Do more or fat chance Malaysia will reduce obesity, govt told

The Star Online

KUALA LUMPUR: The Government needs to be more serious in battling obesity, the Malaysian Association for the Study of Obesity says.

Its president Prof Dr Mohd Ismail Noor said that creating awareness and public education were not enough.

“At some point, the government has to be more serious about controlling the environment that encourages obesity.”

He said this yesterday after the official launch and opening of Nutrition Month Malaysia 2014 by Health Minister Datuk Seri Dr S. Subramaniam.

Dr Mohd Ismail urged the local authorities to shut down all food outlets by midnight instead of allowing them to run 24 hours.

He said the argument that these outlets were kept open for night shift workers did not hold water because many youngsters were frequenting the outlets.

He noted that some countries had imposed a tax on sweet soda drinks.

While the Government needed to be more committed in battling obesity, he added it was also everyone’s responsibility and required a multi-pronged approach.

Asked whether the Health Minist­ry would limit the number of 24-hour food outlets, Dr Subramniam said the emphasis was still on educating people about good eating habits.

“You ban them or you educate people not to use them.

“Life’s temptations will always exist but you need to educate them,” he said.

As to why the Government had yet to create the healthy environment for people to walk or expend their energy (safe walk and bicycle paths along roadways) that was planned many years ago, Dr Subramaniam said the problem was in the implementation.

“There must be greater emphasis on adhering to government policy and guidelines by local authorities,” he said.

The National Health and Morbidity Survey revealed that the rate of obesity in Malaysia had increased by almost three and a half times, from 4.4% in 1996 to 15.1% in 2011.

This puts the number of obese Malaysians at around 2.5 million.

The Nutri-Fun Land Family Carnival is held at Mid Valley Exhibition Hall 1 in conjunction with the Nutrition Month. It ends today.

Confusion over exact percentage of medical fee rise

The Star Online

PUTRAJAYA: Private medical fees are up, but there is confusion over the exact percentage of the rise.

While the Health Minister said the increase has been capped at 14.4% – less than half the amount the Malaysian Medical Association had requested – the medical schedule showed hikes of a few hundred per cent on certain fee ceilings.

Consultation fees, for instance, increased from a range of RM10-RM35 to a new range of RM30-RM125.

While the Health Minister Datuk Seri Dr S. Subramaniam said that the fees were the maximum amount that doctors were allowed to charge and they were free to charge less.

“Those (in the fee schedule) are the maximum rates. We are protecting the people from being charged exorbitantly by the private sector,” he told a press conference here on Wednesday.

On Monday, it was highlighted that the amendment to the 13th Schedule of the Private Healthcare Facilities and Services Act 1998 was implemented without sufficient publicity and awareness of the issue.

The Private Hospitals and Other Private Healthcare Facilities Regulations 2006 of the Act, which was published in the federal gazette on Dec 16 last year, provides for the maximum chargeable fees for registered medical and dental practitioners practising in private hospitals in terms of their professional fees such as consultation and performance of procedures.

These fees were based on Malaysian Medical Association (MMA) Schedule of Fees 4th Edition 2002.

Dr Subramaniam said the ministry had rejected the Malaysian Medical Association’s request for a 30% increase.

He added that the 14.4% increase was reasonable given that the inflation rate was around 23%.

He also said that the previous minister Datuk Seri Liow Tiong Lai did keep the public informed of the increase in July 2012 and the fee schedule was brought to the Cabinet and approved on October 12 the same year after consulting various stakeholders.

The Ministry directed to review the fee schedule in Sept 2010.

However, Health director-general Datuk Dr Noor Hisham Abdullah said that the 14.4% increase was the average fees for surgical and dental procedures.

He said that the doctors’ consultation charges that was increased from a range of RM10-RM35 to a new range of RM30-RM125 took into account of the rental cost in different locations.

Dr Subramaniam said that the market forces were expected to determine the fees that facilities would impose within the ambit.

“Prudent and discerning public are encouraged to seek treatment at private facilities charging reasonable rates,” he said.

The other components of the hospital charges such as fees for accommodation, laboratory investigations, nursing care, use of equipment, operation room, drugs used were not regulated due to the varying costs in operating and maintaining a private hospital at different areas, he said.

The new medical fees schedule was the first revision since it was regulated in 2006. The fees were recommended by the MMA since 2002, he said

Health ministry continues to monitor haze situation, says minister

MSN Malaysia News

The Health Ministry, through the respective State Health Departments, continues to monitor ailments linked to the haze, namely, upper respiratory tract infections, asthma and eye diseases.
Health Minister Datuk Seri Dr S. Subramaniam (pic) said in a statement today, that the monitoring was conducted by selected sentinel clinics in states afflicted by the haze.

He said those experiencing ailment such as cough, flu, asthma, eye problems and chronic lung infection should go to the clinic quickly if their situation worsened.

"The ministry wishes to advise the public to take preventive measures to reduce the effect of the haze including reducing physical activities outside the house, always seek to be in a building and, if forced to go out, to wear suitable nose and mouth masks.

"Furthermore, ensure air in the house/building is clean by reducing internal sources of pollution such as cigarette smoke. When driving and using air-conditioning, switch to internal air circulation operation mode," he said.

He also encouraged the public to drink plenty of water, at least eight glasses a day, and to wash hands and face with clean water after any activities.

Subramaniam said the ministry had monitored the haze in the country from 52 Department of Environment (DOE) air quality monitoring stations, since 7am on February 26.

"Based on our monitoring, several states on the West coast of the peninsula were found to be experiencing haze with unhealthy Air Pollution Index (API) readings (exceeding 100)," he said.

The areas are Nilai, Banting, Petaling Jaya and Batu Muda (Kuala Lumpur) as of 5pm today.

According to the DOE website, as of 5pm today, 19 areas recorded good API levels and 27 areas recorded moderate API readings.

The public can seek information on preventive measures through the health ministry's website at InfoSihat andMOH. – Bernama, March 4, 2014.

Subra: Medical fee cap to protect public

Free Malaysia Today

PUTRAJAYA: The fee hike for private healthcare costs is done in order to protect public interest, Health Minister Dr S Subramaniam said today.

He said the fee amendments under the 13th Schedule of the Private Healthcare Facilities and Services (Privates Hospitals and Other Private Health Facilities) Regulations 2006 would make private healthcare providers compete among themselves to provide better services.

“Under the revised fee, action can be taken against doctors who charge more than what is proposed in the schedule,” he said, adding the ministry was instructed to review the prices in 2010.

Subramaniam added that the 14% rate hike for private medical and dental practitioners was done after studying the consumer price index (CPI) for healthcare between 2002 and 2010.

“In my experience, the public will avoid any clinics which charge high fees. Thus, I believe the private hospital would not impose the maximum charges,” he said.

The revision included a spike in consultation charges from between RM10 and RM35 to RM30 and RM125 for general practitioners, and from between RM30 and RM125 to RM80 and RM235 for specialist doctors.

Fees for medical procedures have soared between 14% and 18%.

Dr Subramaniam said the Health Ministry reviewed the 13th schedule on Sept 22, 2010.

Fees for consultation and medical procedures have not been revised since 2002 and is considered low compared to other nations.

“Consultations and meetings were held. We established two committees and a working group. We then forwarded the proposal to the cabinet which approved the amendment to the 13th schedule on Oct 12, 2012,” he added.

The amended schedule fee structure, was presented to the Attorney-General’s chambers on April 29, 2013 and gazetted on Dec 16 after the cabinet’s approval.

The minister also assured Malaysians that the fee structure would not be amended again, at least for another three to four years.

“It was just gazetted last year. The people need not to worry about the increase of the fees after this,” he added.

Increase in current medical fees acceptable, says MMA

The Star Online

PETALING JAYA: The new increased medical fees following the amendment to the Private Healthcare Facilities and Services Act 1998 are considered acceptable by the Malaysian Medical Association.

Its president Datuk Dr NKS Tharmaseelan said that MMA had been waiting for the increase for 12 years as the prices of drugs, laboratory fees and petrol had increased.

"There is a misconception that GPs are raking in lots of profits when they were actually scraping the bottom of the barrel these days," he said in an e-mail reply.

More than 500 stand-alone general practitioner clinics had closed down or had been bought over by large chain-clinics or business corporations in the last few years, he said.

On Monday, an online news portal highlighted that amendment to the 13th Schedule of the Act was published in the Federal Gazette on Dec 16 last year and implemented in a hush-hush manner.

It reported that the new consultation fees for a general practitioner had increased to between RM30 and RM125, as opposed to RM10-RM35 previously, while a visit to a specialist now costs up to RM235 for consultation alone, nearly double the previous cap of RM125.

Fees for medical procedures, however, increased between 14-18%.

Dr Tharmaseelan also said that while the increase did not reflect inflation rates since 2002, fees on newer procedures were not included in the revised schedule as proposed by MMA and would be left unregulated.

MMA president Datuk Dr NKS Tharmaseelan.

He also said that doctors do not get all the fees charged for services - for short surgical procedures, the ratio might be 40:60 of the total bill for specialist and hospital respectively while for more complex procedures and long staying patients, it might be as low 20-25% for specialist, while the rest were hospital charges.

Moreover, third-party administrators such as managed care organisations (MCOs) often negotiate a discount of 10% to 15% on doctors' fees for hospitals without the consent of the doctors.

"There should be more transparency about the charges," he said.

Medical Practitioners Coalition Association of Malaysia president Dr Jim Loi said that in the past, a general practitioner in a standalone clinic was able to earn a monthly net income of RM40,000 in the Klang Valley, but it had since dropped to RM15,000.

He added it posed a challenge to them as they too had to pay mortgages and send their children to colleges.

He said the more worrying trend was the increase in drug prices - including generic drugs - every few months and doctors had been absorbing the cost.

Federation of Malaysian Consumers Association deputy president Muhammad Sha'ani Abdullah said that the Government must justify the high fee increase.

He said that currently, there were doctors who still charge RM15 for consultation and if that was the case, that should be made the fee for the lower ceiling.

"Why must the lower ceiling increase from RM10 to RM30? That is a 300% increase," he said adding that it was considered price-fixing when the price is set higher than the market floor price.

He also said that drug supply should be made open tender and not monopolised by Pharmaniaga Bhd.

D-Day on doc’s fees

theSundaily

KUALA LUMPUR: Private hospitals and clinics will know tomorrow whether they can increase, with immediate effect, their fees for medical consultation and procedures.

Health Minister Datuk Seri Dr S. Subramaniam will make the announcement after the ministry's post-cabinet meeting.

This was the response of Health Director-General Datuk Dr Noor Hisham Abdullah when asked to comment on a local news portal's report today on the possibility of a fee hike following the amended 13th Schedule of the Private Healthcare Facilities and Services Act 1998 which was gazetted on Dec 16 last year.

"The minister will inform the media tomorrow on the ministry's stand on the issue," he said.

Doctors in the private sector have not had an increase in their fees for the past 15 years and neither has the ministry drawn up any new schedule of fees for them.

The Malaysian Medical Association (MMA) had last year asked for a 30% increase in consultation and procedural charges, but had to put it on hold following a public outcry.

MMA president Datuk Dr N.K.S. Tharmaseelan said today that doctors needed an increase in view of the rise in living and operating costs.

"It's been a long time since the last increase," he added.

General practitioners get between RM30 and RM50 per consultation while specialists charge between RM50 and RM80.

Tharmaseelan had earlier been quoted as saying that it was a misconception that doctors were rich and greedy.

"Many doctors are scraping the barrel with the rising utility bills, rentals and salaries (for staff). Quite a few have even quit practice as it's too expensive to maintain a clinic," he said.

On average, the operating cost for a general practitioner to run a clinic in Kuala Lumpur is about RM20,000 per month.

Tharmaseelan said a general practitioner, for instance, charges between RM45 and RM50, including medication, for a patient having cough and cold.

He said a fee increase is necessary for doctors to cover their "basic costs" in view of mandatory rulings like paying minimum wage.

Now, doctors are also required to have medical indemnity insurance, hire radiographers and engage waste disposal contractors for their clinics, he added.

Private clinics, hospitals to charge more after minister gazettes new fee structure, says report

The Malaysian Insider

An amendment to the 13th Schedule of the Private Healthcare Facilities and Services Act 1998 is set to push medical fees in private clinics and hospitals by several fold, said a report.

News portal Malaysiakini said the amendment was gazetted on December 16 last year without much fanfare, as even members of parliament were not informed.

But the report said the health minister is legally not required to consult MPs, as spelt out by Section 106(2) of the same act, giving the minister powers to amend prices in the schedule after consulting the health director-general.


The increase in medical costs involved fees charged by doctors, from general practitioners to specialists and surgeons.

The new charge for a clinic consultation is now between RM30 and RM125, as opposed to RM10-RM35 previously.

A visit to a specialist may now cost up to RM235 for consultation alone, double the previous cap of RM125, while fees for medical procedures will be increased between 14–18%.

Several MPs with medical backgrounds have spoken out against the increase and the manner in which it was rushed through.

"As a former medical practitioner, I feel this drastic price increase is not warranted... the rakyat are already suffering from all kinds of price hikes," PKR's Wangsa Maju MP, Dr Tan Kee Kwong told Malaysiakini.

Sungai Siput MP Dr Jeyakumar Devaraj, however, said that while stiff competition among general practitioners would mean the fee hike would not be followed, the same would not be the case with medical procedures.

Dr Jeyakumar also criticised the government's investment in private healthcare, saying it was a serious conflict of interest as the government should be focusing on improving public hospitals. – March 4, 2014.

Malaysia aims to break into medical tourism market in big way

New Straits Times

NEW YORK: Since the general character of the tourism industry is gradually compartmentalising itself into highly specialised money-spinning segments, tourism experts are busy devising strategies that would open up these individual segments for them.
Malaysia, for example, is eyeing the medical tourism sector which is inherent with considerable revenue-generating potential as patients in developed western countries, particularly in the United States (US), are looking for good quality but low-cost sites which offer not only medical services but also have attractive tourism attributes.

"As a corporatised agency funded by the Malaysian Government, we are promoting healthcare travel and are positioning Malaysia as a preferred healthcare destination,” explained Kuala Lumpur-based Malaysia Healthcare Travel Council (MHTC) chief executive Dr Mary Wong, in an interview with Bernama at the ongoing three-day New York Times Travel Show (NYTTS).

At the NYTTS, she also presented at a seminar, a book titled 'Patients Beyond Borders' by Josef Woodmann, considered a valuable source of information about facilities along with important contacts for tests/treatment, etc., available in Malaysia.

Wong, whose organisation has participated in a number of international travel and tourism shows worldwide, in conjunction with Tourism Malaysia, believes the medical travel industry is “bound to grow tremendously” because of rising healthcare costs, heightened health awareness and better information available in developed countries about treatment options.

“Many patients in western countries have to wait before they are even examined by the medical care facilities. As you can imagine, this can be fatal if there is any terminal illness involved.

We can provide good, almost immediate care. We have drastically cut down waiting time for patients,” she said.

Although Malaysia has a well-developed healthcare infrastructure, supported by state-of-the-art equipment, many experts in the US often question the availability of sufficient number of medical doctors and other experts. “We have adequate number of doctors to support our healthcare system. Indeed, we have 5,000 new well-trained medical graduates each year.

Besides, our medical force gets an additional 1,000 specialised medical experts each year. Indeed, we are trying to target one doctor for a population of 400 people,” she maintained.

Wong said healthcare tourism would generate “substantial contribution” for Malaysia’s economy, accounting for some RM594 million, in terms of revenue in 2012.

“In 2013, the revenue is estimated to reach RM688 million, according to tentative estimates,” she added.

For the health-conscious traveller, Malaysia offers a unique combination of good quality, low-cost healthcare and an attractive tourist destination, Wong observed. While visiting Malaysia, the traveller can also undergo medical check and use facilities involving preventive wellness, spas, cosmetic and dental surgery, etc.

While Singapore may have built a reputation for itself as a medical tourist destination, it is rapidly losing this advantage because of rising costs and faces fierce competition from other countries, including Malaysia, thanks to their much-lower medical and hospitalisation costs.

Five-star hotels in Malaysia are also much cheaper.

Wong said that as an English-speaking country, Malaysia also offered the ease of direct communication between patients and attending doctors and medical staff at hospitals.

“The traveller should have no problem sharing his or her concerns with doctors and healthcare staff. Malaysian hospitals also offer a combination of Eastern and Western medicine,” she noted.

Asked why Malaysia was 'Johnny-come-lately' in the medical tourism sector, she said her organisation, which was formed only a few years ago, had aggressively pushed for medical tourism in 2011.

“But because of our unique advantages, both governments and patients in developed countries will, invariably, appreciate our cost and other advantages,” she added.

The top 10 foreign nationalities which visited Malaysia in 2012 for medical treatment were Indonesia (375,499), India (22,350), Japan (17,775), China (15,407), United Kingdom (13,366), US (12,158), Libya (11,872), Bangladesh (11,594), Australia (10,369) and Nepal (10,031).

The popular treatments sought in Malaysia are cardiology, oncology, orthopaedic, obstetrics and gynaecology, urology, otolaryngology, gastroenterology, reconstructive surgery, health screening and second opinion.

Tourism Malaysia’s New York office, led by its vice-president, Ahmad Johanif Mohd Ali, had a busy Saturday at the NYTTS as hordes of American visitors descended on the show venue to witness the various cultural and culinary presentations made by the entire world vying to get a slice of the American tourism market.

He told Bernama there was “great interest” amongst American tourists for Malaysia, based on the large turnout of inquisitive visitors who not only came to witness the colourful Malaysian cultural dances at the stage but also sought information, brochures and other materials at the Malaysia stand. -- BERNAMA

Lee calls for early introduction of mental healthcare policy in workplaces

The Malay Mail Online

KUALA LUMPUR, March 2 ― Mental Health Promotion Advisory Council member Tan Sri Lee Lam Thye has called for an early introduction of guidelines for promoting mental healthcare in workplace

He said the guidelines were aimed at reducing the increasing number of employees who were likely to suffer anxiety, depression and mental stress due to job pressure.

He said the guidelines would ensure the happiness and well-being of workers and their families through initiatives to promote good mental health in workplaces.

He noted there was an increasing number of executives and workers who were likely to suffer from anxiety, depression and mental stress, in relation to their jobs and working lives.

“In line with this, it might be timely for the government to expedite the introduction of guidelines for mental healthcare promotion, to enable implementation of basic measures for adoption and implementation by employers in workplaces,” he said in a statement here today.

Elaborating, Lee said employers should utilise the safety and health committees at workplaces to examine and identify the current mental health of employees and promote mental healthcare measures.

He said employers should consider the specific nature of mental health problems, the consideration of individual worker privacy and formulate a fundamental programme on mental wellbeing for employees.

He also called on the government to provide more benefits such as insurance coverage for the mentally-ill, and income tax relief for parents or relatives who had to take care of the mentally-ill. ― Bernama

Health Ministry: Be wary of heat stroke

Free Malaysia Today

KUALA LUMPUR: The Health Ministry has called on Malaysians to be alert towards early signs of heat stroke in the wake of the current hot and dry weather.

Its director-general Dr Noor Hisham Abdullah told Bernama heat stroke happens when the body temperature exceeds 40.5 degree Celcius.

A normal human being’s temperature is at 37.0 degree Celcius.

“Among the early symptoms of a heat stroke are a throbbing headache, nausea, lack of perspiration despite the hot weather and a fast pulse.

“Other signs are weak muscles, spasms, vomiting, dry and reddish skin and seizures and blackouts,” he said.

Noor Hisham said the high temperature invited complications to the nervous system of the brain, which could result in coma and could cause death.

The Meteorological Department, prior to this, had said the hot and dry weather in the country currently was worse than last year and was expected to continue until mid-May.

Noor Hisham said prolonged exposure to the hot weather, not drinking enough water and dehydration were among the causes of heat stroke.

As such, he suggested placing anyone suffering from a heat stroke in a shaded and cool area.

“The high temperature can be reduced by placing the victim under a fan and wiping his body with a wet towel.

“The patient can also be placed in a pool of water to reduce his temperature and cool him down,” he said.

Noor Hisham also urged the public to avoid leisure activities under the sun and to drink a large quantity of water, at least 2.5 litres a day.

-Bernama

Rise In Fatalities Due To Dengue A Cause For Concern - Dr Subramaniam

SJ Echo

KUALA LUMPUR, Feb 27 (Bernama) -- Health Minister Datuk Seri Dr S. Subramaniam today expressed concern over the rising number of fatalities due to dengue fever with 29 deaths recorded from January till Feb 22. Dr Subramaniam said the figure was a 263 percent increase or eight fatalities more when compared with the same period last year. He said 16,383 dengue cases were reported from January to Feb 22, marking a 316 percent increase when compared with the same period last year.

 "For the eighth week (Feb 16 - Feb 22) of the year, four deaths were recorded, involving two women aged 34 and 37 plus two men aged 21 and 35 respectively, due to dengue fever complications," he said in a statement. Of the 580 localities identified as still active in 12 states, 354 localities were from Selangor followed by Negeri Sembilan with 66, Kuala Lumpur & Putrajaya (48), Johor (30), Perak (25) and Kelantan (23). Seven states registered an increase in the number of cases, namely Negeri Sembilan, Selangor, Perak, Sabah, Melaka, Kelantan and Sarawak, he said.

 "We intend to carry out gotong-royong after fogging but public cooperation is also important to help reduce the Aedes mosquito-breeding grounds. The public must cooperate with the authorities to destroy all possible Aedes breeding grounds," he said. -- BERNAMA

Foreigners taking up big share of medical subsidy

The Star Online

PUTRAJAYA: Foreigners are taking about 30% to 40% of the country’s entire allocation for medical treatment meant for Malaysians, Health Minister Datuk Seri Dr S. Subra­maniam said.

“They are eating up our medical subsidy,” he said, adding that in most countries in Europe, foreigners were required to pay the actual cost.

The minister touched on the issue at a press conference after addressing the ministry’s monthly assembly here yesterday.

Last December, Deputy Health Minister Datuk Seri Dr Hilmi Yahaya announced a plan to get foreigners, including students, to pay for their actual cost of medical treatment in government hospitals, not at a subsidised rate.

Dr Subramaniam said the plan was at the final stage, adding that it required some amendments to the Fees Act (Medical) 1951 for Foreigners.

“We are ironing out that part. I think we should be able to list down the new charges in the next few months,” he said.

The charges for foreigners seeking medical treatment in government hospitals was last reviewed in 2003.

Presently, foreign workers given outpatient specialist treatment are charged RM60 while for accident and emergency cases, the charge is RM50.

Those seeking outpatient follow-up treatment are charged RM60 while the charge for general outpatient treatment is RM15.

The charges are paid as registration fees.

Dr Subramaniam was not able to say what the new charges are.

“That is what we are trying to determine because it is the actual cost of the treatment,” he said.

MMA Suggests Government Provide Free Abate To Prevent Dengue

BERNAMA 

KUALA LUMPUR, Feb 16 (Bernama) -- The Malaysian Medical Association (MMA) today suggested that the government provide abate free to all clinics, even those in the private sector, for distribution to the people as a means of preventing dengue.

MMA president Datuk Dr N.K.S. Tharmaseelan said the abate must be given out to all households and should be available at all health clinics.

"The government is giving out so many handouts and aid to Malaysians. This is one thing they should be doing and, if funds are enough, it should be made available in all government departments, especially post offices," he said in a statement.

Abate is a potent larvicide based on the active ingredient temephos that effectively manages a broad spectrum of nuisance and disease-causing insects, such as mosquitoes.

Dr Tharmaseelan pointed out that the government also should provide incentives and funds to non-governmental organisations to encourage them to organise 'gotong-royong' (self-help) clean-up on monthly basis, especially in dengue-prone areas.

He said the people also must assist the district councils and the state governments in playing a major role in the prevention of dengue, which could cause a big loss financially in health costs in addition to loss of precious lives.

"The community must spur clean-up activities in dengue-prone areas to reduce the increasing number of dengue cases in Malaysia annually," he said.

Malaysia reports nearly 10,000 dengue cases in first month of 2014 prompting use of biological agent BTI

The Global Dispatch

The mosquito borne virus, dengue has started strong in Malaysia during the first month or so of 2014, with health officials reporting 9,453 and 17 deaths since Jan. 1, according to a recent Sun Daily report.

This compares to  2,559 cases and five deaths during the same time frame in 2013.

Image/CDC

Deputy Director-General of Health (Public Health) Datuk Dr Lokman Hakim Sulaiman said the ministry has identified 594 denguehotspots in the country, with 115 in Selangor, Negri Sembilan, Kuala Lumpur and Putrajaya.

The severe outbreak of dengue fever, at approximately 2,000 cases a week,  has prompted health officials to attempt to integrate the biological agent Bacillus thurin­giensis israelensis (BTI) into themosquito control strategy (See video report).

Health Minister Datuk Seri Dr S. Subra­maniam said of BTI, “Instead of using just insecticide to kill the (adult) Aedes, we are now also fogging with a biological agent.”

According to a report in The Star Online:

BTI is a bacterium found naturally in soils, and has been used worldwide as a biological control agent to combat mosquitoes and black flies since 1982.

During the spore-forming stage of its life cycle, the bacterium produces a protein crystal which is toxic only to mosquito and black fly larvae.

These protein crystals will be lodged in the larvae’s digestive system when they are feeding.

When the crystals dissolve, they will liberate toxic protein molecules that start to attack the larvae’s stomach lining, causing the creature to die within days.

Several years ago, researchers used BTI in Malaysia during a severe dengue outbreak where they concluded, “a wide application of VectoBac WG at target larval habitats is able to provide control of dengue mosquito vectors”.

Dengue fever is an infectious disease carried by mosquitoes and caused by any of four related dengue viruses. This disease used to be called “break-bone fever” because it sometimes causes severe joint andmuscle pain that feels like bones are breaking.

The World Health Organization (WHO) estimates there may be 50–100 million dengue infectionsworldwide every year. However, new research from the University of Oxford and the Wellcome Trust, using cartographic approaches, estimate there to be 390 million dengue infections per year worldwide.

There are three types of dengue fever in order of less severe to most: the typical uncomplicated dengue fever, dengue hemorrhagic fever (DHS) and dengue shock syndrome (DSS).

There is not a vaccine for dengue fever. There is no treatment for dengue, just treat the symptoms.

Malaysia reports first H7N9 case outside China |

CIDRAP

Health officials announced an H7N9 avian flu infection in Malaysia today, the first case detected outside of China, along with eight other newly confirmed cases—one in Hong Kong and seven more from the mainland.

The patients who are sick with H7N9 infections in Hong Kong and Malaysia had travel links to China's Guangdong province, one of the main hotspots of disease activity in the outbreak's second wave.

Today's new cases lift the number of H7N9 cases reported in the second wave, which began in October, to 211, compared with 136 reported during the first wave last spring. For both waves, the total is 347, according to a list of confirmed cases kept by FluTrackers. The unofficial death count remains at 72.

CDC: Malaysia case underscores surveillance priority

Malaysia's patient is a 67-year-old woman who was part of a tour group from Guangdong province, according to a report today from Bernama, Malaysia's national news agency. The group was visiting Sabah. The woman is being treated in the intensive care unit at a private hospital in Kota Kinabalu.

The country's health minister, Datuk Seri Dr. S. Subramaniam said it was the first H7N9 case reported in the country and that health officials are taking steps to limit contact with the patient.

The US Centers for Disease Control and Prevention (CDC) today issued a statement on the Malaysian H7N9 case, which said the agency has been expecting the detection of H7N9 cases exported from China, including the scenario of an infected traveler. It said the illness in a traveler to Malaysia doesn't change its risk assessment for the H7N9 virus.

The CDC said the most important element in gauging the public health threat is transmissibility, and so far there is no evidence of sustained, ongoing person-to-person spread of H7N9. It emphasized, however, that the case underscores how important international surveillance is for H7N9 and other viruses that have pandemic potential.

Human infections in China linked to poultry exposure are likely to continue, the CDC said, and the virus could spread to neighboring countries, where it could infect people who are exposed to poultry. The most worrisome development would be if the virus gained the ability to spread easily among people, a possibility that the CDC said it and other international health partners are closely monitoring.

Public Needs To Stay Indoors If Sumatra's Volcanic Ashes Hit Malaysia - Health Ministry

BERNAMA

KUALA LUMPUR, Feb 11 (Bernama) -- The public is advised to stay indoors with all doors and windows closed if ashes from the volcanic eruption of Mount Sinabung in North Sumatea are carried by winds towards Malaysia.

Director-General of Health Datuk Dr Noor Hisham Abdullah also advised Malaysians to wear masks or using a cloth or a wet handkerchief as a respiratory protective device if the air is polluted.

"Children, elderly people and those who have medical problems should avoid or reduce outdoor activities during this time.

"People are also advised to drink plenty of water, frequently wash the face and other parts of the body that are exposed," he said in a statement here, today.

He also advised the public to refrain from driving in ashy conditions since it may be difficult due to poor visibility resulting in motor vehicle accidents.

Mount Sinabung has been in an eruptive state since Sept 15 and the latest eruption started on Jan 30 resulted in the release of hot ash in the air of the height of 5km.

Although the possibility of people in Malaysia to be exposed to the ash is low but it is likely to involve Malaysia, especially areas on the west coast and southern part of the peninsula.

Dr Noor Hisham said those who are exposed to the ash will experience various eye, nose, throat and skin symptoms.

He said people usually experience eye discomfort or irritation during and after ash fall, especially those using contact lenses.

He added that the ministry will continue to monitor the situation of the volcanic dust and advise those who suffer medical illnesses related to the ash to seek medical treatment from the nearest clinic or hospital.

-- BERNAMA

Dengue deaths soar in Malaysia

The Malaysian Insider

Deaths from dengue fever have nearly tripled in Malaysia this year compared with the same period in 2013, sparking a stepped-up campaign to control the mosquitos that spread the virus.

As of this week, 22 people had died from dengue in 2014, compared to eight deaths over the same stretch last year, Health Minister S. Subramaniam told AFP yesterday.

While still early in the year, at the current pace the numbers would surpass 2010, the deadliest year on record, when 134 people died from an illness that the World Health Organisation calls one of the fastest-growing viral threats globally, especially in the tropics.

A total of 11,879 cases had been reported as of Monday, up nearly four-fold from the same period in 2013.

"I think the number of cases will increase," Subramaniam said.

"We urge the public to play their role. The spike in cases is putting a strain on our medical services," he said, calling on Malaysians to eliminate mosquito breeding sites such as standing water and garbage piles.

More than 43,000 cases were reported in 2013, with 92 deaths, up from 35 dead the year before.

"Every three to four years, we witness a peak in the cycle," Subramaniam said.

Dengue fever is a flu-like illness marked by symptoms including nausea, headache, and severe muscle and joint pain that gives rise to its nickname "break-bone fever".

In severe cases, it can cause internal bleeding, organ impairment, respiratory distress and death.

Dengue is transmitted by the Aedes aegypti mosquito, which can pick up the virus from an infected human and transmit it to the next person it bites.

According to the World Health Organisation, the disease may be infecting up to 50-100 million people each year.

There is no vaccine, so prevention focuses on mosquito control.

Malaysian authorities have stepped up a nationwide campaign to fumigate or eliminate mosquito breeding hotbeds in standing water, garbage dumps and construction sites.

This includes what authorities have called the first large-scale use in Malaysia of the biological agent bacillus thuringiensis israelensis, or BTI, a naturally-occurring bacterium used in insect control.

The government also has ordered local clinics in dengue "hot spot" areas – which have been concentrated in and around the capital Kuala Lumpur – to extend their operating hours to accommodate the roughly 2,000 new cases emerging weekly.

"Hot spot" residents also are being advised to wear long sleeves and use mosquito repellent.

Researchers estimate around three billion people live in regions of the world susceptible to dengue. – AFP, February 12, 2014.

Malaysians state of health worrying: Dr Hilmi

New Straits Times

KUALA LUMPUR: Deputy Health Minister Datuk Seri Dr Hilmi Yahaya today expressed worry over the state of health of Malaysians, saying both government and private hospitals in the country recorded three million warded patients last year.

He said the figure was huge because it was more than 10 per cent of the total 27 million population of the country. 

"It is quite high and worrying and should be taken seriously by all the people.

Every individual must take steps to maintain his or her health because preventive care is cheaper than treatment," he said. 

Hilmi spoke to reporters after officiating at the signing of a memorandum of understanding between Orion Healthcare Management Services Sdn Bhd and Angkatan Koperasi Kebangsaan Malaysia Berhad (Angkasa), here.  

Also present were Orion Healthcare Management chairman Datuk Dr Ma'amor Osman, Orion Healthcare Management CEO Kho Brandon and Angkasa president Datuk Abdul

Fattah Abdullah. Kho and Abdul Fattah signed the MoU, witnessed by Hilmi and Ma'amor.

Hilmi said good health not only contributed to national development but also helped the government save costs in terms of medical treatment. 

"The deteriorating health of the people had raised the government's medical treatment expenditure, from RM20 billion in 2013 to RM22 billion this year," he said. 

On the MoU, Hilmi said it was a collaboration between Orion Healthcare Management and Angkasa in creating awareness on the importance of medical examination for all members of cooperatives. 

Ma'amor said the collaboration enabled Orion Healthcare Management to provide information and health checks to about eight million members of cooperatives. - BERNAMA

46,000 medical images wiped out in UMMC

theSundaily

KUALA LUMPUR (Feb 4, 2014): Some 46,000 electronic images of X-rays and scans of patients at University Malaya Medical Centre (UMMC) have been lost during a migration process from the old computer system to a new one.

As a result, some patients may be left in the lurch as their old medical information dating back to 2000 are unavailable.

The problem arose over the last two years when an American multi-national company, given the task of migrating a few million images of patients to the new system, lost the 46,000 images.

In an immediate reaction, the Health Ministry has asked UMMC to conduct an internal investigation to determine the cause of the computer foul-up.

However, UMMC director Professor Datuk Dr Ikram Shah Ismail said millions of images taken between 2000 and 2010 were safe and that the images lost were only a small fraction of the total.

He said the hospital is identifying other possible sources where the information could have been saved.

"It is very unfortunate that the problem arose as the back-up hard disc overworked and failed. The company had to copy the images in a temporary hard disc and then convert them to the new format. It was during this migration that we lost the images," he told theSun.

He said the images did not involve patients who came for the first time after 2010.

"Till today, we have not received any complaints from doctors or patients on the issue. I believe the doctors use recent or current images to do comparisons and treat patients."

Meanwhile, Deputy Director-General of Health (Medical) Datuk Dr Jeyaindran Sinnadurai said the loss is worrying as any form of electronic record- keeping must have sufficient safeguards to ensure a secure back-up.

The back-up, he said, was important to counter any form of hacking or records being accidentally deleted. He said medical records are vital for doctors to manage and treat their patients efficiently and effectively.

On the next course of action, he said UMMC should try its best to recover the lost images while conducting its internal investigation.

"This is important so as to give patients a valid explanation," he added.