N1) is above 0.4% from the current 0.1%-0.3%. Health Minister Datuk Seri Liow Tiong Lai said that they are currently treating the flu as a "health emergency".

Mask use

Health Minister Datuk Seri

urged the public to wear a

mask A mask is an object normally worn on the face, typically for protection, disguise, performance, or entertainment and often they have been employed for rituals and rights. Masks have been used since antiquity for both ceremonial and pra ...

if showing symptoms of the flu.

School closures

In response to the country's first case of A (H1N1), the health ministry urged calm among the populace "as the situation is under control" and "the ministry has taken all the possible precautionary measures to control and contain the disease after the WHO issued a level-five alert." In addition, schools were issued strict hygiene procedures on 16 May to contain any H1N1 outbreak among students and teachers. Sekolah Rendah Kebangsaan Assunta 1 in Petaling Jaya became the fourth school to be closed in a week.

A (H1N1) cases

The country had reported no suspected cases before 4 May 2009, but all cases tested negative between 4 and 15 May. The 2009 FOBISSEA primary tournament in Kuala Lumpur was cancelled due to an unidentified student who was found to have contracted the virus whilst at the airport. Teams from British International Schools throughout South-East Asia were immediately sent home and quarantined.

15 May – 10 June

On 15 May, the Health Ministry confirmed Malaysia's first case of A (H1N1) infection of a 21-year-old male student who had arrived at the KLIA on 13 May via a

Malaysia Airlines Malaysia Airlines Berhad (MAB; ms, Penerbangan Malaysia Berhad), formerly known as Malaysian Airline System (MAS; ), and branded as Malaysia Airlines, is the flag carrier airline of Malaysia and a member of the Oneworld airline alliance. (Th ...

flight (MH091) from Newark and on transit at

Stockholm-Arlanda Airport Stockholm Arlanda Airport is an international airport located in the Sigtuna Municipality of Sweden, near the town of Märsta, north of Stockholm and nearly south-east of Uppsala. The airport is located within Stockholm County and the p ...

, followed by a second case on 16 May of a female student in Penang who shared the same flight as the first patient and boarded an

AirAsia Capital A Berhad, () operating as AirAsia (stylized as ''airasia'') is a Malaysian multinational low-cost airline headquartered near Kuala Lumpur, Malaysia. It is the largest airline in Malaysia by fleet size and destinations. AirAsia operat ...

flight (AK5358) from KLIA to

Penang International Airport Penang International Airport is an airport in northern Malaysia. The airport is located near Bayan Lepas at the southeastern tip of Penang Island, south of the city centre. This makes Malaysia the 36th country to detect A (H1N1) within its borders. The first patient has been hospitalised at the Sungai Buloh Hospital, while house quarantines were undertaken on two of the second patient's friends who boarded the same flight, along with their family members. All passengers of the flights were also asked to contact the Health Ministry or head to any hospital, clinic or health office or further action, and crew members of MH091 and AK5358 were located and grounded. As the first patient has indicated, the use of thermal scanners is revealed not to be entirely effective as symptoms of his flu had yet to manifest; the Health Ministry resumes the use of the scanners nevertheless. Singapore Changi Airport Thermal Scanning

Singapore Changi Airport Thermal Scanning

On 4 June, three additional inbound airline passengers were reported to be carrying the virus. The earliest of the three is a 23-year-old male student who returned from United States on 1 June via the same Malaysian Airlines flight (MH091) that the first cases of A (H1N1) were detected. On the same day, two German tourists and friends (aged 30 and 32) who were holidaying in Southeast Asia and arrived in Malaysia were confirmed to be infected with the virus; both had flown into the country on 3 June via an Air Asia flight (AK702) after transferring from a

Singapore Airlines Singapore Airlines ( abbreviation: SIA) is the flag carrier airline of the Republic of Singapore with its hub located at Singapore Changi Airport. The airline is notable for highlighting the Singapore Girl as its central figure in corporat ...

flight (SQ45) from Germany to

Singapore Singapore (), officially the Republic of Singapore, is a sovereign island country and city-state in maritime Southeast Asia. It lies about one degree of latitude () north of the equator, off the southern tip of the Malay Peninsula, bor ...

on 1 June. The third reported victim developed symptoms on 3 June and was hospitalised in Tunku Jaafar Hospital, while the two tourists developed symptoms while in Kuala Lumpur on 3 June and were given similar medical treatment. All three patients were reported to be stable. As it has been for the last two cases, passengers sharing both the Malaysian Airlines and Air Asia flights are being traced. On 5 June, sixth case were reported from a student who took the same flight with the fourth patient. On the next day, a girl from Australia was confirmed to be infected with Influenza A (H1N1) when the airport scanner detected severe fever making her the 7th confirmed case overall in Malaysia.

10–20 June

On 10 June, two new Influenza A(H1N1) cases had been detected in Malaysia. The eighth case involved a 17-year-old American student who accompanied her parents for a holiday in the country. The ninth case was a New Zealand national who arrived in the country at 7.30am on 5 June on an Air Asia flight DX7 2723. Malaysia recently registered two more cases of the disease, bringing the total to 11 cases. The 10th patient in the country was a 17-year-old girl who had just returned from a holiday in Melbourne, Australia on 9 June. The 11th patient was a 41-year-old woman who had returned from Manila to Penang on 6 June. A 12th case was reported on 13 June 2009 whereby a 19-year-old medical student was returning to Malaysia after a 17-day holiday in Melbourne. As of 15 June 2009, the total number of cases have increased to 17, with an addition of 5 new cases. The 13th case was a 12-year-old student who returned from a holiday in Manila. The 14th case was a British tourist, hospitalised in Kuantan after showing symptoms in Pulau Tioman. The 15th and 17th cases involved Malaysians who recently came back from Melbourne, both being currently hospitalised in

Sungai Buloh Sungai Buloh, or Sungei Buloh, is a town, a mukim (commune) and a parliamentary constituency in the northern part of Petaling District, Selangor, Malaysia. The name itself means ''bamboo river'' in the Malay language. It is located 16 km NW ...

Hospital. The 16th case involved an American resident, currently hospitalised in Queen Elizabeth Hospital in

Kota Kinabalu , image_skyline = , image_caption = From top, left to right, bottom:Kota Kinabalu skyline, Wawasan intersection, Tun Mustapha Tower, Kota Kinabalu Coastal Highway, the Kota Kinabalu City Mosque, the Wism ...

Sabah Sabah () is a state of Malaysia located in northern Borneo, in the region of East Malaysia. Sabah borders the Malaysian state of Sarawak to the southwest and the North Kalimantan province of Indonesia to the south. The Federal Territory o ...

. A

Filipino Filipino may refer to: * Something from or related to the Philippines ** Filipino language, standardized variety of 'Tagalog', the national language and one of the official languages of the Philippines. ** Filipinos, people who are citizens of th ...

man was confirmed as the 18th victim of influenza A (H1N1) in Malaysia, after being detected as having a fever and cough during the screening process when he arrived at the KL International Airport from

Manila Manila ( , ; fil, Maynila, ), officially the City of Manila ( fil, Lungsod ng Maynila, ), is the capital of the Philippines, and its second-most populous city. It is highly urbanized and, as of 2019, was the world's most densely populate ...

. Malaysia recorded its first local infection of influenza A(H1N1) on 17 June 2009 involving the 19th case as that person had no history of having travelled to a country that had the flu. A 20th case was reported whereby a 23-year-old local public university male student who made a seven-day study visit together with 12 students and lecturers to Melbourne, returned from Melbourne aboard Air Asia X D7 2723 and landed at the Low Cost Carrier Terminal on 17 June. The 21st case came about with a 20-year-old medical student of a Melbourne university who returned to holiday in Malaysia aboard MH 128 and arrived at the KLIA on 16 June. The 22nd case showed that a 54-year-old man who had travelled to Manila on business on 9 June and arrived at KLIA on 12 June. It was reported that the 23rd case was a 22-year-old female Malaysian student who arrived from Melbourne by Air Asia at the LCCT on 14 June. On 18 June 2009 the Crisis Preparedness and Response Centre in Malaysia reported there were four imported cases of Influenza A(H1N1), bringing to total of 27 cases overall. On 19 June 2009 Director-General of Health Tan Sri Dr Mohd Ismail Merican said that eight new Influenza A(H1N1) cases were detected bringing the total number of cases of the disease in Malaysia to 35. The 35th case is a 20-year-old male Malaysian student who is studying in a university in

Melbourne Melbourne ( ; Boonwurrung/Woiwurrung: ''Narrm'' or ''Naarm'') is the capital and most populous city of the Australian state of Victoria, and the second-most populous city in both Australia and Oceania. Its name generally refers to a met ...

and has been there since January who came back to Malaysia for a holiday.

20–30 June

On 20 June 2009 7 new cases of A(H1N1) were reported bringing the total number of confirmed cases so far to 42. One of the new cases included a local transmission of the virus whereby an 11-year-old student of Sekolah Jenis Kebangsaan Cina (SJKC) Davidson, Kuala Lumpur, contracted the virus from her grandmother who was 31st case confirmed. On 21 June 2009, eight more cases confirmed. Three of them were students from SJK(C) Jalan Davidson who contracted the virus from the 31st patient, which brought the total of confirmed cases in the country soaring to 50. SJK(C) Jalan Davidson had also been closed and more than one thousand people in the school had been quarantined. On 22 June 2009 it was reported that there were 8 new cases of A(H1N1) in Malaysia bringing the total number of confirmed cases to 58 overall. The 51st case is a three-year-old girl who returned from a week-long holiday in Melbourne on 19 June with her parents on MH 148. The 52nd case is a 35-year-old MAS air steward who was on duty on MH1 Delta from London and arrived in KLIA on 18 June. The 53rd case is a 27-year-old woman who returned from a holiday in Sydney with her husband on 16 June on MH 122. She is in Kuala Lumpur Hospital. The 54th case is a 25-year-old woman who had contact with the 48th case and was confirmed with the flu 21 June in Hospital Sultanah Bahiyah,

Alor Star Alor Setar ( Jawi: الور ستار, Kedahan: ''Loqstaq'') is the state capital of Kedah, Malaysia. It is the second-largest city in the state after Sungai Petani and one of the most-important cities on the west coast of Peninsular Malaysia. ...

. She is the 5th local transmission.

1–10 July

On 9 July 61 new cases of Influenza A(H1N1) were confirmed, consisting of 37 imported cases and 24 locally transmitted which makes the number of cases in Malaysia soared to 574. Among the 574 cases, 415 cases were reported to have been imported while 159 cases were locally transmitted. One of the visitors who visited a company in

Cyberjaya Cyberjaya (a portmanteau of ''cyber'' and ''Putrajaya'') is a city with a science park as the core that forms a key part of the Multimedia Super Corridor in Malaysia. It is located in Sepang District, Selangor. Cyberjaya is adjacent to, and deve ...

were confirmed to have contracted the virus, which caused 12 workers to be put under home quarantine.

11–31 July

On 23, 18 July new cases were confirmed in Malaysia consisting 17 local transmission and 1 imported case.

1 August onwards

According to the Health Ministry another 39 cases of A(H1N1) were reported on 2 August. 16 new cases of H1N1 were discovered on 5 August 2009 bringing the total number of cases to 1,492. 33 new cases were reported on 6 August 2009, bringing the total cases in Malaysia to 1525. It was reported on the same day that an

immigration Immigration is the international movement of people to a destination country of which they are not natives or where they do not possess citizenship in order to settle as permanent residents or naturalized citizens. Commuters, tourists, a ...

detainee from

Togo Togo (), officially the Togolese Republic (french: République togolaise), is a country in West Africa. It is bordered by Ghana to the west, Benin to the east and Burkina Faso to the north. It extends south to the Gulf of Guinea, where its c ...

was found dead at the Sepang detention centre. According to the guard, the prisoner did not complain of fever or cough. Autopsy were conducted on 4 August 2009 in

Selayang Selayang is a town in Gombak District, Selangor, Malaysia. Location Selayang is located on the main route to Rawang through Jalan Ipoh, and this route is connected to Jalan Kuching as main Rawang-Kuala Lumpur route. It is also an optional ...

Hospital and discovered that the patient had Influenza A(H1N1). However, they were still unable to determine if the flu was the direct cause of the patient's fatality. On 8 August 2009, 53 more cases were confirmed and brought the number of cases in Malaysia to 1578. Among the 1578 cases, 574(36%) were imported cases and 1004(64%) were local transmission. A record of more than 200 cases were confirmed on 9 August 2009. 202 new local transmitted cases were confirmed which brought the number of flu cases soared to 1780. 13 patients were still in ICU, and four of them were still in critical condition. 270 new local cases were confirmed on 11 August 2009, bringing the total cases in Malaysia to 2,253.

Deaths

July

On 23 July 2009 first A(H1N1) related death was confirmed. The patient is a 30-year-old Indonesian man who had multiple medical condition, including

obesity Obesity is a medical condition, sometimes considered a disease, in which excess body fat has accumulated to such an extent that it may negatively affect health. People are classified as obese when their body mass index (BMI)—a person's ...

and enlarged heart. However, Health Minister Datuk Liow Tiong Lai revealed that the flu was not the direct cause of the patient's fatality.

August

On 6 August 2009, in Putrajaya another death was confirmed involving a 57-year-old

pensioner A pensioner is a person who receives a pension, most commonly because of retirement from the workforce. This is a term typically used in the United Kingdom (along with OAP, initialism of old-age pensioner), Ireland and Australia where someone of p ...

who was a diabetic and had hypertension. On 7 August 2009, a 40-year-old

obese Obesity is a medical condition, sometimes considered a disease, in which excess body fat has accumulated to such an extent that it may negatively affect health. People are classified as obese when their body mass index (BMI)—a person's we ...

man who was admitted to Kuala Lumpur Hospital died of acute coronary syndrome and cardiogenic shock. The man had developed a fever and had been coughing since 28 July 2009. His autopsy result confirmed that he is the nation's fifteen Influenza A(H1N1) death. On 8 August 2009, three more deaths were recorded, which brought the death cases in Malaysia to 18. The sixteenth death was a 5-year-old boy who had

upper respiratory tract infection An upper respiratory tract infection (URTI) is an illness caused by an acute infection, which involves the upper respiratory tract, including the nose, sinuses, pharynx, larynx or trachea. This commonly includes nasal obstruction, sore thro ...

and sought treatment in a private clinic on 3 August. He was then had a

seizure An epileptic seizure, informally known as a seizure, is a period of symptoms due to abnormally excessive or synchronous neuronal activity in the brain. Outward effects vary from uncontrolled shaking movements involving much of the body with l ...

and was sent to Tengku Ampuan Afzan Hospital and confirmed to have the H1N1 virus. He died on 7 August 2009 due to acute encephalitis secondary to Influenza A(H1N1). The seventeenth death was a one-year-old toddler who had history of

hyperthyroidism Hyperthyroidism is the condition that occurs due to excessive production of thyroid hormones by the thyroid gland. Thyrotoxicosis is the condition that occurs due to excessive thyroid hormone of any cause and therefore includes hyperthyroidis ...

and was under treatment for it. He had symptoms of the flu but did not seek for treatment. He was then sent to Sultanah Amanah Hospital, Johor Bahru. He was confirmed to have the flu on 4 August 2009. However, after five days of treatment, his condition deteriorated with symptoms of

drowsiness Somnolence (alternatively sleepiness or drowsiness) is a state of strong desire for sleep, or sleeping for unusually long periods (compare hypersomnia). It has distinct meanings and causes. It can refer to the usual state preceding falling asleep ...

, lethargy and altered consciousness and was sent to ICU. On 7 August 2009, he died due to

pneumonia Pneumonia is an inflammatory condition of the lung primarily affecting the small air sacs known as alveoli. Symptoms typically include some combination of productive or dry cough, chest pain, fever, and difficulty breathing. The severi ...

with underlying

H1N1 In virology, influenza A virus subtype H1N1 (A/H1N1) is a subtype of influenza A virus. Major outbreaks of H1N1 strains in humans include the Spanish flu, the 1977 Russian flu pandemic and the 2009 swine flu pandemic. It is an orthomyxoviru ...

infection. The eighteenth death was a 63-year-old man who had

asthma Asthma is a long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wheezing, co ...

and

tuberculosis Tuberculosis (TB) is an infectious disease usually caused by '' Mycobacterium tuberculosis'' (MTB) bacteria. Tuberculosis generally affects the lungs, but it can also affect other parts of the body. Most infections show no symptoms, i ...

. He was admitted to Selayang Hospital and died on 6 August due to severe

with positive Influenza A(H1N1) and underlying pulmonary tuberculosis. Eight more deaths were confirmed on 9 August 2009. Among the eight patient who died, three died on 3 August, two on 5 August, four on 7 August and one on 8 August. All of them were in the high-risk group except a 20-year-old college student who was found dead at her hostel about a week after obtaining outpatient treatment. Among the dead were two Sabahans, one of them was a 24-year-old

woman from

Ranau 'Ranau'' ( ms, Pekan Ranau) is the capital of the Ranau District in the West Coast Division of Sabah, Malaysia. Its population was estimated to be around 8,970 in 2010. Climate Ranau has a tropical rainforest climate A tropical rainforest cl ...

who died of

pulmonary oedema Pulmonary edema, also known as pulmonary congestion, is excessive liquid accumulation in the tissue and air spaces (usually alveoli) of the lungs. It leads to impaired gas exchange and may cause hypoxemia and respiratory failure. It is due to ...

after a bout of flu while the other one was a 74-year-old man who had a history of heart problem who died of

and pulmonary oedema. The other deaths were a 47-year-old patient with

in Sarawak and a 37-year-old obese man who died of broncho-pneumonia at the hospital in Johor Bahru. Six more deaths were confirmed on 10 August 2009, bringing the total death cases in Malaysia skyrocketed to 32. Of the six cases, four of them had underlying medical cases. Another six deaths were recorded on 11 August 2009. Among the six death cases, four of them had been diagnosed with

, hypertension and

diabetes Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level ( hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ...

. As at 12 August 2009 the total of deaths reported raised to 44 with six more cases confirmed. A 60-year-old man who had histories of

, hypertension and heart problems was hospitalised on 6 August after showing symptoms of the flu. Throat swab and antiviral drugs were prescribed. However, he died on the next day due to severe pneumonia. Lab result confirmed the man as an Influenza A(H1N1) patient on 9 August. A 62-year-old man who was a diabetic was hospitalised on 6 August. He was then later

dehydrated In physiology, dehydration is a lack of total body water, with an accompanying disruption of metabolic processes. It occurs when free water loss exceeds free water intake, usually due to exercise, disease, or high environmental temperature. Mil ...

and given antiviral drug for precaution against the flu. Throat swab was taken on 7 August. However, he died on the same day due to

and possible cancer. A 20-year-old who didn't have any history of underlying medical condition experienced

fever Fever, also referred to as pyrexia, is defined as having a temperature above the normal range due to an increase in the body's temperature set point. There is not a single agreed-upon upper limit for normal temperature with sources using val ...

cough A cough is a sudden expulsion of air through the large breathing passages that can help clear them of fluids, irritants, foreign particles and microbes. As a protective reflex, coughing can be repetitive with the cough reflex following three ph ...

ing and

sore throat Sore throat, also known as throat pain, is pain or irritation of the throat. Usually, causes of sore throat include * viral infections * group A streptococcal infection (GAS) bacterial infection * pharyngitis (inflammation of the throat) * to ...

. He sought for treatment at a hospital on 6 August and was later hospitalised due to suffocation. Antiviral drugs were later prescribed by the doctor. On the next day, he died due to severe pneumonia and

septicaemia Sepsis, formerly known as septicemia (septicaemia in British English) or blood poisoning, is a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. This initial stage is follo ...

. A 10-year-old baby was among the death cases confirmed on 12 August. She showed symptoms but was hospitalised six days later due to suffocation. Antiviral drugs were not given. On the next day, she died due to

bronchopneumonia Bronchopneumonia is a subtype of pneumonia. It is the acute inflammation of the bronchi, accompanied by inflamed patches in the nearby lobules of the lungs. citing: Webster's New World College Dictionary, Fifth Edition, Copyright 2014 It is ofte ...

. An 18-year-old woman who was 26 weeks pregnant, and was also

, showed symptoms on 3 August. Her condition deteriorated and was then later sent to ICU, where a throat swab was performed. She died due to severe pneumonia. A 1-year-old toddler who had congenital heart disease had a

and fever on 7 August. Antiviral drugs were not given to the toddler and he died on 9 August 2009 while undergoing a surgery. Seven more deaths were confirmed on 13 August 2009, bringing the total number of death cases in Malaysia rose to 51. All of the seven fatalities were in high-risk group. A 4-month-old baby who had an extremely low immunity was hospitalised on 8 August 2009 after he showed symptoms of

, breathing difficulty,

vomiting Vomiting (also known as emesis and throwing up) is the involuntary, forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose. Vomiting can be the result of ailments like food poisoning, gastroenteri ...

, coughing and

diarrhoea Diarrhea, also spelled diarrhoea, is the condition of having at least three loose, liquid, or watery bowel movements each day. It often lasts for a few days and can result in dehydration due to fluid loss. Signs of dehydration often begin wi ...

. A throat swab was conducted, but he died on 10 August due to severe

. Lab result confirmed he had Influenza A(H1N1) on the next day, making him one of the victims of the flu. A 37-year-old

diabetic Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level ( hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ...

woman was hospitalised after showing symptoms. She was later given antiviral drugs but died on 10 August. A 69-year-old woman who had history of hypertension was found to have been coughing. Throat swab was conducted after she was transferred to ICU due to suffocation. On 11 August 2009, she died due to acute myocarditis. A woman in her 20s, who also had a history of congenital disease, started to have fever and coughing on 6 August. She was later admitted and given antiviral drugs on 8 August. However, she died on 10 August due to severe

. A 4-year-old boy who had congenital disease was treated on 2 August after exhibiting symptoms of the flu. He was later confirmed to have the flu after a throat swab was taken; however, he died before the confirmation was received. A 92-year-old lady who had

and a 43-year-old man who had

, hypertension and heart diseases died on 11 August 2009 due to severe

. Five more cases were confirmed on 14 August. A two-month-old baby who was born prematurely was admitted to the hospital following

, coughing,

sneezing A sneeze (also known as sternutation) is a semi-autonomous, convulsive expulsion of air from the lungs through the nose and mouth, usually caused by foreign particles irritating the nasal mucosa. A sneeze expels air forcibly from the mouth and ...

and difficulty in breathing. He was given antiviral drugs and was placed on

mechanical ventilation Mechanical ventilation, assisted ventilation or intermittent mandatory ventilation (IMV), is the medical term for using a machine called a ventilator to fully or partially provide artificial ventilation. Mechanical ventilation helps move a ...

as his condition deteriorated, but he died on 12 August due to

. Another two-month-old baby was rushed to the hospital when he was found unconscious. His condition was critical and was sent to ICU. He tested positive for the flu on 8 August, but died on 10 August due to myocarditis,

hepatitis Hepatitis is inflammation of the liver tissue. Some people or animals with hepatitis have no symptoms, whereas others develop yellow discoloration of the skin and whites of the eyes ( jaundice), poor appetite, vomiting, tiredness, abdominal ...

and

renal impairment Kidney failure, also known as end-stage kidney disease, is a medical condition in which the kidneys can no longer adequately filter waste products from the blood, functioning at less than 15% of normal levels. Kidney failure is classified as eit ...

associated with H1N1. A 49-year-old diabetic woman, who was also obese and having

was confirmed to have the virus on 11 August. A 57-year-old diabetic man sought for treatment on 2 August after showing symptoms of the flu. On 3 August, he returned to the clinic after experiencing fever, vomiting and diarrhoea. He was then sent to hospital and given antiviral drugs. Despite given antiviral drugs, he died on 12 August due to

sepsis Sepsis, formerly known as septicemia (septicaemia in British English) or blood poisoning, is a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. This initial stage is follo ...

. A 19-year-old teenager was admitted to the hospital after complaining having fever and coughing. He was then suffocated and died on 11 August due to

. 3 more deaths were confirmed on 15 August. A 22-year-old

man was hospitalised on 9 August but died on 12 August due to viral pneumonia. A 29-year-old man who had

valvular heart disease Valvular heart disease is any cardiovascular disease process involving one or more of the four valves of the heart (the aortic and mitral valves on the left side of heart and the pulmonic and tricuspid valves on the right side of heart). These ...

was admitted to the hospital after flu symptoms persisted for 2 days. Antiviral drugs were given on 10 August but he died 2 days later due to

. A 44-year-old woman who had

was tested positive for the flu on 10 August but died on 13 August due to pneumonia. Another three deaths were confirmed on 16 August, raising the total number of deaths to 62. The 59th death was a 6-year-old child with

Down's syndrome Down syndrome or Down's syndrome, also known as trisomy 21, is a genetic disorder caused by the presence of all or part of a third copy of chromosome 21. It is usually associated with physical growth delays, mild to moderate intellectual disa ...

who had the flu for 3 days before being confirmed as a H1N1 patient. He died on 13 August due to

with underlying Down's syndrome with AVSD and pulmonary hypertension. A 3-year-old child was hospitalised on 1 August after having symptoms for 5 days. Confirmed to have contracted the virus on 3 August and antiviral drugs were given on the same day. However, he died on 14 August due to severe pneumonia. A man in his 50s who had symptoms on 28 July was hospitalised. He also had been vomiting and had had diarrhoea two days before he was admitted. On 13 August, he was confirmed dead due to

with severe pneumonia. On 17 August, two more deaths were announced. A 7-month-old boy who had

was transferred to ICU after having fever and coughing for 2 days. Antiviral drugs were given and was confirmed to have the virus on 12 August. However, he was confirmed dead three days later due to severe

and acute respiratory failure. A 74-year-old

woman, who also had CCF was admitted to the hospital after she was found unconscious in her house. She died on 11 August due to severe pneumonia. Her test results came back on 12 August and confirmed her as a H1N1 patient. On 18 August, three more death cases were confirmed and brought the number of death cases in Malaysia to 67. A 33-year-old woman was transferred to ICU after her lungs disease began to deteriorate after 4 days of treatment in a private hospital. She showed symptoms on 31 July and antiviral drugs were started on 7 August. On 12 August, she died due to bronchopneumonia. Her result later came back and was positive for the flu. A 10-year-old school girl, who was diagnosed with Systemic lupus erythematosus was sent to ICU after she had breathing difficulty, chest pain and stomach ache. Antiviral drugs were given since 8 July. Despite on medicine, she died on 13 August due to Systemic lupus erythematous with severe pneumonia with

. A 71-year-old woman with

Chronic obstructive pulmonary disease Chronic obstructive pulmonary disease (COPD) is a type of progressive lung disease characterized by long-term respiratory symptoms and airflow limitation. The main symptoms include shortness of breath and a cough, which may or may not produce ...

, hypertension,

Ischaemic heart disease Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD), myocardial ischemia, or simply heart disease, involves the reduction of blood flow to the heart muscle due to build-up of atherosclerotic pla ...

and Diabetes mellitus type 2, showed symptoms of the flu and was hospitalised on 12 August. However, on 14 August, she died due to Ischaemic dilated cardiomyopathy precipitated by pneumonia. On 20 August, one new death was confirmed. The victim was a 34-year-old woman who was in the 34th week of pregnancy. The patient was treated and admitted into a private hospital in Johor Baru on 8 Aug after developing fever and cough for a day. She was subsequently, referred and admitted to the intensive care unit of the Sultanah Aminah Hospital in Johor Baru for breathing difficulties five days later. Tamiflu was administered. However, she died on next day due to severe

and respiratory failure. Another death was confirmed on 24 August, increasing the death toll to 69. The patient, a 38-year-old teacher, who was also obese, tested positive for H1N1 by a private clinic. Tamiflu was not administered but only gave her symptomatic treatment. Five days later, on 18 August, she was admitted to the hospital after having breathing difficulties and cyanosis. She was referred to KL Hospital and Tamiflu was administered. However, the woman died on 19 August due to pneumonia with AVDS. One more death was confirmed on 25 August by the Mortality Review Committee. A 3-year-old boy who had febrile convulsion and cough was hospitalised on 12 August. The boy was then transferred to ICU after his condition deteriorate and tamiflu was administered. He tested positive for the flu on 17 August. However, he died on the next day due to H1N1 encephalitis with Cerebral oedema and multiorgan failure. The death of a 24-year-old woman brought the number of cases in Malaysia to 71. The patient, having

, cough and headache was admitted to a private hospital in

Kuantan Kuantan ( Jawi: ) is a city and the state capital of Pahang, Malaysia. It is located near the mouth of the Kuantan River. Kuantan is the 18th largest city in Malaysia based on 2010 population, and the largest city in the East Coast of Peni ...

on 10 August and received viral pneumonitis treatment. She was then referred to a government hospital and placed in ICU after her condition worsened. Her condition continued to deteriorate despite the administration of Tamiflu. On 19 August, she was confirmed dead due to H1N1 secondary to

ARDS Acute respiratory distress syndrome (ARDS) is a type of respiratory failure characterized by rapid onset of widespread inflammation in the lungs. Symptoms include shortness of breath (dyspnea), rapid breathing (tachypnea), and bluish skin color ...

. One more death was confirmed on 30 August. A 49-year-old patient with heart problems was brought to Melaka Hospital after having

and vomiting which persisted for 2 days. He was given antiviral drugs and antibiotics and he was also tested for

typhoid Typhoid fever, also known as typhoid, is a disease caused by ''Salmonella'' serotype Typhi bacteria. Symptoms vary from mild to severe, and usually begin six to 30 days after exposure. Often there is a gradual onset of a high fever over several d ...

dengue Dengue fever is a mosquito-borne tropical disease caused by the dengue virus. Symptoms typically begin three to fourteen days after infection. These may include a high fever, headache, vomiting, muscle and joint pains, and a characteristic ...

, Leptospirosis and

but all of the tests came back negative. The patient's condition deteriorate and was confirmed dead on 19 August due to severe

with septic shock and H1N1. The post-mortem biopsy report based on lung samples tested positive for Influenza A(H1N1) on 24 Aug.

September

On 3 September 2009 the death of a 25-year-old woman was confirmed bringing the total number of deaths related to A(H1N1) to 73. The woman received outpatient treatment after developing flu symptoms. She was then subsequently brought to Sibu Hospital and administered antiviral drugs. However, she died on 1 September due to severe pneumonia with H1N1 infection. It was announced that on 11 September, the death of the 19-year-old man brought the total number of death cases to 74. The patient was brought to Gerik Hospital after flu symptoms persisted for 4 days. On 20 August, he was transferred to Ipoh Hospital where he was administered Tamiflu. Despite given antiviral drugs, he died on 23 August due to Acute

Pulmonary Oedema Pulmonary edema, also known as pulmonary congestion, is excessive liquid accumulation in the tissue and air spaces (usually alveoli) of the lungs. It leads to impaired gas exchange and may cause hypoxemia and respiratory failure. It is due to ...

with Underlying Influenza A(H1N1) infection. Another two death cases were confirmed on 15 September, bringing the total number of cases to 76 in total. The first death, a 45-year-old woman who had hypertension was referred to Tambunan Hospital on 17 August after flu symptoms persisted. She was then sent to Keningau Hospital and antiviral was administered. After 10 days in ICU, she died due to severe

and Acute respiratory distress syndrome. The second death registered was a 19-year-old teenage girl. She was sent to Kuala Lumpur Hospital and antiviral was administered. Despite given antiviral drugs, she died on 31 August due to severe pneumonia with H1N1 infection.

Terminology

The flu virus is officially designated by the WHO as "Influenza A (H1N1)", following a name change from "swine flu" to avoid suggestions that eating pork products carried a risk of infection, and is referred as such by Malaysia's Health Minister. However, Information Communication and Culture Minister

Rais Yatim Tan Sri Dato' Seri Utama Dr. Rais bin Yatim ( Jawi: رئيس بن يتيم; born 15 April 1942) is a Malaysian politician who is now serving as the 18th President of the Dewan Negara since September 2020. He was a Cabinet Minister in mul ...

suggested on 25 June that the local media use "swine flu" ( ms, selsema babi) instead, justifying that the dangers of the flu would be better understood by the public, and that the flu would be easily described in Malay, a language which is officially used in news programmers of government-owned television and radio channels.

Notes

External links

Ministry of Health, Malaysia
Official A(H1N1) Portal
{{DEFAULTSORT:2009 Flu Pandemic In Malaysia

Flu Pandemic in Malaysia, 2009 Health disasters in Malaysia 2009 disasters in Malaysia