Nikkei Asia Prizes 2002

The Department of Medical Microbiology

Fighting new disease took guts, determination, skill After 100 people died, team had to race against time to isolate new virus

BY ATSUHIRO YAMAZAKI
staff writer

KUALA LUMPUR - In September 1998 an unknown virus, soon to be known as the Nipah virus, struck Malaysia; 265 people were infected and over 100 died through the following year.

This often lethal form of encephalitis was first thought to be Japanese encephalitis, but the Department of Medical Microbiology, Faculty of Medicine, the University of Malaya, discovered that it was caused by something never before seen.

The outbreak hit Ipoh, a farming region in the northern state of Perak. Victims became delirious with fever and developed encephalitis, leading to death for many. Because all the victims worked on pig farms, the government health care organization thought it was Japanese encephalitis, which normally affects several dozen Malaysians each year.

To exterminate mosquitoes, the vector for the Japanese disease, workers sprayed insecticide on thousands of pig farms and neighboring houses and provided Japanese encephalitis vaccine to tens of thousands of people in the risk group.

But the disease continued to spread and took the lives of at least 95 people in the first six months. Unexpected effects appeared that indicated the disease was something different: pigs and working-age men were dying, whereas Japanese encephalitis mostly attacks old people and children, and never pigs.

'Most exciting time'

The government went to the Department of Medical Microbiology for advice. On March 1, 1999, the department received samples of spinal and other bodily fluids taken from a man found dead on a pig farm in Sungei Nipah, after which the virus was named. The department's professor Lam Sai Kit recalls the following five days as "a most exciting time."

The department was asked by the government to determine whether the patient had Japanese encephalitis. Anticipating that the man had something else, the researchers rose to the challenge of fighting an unknown virus with limited equipment. They decided to cell-culture the virus.

They then tested the cultured virus against antibodies that would identify every known strain of encephalitis. All the tests were negative. The University of Malaya research team worked to determine from the shape and behavior of the virus, which it isolated in five days, that it was different from the Japanese encephalitis virus.

Lacking the equipment to fully identify the virus, the department took a sample to the Centers for Disease Control and Prevention in the U.S. The virus was found to be a previously unknown strain, something close in nature to Hendra, a virus discovered in Australia in 1994.

The department then conducted a field investigation and discovered that an indigenous species of fruit bat is the carrier of the virus. Using the team's results, the Malaysian government stopped the spread of the disease by culling about 900,000 infected pigs.

Major threat

New diseases caused by little-known viruses like HIV, the virus that causes AIDS, Ebola, and others are becoming a major threat to humans. With the increasing mobility of people and goods around the world, there is a danger that one of these diseases could spread quickly.

Lam says that it is the mission and obligation of the scientist to deal with national and global crises, in spite of the dangers. The courage of such dedicated scientists is growing increasingly important.