The 2019 Kuala Koh measles outbreak was a

measles Measles is a highly contagious infectious disease caused by measles virus. Symptoms usually develop 10–12 days after exposure to an infected person and last 7–10 days. Initial symptoms typically include fever, often greater than , cough, ...

outbreak that occurred among the

Orang Asli Orang Asli (''lit''. "first people", "native people", "original people", "aborigines people" or "aboriginal people" in Malay) are a heterogeneous indigenous population forming a national minority in Malaysia. They are the oldest inhabitants ...

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 ...

in Kuala Koh Village in the state of

Kelantan Kelantan (; Jawi: ; Kelantanese Malay: ''Klate'') is a state in Malaysia. The capital is Kota Bharu and royal seat is Kubang Kerian. The honorific name of the state is ''Darul Naim'' (Jawi: ; "The Blissful Abode"). Kelantan is located in t ...

Malaysia Malaysia ( ; ) is a country in Southeast Asia. The federal constitutional monarchy consists of thirteen states and three federal territories, separated by the South China Sea into two regions: Peninsular Malaysia and Borneo's East Mal ...

, 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

villagers in Kuala Koh Village was at first considered a mystery with two people dying from

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 severit ...

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 extraction of valuable minerals or other geological materials from the Earth, usually from an ore body, lode, vein, seam, reef, or placer deposit. The exploitation of these deposits for raw material is based on the econom ...

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, 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 known as a federal state) is a political entity characterized by a union of partially self-governing provinces, states, or other regions under a central federal government ( federalism). In a federation, the self-gover ...

through Deputy Prime Minister Wan Azizah Wan Ismail said they are investigating the cause as well the allegations of

water pollution Water pollution (or aquatic pollution) is the contamination of water bodies, usually as a result of human activities, so that it negatively affects its uses. Water bodies include lakes, rivers, oceans, aquifers, reservoirs and groundwater. ...

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 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 ( ta, வேதமூர்த்தி பொன்னுசாமி, Vētamūrtti poṉṉucāmi; born 16 July 1966), is a Malaysian people, Malaysian politician and lawyer who serve ...

, Health Minister Dzulkefly Ahmad 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 with the Symbol (chemistry), symbol Mn and atomic number 25. It is a hard, brittle, silvery metal, often found in minerals in combination with iron. Manganese is a transition metal with a multifaceted array of ...

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. On the same day, the affected area was declared by

police The police are a Law enforcement organization, constituted body of Law enforcement officer, persons empowered by a State (polity), state, with the aim to law enforcement, enforce the law, to ensure the safety, health and possessions of citize ...

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 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 Gene ...

, and rubella (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.

Background of the disease

Villager claims

Official response, investigation, and conclusion

See also

Notes

References

Further reading