2019 Kuala Koh measles outbreak

The 2019 Kuala Koh measles outbreak was a measles outbreak that occurred among the Orang Asli sub-group of Batek people in Kuala Koh Village in the state of Kelantan, Malaysia, from May until July.[4] 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.[2][5][6]

2019 Kuala Koh measles outbreak
The site of the outbreak in 2019.
Disease	Measles
Virus strain	Measles virus
Index case	2 May 2019
Confirmed cases	43[1]
Suspected cases^‡	113[1]
Deaths	15 (total deaths)[n 1] 4 (according to MOH)[n 2]
^‡Suspected cases have not been confirmed as being due to this strain by laboratory tests, although some other strains may have been ruled out.

Background of the disease

The range of the traditional territories of the Batek people in orange.

The sudden deaths of 14 Orang Asli villagers in Kuala Koh Village was at first considered a mystery with two of the victims dying from pneumonia complications between 2 May and 7 June, while the remaining victims' causes of death remain unknown as their bodies were buried by locals prior to reports of the outbreak.[4][5] 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.[5] 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.[5] Another died on 16 June, bringing the total death toll to 15.[2]

Villager claims

One of the villagers claimed that the deaths are caused by mining 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; his neighbours also suffering from the same disease, some of which have died.[4] 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.[5]

Official response, investigation, and conclusion

On 9 June, the Malaysian federal government through Deputy Prime Minister Wan Azizah Wan Ismail said they are investigating the cause as well the allegations of water pollution 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.[7] A similar statement was echoed by Water, Land and Natural Resources Minister Tengku Zulpuri Shah Raja Puji during his visit to the affected community.[8] 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, Health Minister Dzulkefly Ahmad and Energy, Technology, Science, Climatic Change and Environment Minister Yeo Bee Yin.[9]

Based on samples taken by the Environment Department from the manganese 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.[10] On the same day, the affected area was declared by police as a "red zone".[11] 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.[2][6] Until 20 June, a further 43 measles cases are confirmed among the community with three more respiratory illnesses also being reported in the area.[12][13]

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, and rubella (MMR) shots, only 30% of them had their follow-up shots.[2][14] Since the outbreak was announced, 113 cases has been reported in the affected area with a total 43 confirmed cases.[1] 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 victims.[15] The "red zone" declaration was lifted on 8 July after the area was declared safe for the public.[16]

See also

• Epidemiology of measles

Notes

1. Since before the announcement of outbreak, including from complications of pneumonia but not acknowledged by the Health Ministry.[2]
2. Since the announcement of outbreak, acknowledged by the Health Ministry.[1][3]

Further reading

• Rachel Tay (18 June 2019). "The mysterious illness that caused 15 deaths in a Malaysian tribe has been linked to a measles outbreak". Business Insider Malaysia. Retrieved 27 August 2019.
• Nadirah H. Rodzi (2 July 2019). "Measles outbreak among Orang Asli in remote Malaysia catches national attention". The Straits Times. Retrieved 27 August 2019.

References

1. "43 confirmed measles cases among Kuala Koh Batek tribesmen - MOH". Bernama. 20 June 2019. Archived from the original on 27 August 2019. Retrieved 27 August 2019.
2. Alyssa J. Oon (17 June 2019). "A Measles Outbreak Is The Cause of 15 Orang Asli Deaths In Kelantan". Says.com. Archived from the original on 27 August 2019. Retrieved 27 August 2019.
3. Shathana Kasinathan (9 July 2019). "Another Kuala Koh death due to measles". Free Malaysia Today. Archived from the original on 27 August 2019. Retrieved 27 August 2019.
4. Hannah Ellis-Petersen (11 June 2019). "Malaysia's last indigenous nomadic tribe threatened by deadly mystery illness". The Guardian. Archived from the original on 27 August 2019. Retrieved 27 August 2019.
5. Jia Vern Tham (10 June 2019). "14 Orang Asli Have Died In Kelantan Within A Month. Here's All You Need To Know". Says.com. Archived from the original on 27 August 2019. Retrieved 27 August 2019.
6. Joseph Kaos Jr. (17 June 2019). "Health Minister: Disease affecting Kampung Kuala Koh is measles". The Star. Retrieved 27 August 2019.
7. "Malaysia to investigate water pollution allegations after Orang Asli deaths in Kelantan: DPM". Channel NewsAsia. 9 June 2019. Archived from the original on 27 August 2019. Retrieved 27 August 2019.
8. "Pneumonia outbreak: Ministry probing claims of water contamination". Bernama. New Straits Times. 10 June 2019. Retrieved 27 August 2019.
9. "Dr Wan Azizah chairs emergency meeting on 'unexplained' Orang Asli deaths". Bernama. The Malay Mail. 11 June 2019. Archived from the original on 27 August 2019. Retrieved 27 August 2019.
10. Jo Timbuong (14 June 2019). "Water samples near Kuala Koh Orang Asli settlement free from contaminants, says DOE". The Star. Retrieved 27 August 2019.
11. Sharifah Mahsinah Abdullah (12 June 2019). "Orang Asli deaths: Kampung Kuala Koh declared 'red zone'". New Straits Times. Retrieved 27 August 2019.
12. "43 confirmed measles cases among Kuala Koh Batek tribesmen - MOH". Bernama. 20 June 2019. Archived from the original on 27 August 2019. Retrieved 27 August 2019.
13. Tarrence Tan (22 June 2019). "Health Ministry: Three more cases of respiratory illness reported in Kg Kuala Koh". The Star. Retrieved 27 August 2019.
14. Debra Chong (17 June 2019). "Health minister verifies Kuala Koh Orang Asli hit by measles outbreak". The Malay Mail. Archived from the original on 27 August 2019. Retrieved 27 August 2019.
15. "Kampung Kuala Koh Orang Asli deaths: post-mortems inconclusive". Bernama. New Straits Times. 6 July 2019. Retrieved 27 August 2019.
16. Sharifah Mahsinah Abdullah (7 July 2019). "Kampung Kuala Koh safe, authorities to lift 'red zone' order tomorrow". New Straits Times. Retrieved 27 August 2019.