The current Ebola outbreak, which is the first to affect West African countries, has been declared to have met the conditions for a Public Health Emergency of International Concern (PHEIC) by the World Health Organization (WHO). Thus, the Ministry of Health (MOH) of Malaysia has taken steps to strengthen and enhanced the five core components of preparedness and response to mitigate the outbreak. The National Crisis Preparedness and Response Centre (CPRC) commands, controls and coordinates the preparedness and response plans for disasters, outbreaks, crises and emergencies (DOCE) related to health in a centralised way. Through standardised case definition and mandatory notification of Ebola by public and private practitioners, surveillance of Ebola is made possible. Government hospitals and laboratories have been identified to manage and diagnose Ebola virus infections, and medical staff members have been trained to handle an Ebola outbreak, with emphasis on strict infection prevention and control practices. Monitoring of the points of entry, focusing on travellers and students visiting or coming from West African countries is made possible by interagency collaborations. To alleviate the public’s anxiety, effective risk communications are being delivered through various channels. With experience in past outbreak control, the MOH’s preparedness and response plans are in place to abate an Ebola outbreak.

Introduction: : Influenza is an upper respiratory infection is caused by the influenza virus. It occurs throughout the whole year in Malaysia with occasional outbreaks. Influenza-like illnesses (ILI) are generally treated as outpatient care while the more severe (SARI) is managed in patient care. The Casemix system, used in healthcare professionals' practices, may help in estimating the cost of influenza management. Methods: : This cross-sectional study extracts the cost of influenza management from different public hospitals in years 2016, 2017 and 2018. Data used selected ICD-10 codes, and the cost was abstracted from Malaysian Diagnostic Related Groups (MyDRG) software. The secondary data are from 2 sources, an urban teaching hospital Hospital Cancellor Tuanku Muhriz (HCTM) and Ministry of Health (MoH) inpatient hospitals database. The sample size of the study was 586, while a structured datasheet collating patients' sociodemographic data and cost of admission, per case, was obtained from the MyDRG software. Microsoft Excel and SPSS software were used in the analysis. Results: : Most influenza cases (61.8%) are between the ages of 0 and 10, Malays, and have similar gender proportions. Overall, the influenza treatment cost for inpatient care, totalled to RM 294,017,112. In 2018, the GDP for health consumed 3.76% of Malaysia's GDP income of RM 1.4 trillion, with an estimated RM 60,339 million used for health. Thus, the three-year public cost consumed 0.5% of 2018 GDP. Conclusion: Influenza screening at the primary healthcare setting, health education and treatment compliance should be scale-up to minimize the cost of influenza management of the public providers.

Aims: To develop a real-time polymerase chain reaction system Vi-qPCR in the detection of Salmonella enterica serovar Typhi (S. Typhi), targeting the vexC gene encoding for Vi antigen (capsular polysaccharide antigen) and to evaluate its sensitivity and specificity performance using pure cultures of S. Typhi and other enteric pathogens. Methodology and results: Microbiological, biochemical and serotyping tests were conducted to determine the phenotypic characteristics of S. Typhi and other enteric pathogens in our collection. Primers were designed using Primer3 software and their in-silico specificity were analysed using Basic Local Alignment System Tool (BLAST). Optimisation of PCR annealing temperature was done prior to assessment of sensitivity and specificity performance against artificial serially diluted seeded stools. The primers were found to be 100% specific in the detection of S. Typhi towards 32 tested clinical strains. Verification of gene amplification by comparing the nucleotide sequences against reference genes in the GenBank database revealed high specificity to S. Typhi. Statistical analysis indicates that this method results in 100% sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Moreover, Vi-qPCR allows the detection of S. Typhi as low as 131.4 CFU/g of stool sample. Conclusion, significance and impact of study A rapid and sensitive method for detection of Salmonella enterica serovar Typhi (S. Typhi) is desired as a diagnostic tool to improve typhoid management. The Vi-qPCR represent a promising non-invasive diagnostic tool for medical microbiology laboratories as a method for the detection of S. Typhi in both pure culture and stool specimens especially in chronic asymptomatic carriers where shedding of S. Typhi is intermittent and sometimes occurs in low level.