Page 96 - ANUAL REPORT MOH 2017

• Hand Foot and Mouth Disease (HFMD)
In 2017, a total of 29,359 HFMD cases was reported and no death cases. This showed a 38 per cent
reduction of cases as compared to 2016 (47,008). There were 926 HFMD outbreaks reported in 2017,
with 35 per cent reduction compared to previous year (1,431).

• Rabies
Since 1990, there was no rabies cases reported until 2017. There were six (6) cases including five
(5) deaths reported in Serian with case fatality rate of 83 per cent. Five (5) of the six (6) cases were
children aged between 4 to 7 years. Only a case survived, aged 7 years old boy, and was discharged
from hospital with respiratory support. Prevention and control activities on animals were handled by
Department of Veterinary Services. Surveillance in the animals noted 62 dogs and six (6) cats were
positive rabies. They came from 28 localities in five (5) divisions in Sarawak and were declared as
rabies outbreak areas. The Virology Unit, IMR sequenced the rabies virus isolated from a human case
in Serian and noted that the virus has the highest genome sequence equation with the sequence of
genome strains of rabies virus originating from Kalimantan and Sulawesi.

Table 15
Rabies outbreak areas by division in Sarawak

Division Serian Kuching Samarahan Sri Aman Sarikei

No. of rabies outbreak areas 21 4 1 1 1

Source: Disease Control Division, MoH

• Melioidosis
In 2017, there were 492 cases reported with an incidence rate of 1.52 per 100,000 populations. The
number of cases increased by 54.7 per cent as compared to 2016. The number of dead cases was
increased by 75 per cent with 119 deaths as compared to last year. There was no melioidosis outbreak
reported in 2017.

• Avian Influenza
Avian influenza was gazetted as a notifiable disease on 30 November 2016. In 2017, there was an
outbreak among birds in six (6) districts of Kelantan i.e. Kota Bharu, Pasir Mas, Pasir Puteh, Bachok,
Tumpat dan Tanah Merah. However, there was no human case.

• Brucellosis
In 2017, Bacteriology Unit of Institute for Medical Research (IMR) reported 42 lab-confirmed brucellosis
cases. Selangor reported the most with 19 cases, followed by Perak with seven (7) cases and six (6)
cases from Kelantan. In 2017, there were three (3) brucellosis outbreaks reported; which were two (2)
from Selangor and one (1) from Kelantan. All cases had history of drinking unpasteurized goat milk;
either they bought it online from a supplier (a cluster) or bought the milk from the collecting centre of
goats’ farm.

• Ebola, Plague, And Nipah
There was no Ebola, Plague and Nipah cases being reported in 2017.

MINISTRY OF HEALTH MALAYSIA ANNUAL REPORT 2017 95