1.Epidemiological and clinical features of enteroviral acute lower respiratory tract infections in hospitalized paediatric patients in a Malaysian tertiary center
Jason Tan Weng Yew ; Nuryasmin Ramli ; Mohd Apandi Yusof ; Nethiya Vengataraman ; Hazilawati Hussin ; Zuraidah Abdul Latif
The Medical Journal of Malaysia 2016;71(5):264-268
Background: Human enteroviruses (HEVs) have been
recognized to cause a significant number of respiratory tract
infections in many regions. Previous studies conducted to
analyse enteroviral respiratory tract infections focused on
outbreaks. Data in the Southeast Asian region is still rather
limited to date.
Objectives: We conducted a prospective analysis to
understand the epidemiological characteristics of
enteroviral lower respiratory tract infections (LRTIs) among
paediatric patients admitted to Hospital Ampang, a tertiary
hospital in Malaysia.
Methodology: Nasopharyngeal aspirates for common
respiratory viruses and throat swabs for enteroviruses were
obtained for rtPCR analyses. All positive enteroviral results
were then cultured for species identification.
Results and conclusion: Of the total 211 recruited patients,
enteroviral LRTIs made up 8%. The clinical features of
enteroviral infections are mostly clinically indistinguishable
from that of respiratory syncytial virus (RSV) infections.
However, RSV appears to be more lymphocytosis causing
than enteroviruses (EV). We found a higher asthma
incidence within the enteroviral group compared to RSV
group. Enteroviral infections continue to play an important
role in LRTIs in children beyond infancy and up to school
age. Among the enteroviral strains, EV71 contributes a
major role in enteroviral LRTIs in our center. Routine testing
for enterovirus would certainly help identify a significant
proportion of unexplained viral LRTIs among paediatric
patients. However, further cost analyses studies would be
helpful to determine if incorporating testing for
enteroviruses into routine respiratory viruses panel tests is
economically feasible.
2. Echovirus serotypes circulating in Malaysia from 2002 to 2013
Jeyanthi SUPPIAH ; Jeyanthi SARASWATHY ; Jeyanthi AMRY ; Apandi YUSOF ; Zainah SAAT
Asian Pacific Journal of Tropical Medicine 2016;9(3):252-255
Objective: To identify the circulating serotypes of human echovirus in Malaysia from 2002 to 2013. Methods: A total of 31 retrospective samples from non-polio acute flacid paralysis, hand-food-and-mouth disease, viral meningitis and enterovirus cases were subjected to amplification of partial VP1 gene by RT-PCR. Results: Sequencing and phylogenetic analysis of the partial sequences identified presence of human echovirus and human coxsackie viruses. It was found that echovirus 11 was the commonly circulating serotype followed by echovirus 6, echovirus 7, echovirus 3, echovirus 9, echovirus 30 and echovirus 1 in decreasing order. Additionally two types of human coxsackie virus isolates were detected which were coxsackie A24 and B3. Conclusions: From the findings, there is a possibility that echovirus 11 is the predominant serotype among Malaysian patients with echovirus infection. However, a larger sample size will yield a more confident result to support this evidence.
3. Sharing experiences from a reference laboratory in the public health response for Ebola viral disease, MERS-CoV and H7N9 influenza virus investigations
Ravindran THAYAN ; Mohd Apandi YUSOF ; Jeyanthi SUPPIAH ; Tengku Rogayah TG ABD RASHID ; Zarina Mohd ZAWAWI ; Nor Aziyah MAT RAHIM ; Fauziah KASSIM ; Rozainanee Mohd ZAIN ; Zainah SAAT
Asian Pacific Journal of Tropical Medicine 2016;9(2):201-203
An efficient public health preparedness and response plan for infectious disease management is important in recent times when emerging and exotic diseases that hitherto were not common have surfaced in countries with potential to spread outside borders. Stewardship from a reference laboratory is important to take the lead for the laboratory network, to proactively set up disease surveillance, provide referral diagnostic services, on-going training and mentorship and to ensure coordination of an effective laboratory response. In Malaysia, the Institute for Medical Research has provided the stewardship for the Ministry of Health's laboratory network that comprises of hospital pathology, public health and university laboratories. In this paper we share our experiences in recent infectious disease outbreak investigations as a reference laboratory within the Ministry of Health infectious disease surveillance network.
4.Longitudinal Extensive Transverse Myelitis as a Neurological Sequelae post-Sea Urchin Stings: A Case Report
Anas Aminin W M Izzuddin ; Abdul Hanif Khan Yusof Khan ; Liyana Najwa Inche Mat ; Laila Mastura Ahmad Apandi ; Peck Kee Chia ; Hamidon Basri
Malaysian Journal of Medicine and Health Sciences 2021;17(No.1):187-190
Puncture injury from sea-urchin stings may lead to a local and systemic inflammatory reaction. We are reporting a
case of longitudinal extensive transverse myelitis (LETM), which occurred ten days post-sea-urchin stings, where the
patient presented with bilateral lower limb weakness. MRI showed multilevel segment spinal cord T2-weighted hyperintensity. Prompt intravenous methylprednisolone was administered, and the patient had a full recovery. To date,
there is no case report of LETM associated with sea-urchin stings. Possible mechanism due to delayed immunological
hypersensitivity to sea-urchin venom. This case demonstrates the potential serious neurological sequelae that may be
associated with post-sea-urchin sting and the importance of prompt recognition and management in aiding recovery.
5.Acute Mycoplasma Pneumoniae Encephalitis in an Adult
Leong Wan Yi ; Abdul Hanif Khan Yusof Khan ; Janudin Baharin ; Wei Chao Loh ; Anna Misya&rsquo ; il Abdul Rashid ; Wan Aliaa Wan Sulaiman ; Fan Kee Hoo ; Hamidon Basri ; Laila Mastura Ahmad Apandi ; Liyana Najwa Inche Mat
Malaysian Journal of Medicine and Health Sciences 2022;18(No.5):222-224
Mycoplasma pneumonia is an atypical bacterium that causes mild respiratory tract infections, especially in the upper
respiratory system. Mycoplasma pneumoniae infection is infrequently associated with various CNS manifestations
such as encephalitis, meningoencephalitis, myelitis, Guillain-Barre syndrome and acute disseminated encephalomyelitis (ADEM). Here we report a rare case of mycoplasma encephalitis in an adult who presented with a first episode
of seizure following fever and neck stiffness for one week. Mycoplasma pneumoniae antibody titer was markedly
elevated at >1:320 and MRI brain revealed encephalitic changes with a lesion in the splenium. Interestingly, there
was no associated respiratory infection and his stay in the hospital was also complicated by SIADH. The patient improved after treatment with a macrolide antibiotic.