Background: Healthcare workers (HCWs) are at increased risk of getting influenza than the general population, therefore putting patients at risk of nosocomial infection. Influenza vaccination coverage among HCWs is low despite the availability of a safe and effective vaccine. However, the reasons for such a poor uptake are not well reported in Malaysia. This study aimed at assessing the rate of influenza vaccination uptake, knowledge and attitude of healthcare workers regarding influenza, and employers’ policy on influenza vaccination. Methods: A cross-sectional questionnaire survey was conducted in three hospitals in the Klang Valley. Mann–Whitney test was used to assess possible differences in knowledge and attitude towards flu vaccination and the χ2 was used for categorical variables. Analyses were performed with SPSS 22.0. Results: A total of 690 questionnaires were distributed; 527 were returned (giving a response rate of 76.4%. The vaccine uptake was 51.4% with the majority (83.5%) of those believing they were vaccinated to protect themselves. Higher proportion of vaccinated HCWs (p <0.05) agreeing to the fact that influenza is a serious threat to their health, however, 10% were not sure of its safety. Eighty-three (15.7%) claimed their employers did not have a vaccination policy, while 43.3% were not sure if their employers have vaccination policy. Conclusion: This study has demonstrated more than half of the healthcare workers were vaccinated, with a significant proportion of the healthcare workers believed they were vaccinated to protect themselves, while most of those that were not vaccinated claimed they are worried about the safety of the vaccine. Most employers did not have a flu vaccination policy in place. Hence, the need for government to enforce such policy and make annual flu vaccination free and compulsory for all healthcare workers KEY WORDS:

Hand, foot and mouth disease (HFMD) is a common viral infection among infants and children. The major causative agents of HFMD are enterovirus 71 (EV71) and coxsackievirus A16 (CVA16). Recently, coxsackievirus A6 (CVA6) infections were reported in neighboring countries. Infected infants and children may present with fever, mouth/throat ulcers, rashes and vesicles on hands and feet. Moreover, EV71 infections might cause fatal neurological complications. Since 1997, EV71 caused fatalities in Sarawak and Peninsula Malaysia. The purpose of this study was to identify and classify the viruses which detected from the patients who presenting clinical signs and symptoms of HFMD in Seri Kembangan, Malaysia. From December 2012 until July 2013, a total of 28 specimens were collected from patients with clinical case definitions of HFMD. The HFMD viruses were detected by using semi-nested reverse transcription polymerase chain reaction (snRT-PCR). The positive snRTPCR products were sequenced and phylogenetic analyses of the viruses were performed. 12 of 28 specimens (42.9%) were positive in snRT-PCR, seven are CVA6 (58.3%), two CVA16 (16.7%) and three EV71 (25%). Based on phylogenetic analysis studies, EV71 strains were identified as sub-genotype B5; CVA16 strains classified into sub-genotype B2b and B2c; CVA6 strains closely related to strains in Taiwan and Japan. In this study, HFMD in Seri Kembangan were caused by different types of Enterovirus, which were EV71, CVA6 and CVA16.