Abstract. Background: In March 1999, an outbreak of encephalitis and pneumonia occurred in workers at an abattoir in Singapore. We describe the clinical ...Clipboard,SearchHistory,andseveralotheradvancedfeaturesaretemporarilyunavailable.SkiptomainpagecontentCOVID-19isanemerging,rapidlyevolvingsituation.Publichealthinformation(CDC)Researchinformation(NIH)SARS-CoV-2data(NCBI)Preventionandtreatmentinformation(HHS) AccesskeysNCBIHomepageMyNCBIHomepageMainContentMainNavigationSearch:SearchAdvancedClipboardUserGuideSaveEmailSendtoClipboardMyBibliographyCollectionsCitationmanagerDisplayoptionsDisplayoptionsFormatAbstractPubMedPMIDSavecitationtofileFormat:Summary(text)PubMedPMIDAbstract(text)CSVCreatefileCancelEmailcitationSubject:1selecteditem:10520634-PubMedTo:Format:SummarySummary(text)AbstractAbstract(text)MeSHandotherdataSendemailCancelAddtoCollectionsCreateanewcollectionAddtoanexistingcollectionNameyourcollection:Namemustbelessthan100charactersChooseacollection:UnabletoloadyourcollectionduetoanerrorPleasetryagainAddCancelAddtoMyBibliographyMyBibliographyUnabletoloadyourdelegatesduetoanerrorPleasetryagainAddCancelYoursavedsearchNameofsavedsearch:Searchterms:TestsearchtermsWouldyoulikeemailupdatesofnewsearchresults?SavedSearchAlertRadioButtonsYesNoEmail:(change)Frequency:MonthlyWeeklyDailyWhichday?ThefirstSundayThefirstMondayThefirstTuesdayThefirstWednesdayThefirstThursdayThefirstFridayThefirstSaturdayThefirstdayThefirstweekdayWhichday?SundayMondayTuesdayWednesdayThursdayFridaySaturdayReportformat:SummarySummary(text)AbstractAbstract(text)PubMedSendatmost:1item5items10items20items50items100items200itemsSendevenwhentherearen'tanynewresultsOptionaltextinemail:SaveCancelCreateafileforexternalcitationmanagementsoftwareCreatefileCancelYourRSSFeedNameofRSSFeed:Numberofitemsdisplayed:510152050100CreateRSSCancelRSSLinkCopyFulltextlinksElsevierScienceFulltextlinksActionsCiteFavoritesDisplayoptionsDisplayoptionsFormatAbstractPubMedPMIDSharePermalinkCopyPagenavigationTitle&authors

NCBISkiptomaincontentSkiptonavigationResourcesHowToAboutNCBIAccesskeysMyNCBISignintoNCBISignOutJournalListEmergInfectDisv.12(12);2006DecPMC3291367EmergInfectDis.2006Dec;12(12):1888–1894.doi: 10.3201/eid1212.060732PMCID:PMC3291367PMID:17326940FoodborneTransmissionofNipahVirus,BangladeshStephenP.Luby,*MahmudurRahman,†M.JahangirHossain,*LaurenS.Blum,*M.MushtaqHusain,†EmilyGurley,*RashedaKhan,*Be-NazirAhmed,†ShafiqurRahman,†NazmunNahar,*EbenKenah,*JamesA.Comer,‡andThomasG.Ksiazek‡StephenP.Luby*InternationalCentreforDiarrhealDiseaseResearch,Dhaka,Bangladesh;FindarticlesbyStephenP.LubyMahmudurRahman†InstituteforEpidemiologyDiseaseControlandResearch,Dhaka,Bangladesh;FindarticlesbyMahmudurRahmanM.JahangirHossain*InternationalCentreforDiarrhealDiseaseResearch,Dhaka,Bangladesh;FindarticlesbyM.JahangirHossainLaurenS.Blum*InternationalCentreforDiarrhealDiseaseResearch,Dhaka,Bangladesh;FindarticlesbyLaurenS.BlumM.MushtaqHusain†InstituteforEpidemiologyDiseaseControlandResearch,Dhaka,Bangladesh;FindarticlesbyM.MushtaqHusainEmilyGurley*InternationalCentreforDiarrhealDiseaseResearch,Dhaka,Bangladesh;FindarticlesbyEmilyGurleyRashedaKhan*InternationalCentreforDiarrhealDiseaseResearch,Dhaka,Bangladesh;FindarticlesbyRashedaKhanBe-NazirAhmed†InstituteforEpidemiologyDiseaseControlandResearch,Dhaka,Bangladesh;FindarticlesbyBe-NazirAhmedShafiqurRahman†InstituteforEpidemiologyDiseaseControlandResearch,Dhaka,Bangladesh;FindarticlesbyShafiqurRahmanNazmunNahar*InternationalCentreforDiarrhealDiseaseResearch,Dhaka,Bangladesh;FindarticlesbyNazmunNaharEbenKenah*InternationalCentreforDiarrhealDiseaseResearch,Dhaka,Bangladesh;FindarticlesbyEbenKenahJamesA.Comer‡CentersforDiseaseControlandPrevention,Atlanta,Georgia,USAFindarticlesbyJamesA.ComerThomasG.Ksiazek‡CentersforDiseaseControlandPrevention,Atlanta,Georgia,USAFindarticlesbyThomasG.KsiazekAuthorinformationCopyrightandLicenseinformationDisclaimer*InternationalCentreforDiarrhealDiseaseResearch,Dhaka,Bangladesh;†InstituteforEpidemiologyDiseaseContro

MeSH terms. Abattoirs; Animals; Centers for Disease Control and Prevention, U.S.; Diagnosis, Differential; Disease Outbreaks*; Encephalitis, Viral / diagnosis ...Clipboard,SearchHistory,andseveralotheradvancedfeaturesaretemporarilyunavailable.SkiptomainpagecontentCOVID-19isanemerging,rapidlyevolvingsituation.Publichealthinformation(CDC)Researchinformation(NIH)SARS-CoV-2data(NCBI)Preventionandtreatmentinformation(HHS) AccesskeysNCBIHomepageMyNCBIHomepageMainContentMainNavigationSearch:SearchAdvancedClipboardUserGuideSaveEmailSendtoClipboardMyBibliographyCollectionsCitationmanagerDisplayoptionsDisplayoptionsFormatAbstractPubMedPMIDSavecitationtofileFormat:Summary(text)PubMedPMIDAbstract(text)CSVCreatefileCancelEmailcitationSubject:1selecteditem:10489489-PubMedTo:Format:SummarySummary(text)AbstractAbstract(text)MeSHandotherdataSendemailCancelAddtoCollectionsCreateanewcollectionAddtoanexistingcollectionNameyourcollection:Namemustbelessthan100charactersChooseacollection:UnabletoloadyourcollectionduetoanerrorPleasetryagainAddCancelAddtoMyBibliographyMyBibliographyUnabletoloadyourdelegatesduetoanerrorPleasetryagainAddCancelYoursavedsearchNameofsavedsearch:Searchterms:TestsearchtermsWouldyoulikeemailupdatesofnewsearchresults?SavedSearchAlertRadioButtonsYesNoEmail:(change)Frequency:MonthlyWeeklyDailyWhichday?ThefirstSundayThefirstMondayThefirstTuesdayThefirstWednesdayThefirstThursdayThefirstFridayThefirstSaturdayThefirstdayThefirstweekdayWhichday?SundayMondayTuesdayWednesdayThursdayFridaySaturdayReportformat:SummarySummary(text)AbstractAbstract(text)PubMedSendatmost:1item5items10items20items50items100items200itemsSendevenwhentherearen'tanynewresultsOptionaltextinemail:SaveCancelCreateafileforexternalcitationmanagementsoftwareCreatefileCancelYourRSSFeedNameofRSSFeed:Numberofitemsdisplayed:510152050100CreateRSSCancelRSSLinkCopyActionsCiteFavoritesDisplayoptionsDisplayoptionsFormatAbstractPubMedPMIDSharePermalinkCopyPagenavigationTitle&authorsSimilararticlesCitedbyPublicationty

The next year the disease spread to abattoir workers in Singapore. The movement of the disease was a consequence of transport of pigs from ...SkiptomaincontentSkiptoprimarysidebarThisweekIattendedtheNipahVirusInternationalConferenceinSingapore,markingthediscoveryofthevirus20yearsago.It’sanopportunetimetorecalltheeventsaroundtheemergenceofthisdeadlypathogen.Anoutbreakofrespiratorydiseaseandencephalitisinpigsduring1998tookplaceinIpohCityofPerakstateinMalaysia(illustrated),andwasfollowedbylethalencephalitisinpatientsassociatedwithpigfarming.Initiallythepigdiseasewasthoughttobecausedbyclassicalswinefevervirus,whilethehumandiseasewasconsideredaresultofinfectionwithJapaneseencephalitisvirus(JE).Measuresweretakentoreducemosquitopopulationsbyspraying,andimmunizingworkerswithaJEvaccine.Neithermeasureslowedtheepidemic.Bytheendof1998theoutbreakspreadtoSikimatinNegeriSembilan.ThenextyearthediseasespreadtoabattoirworkersinSingapore.ThemovementofthediseasewasaconsequenceoftransportofpigsfromfarmtofarminMalaysia,andtoaslaughterhouseinSingapore(wenowunderstandthatmostinfectedpigsdonotshowsignsofdisease).TheoutbreakinMalaysiaendedwhen1.1millionpigswereculled,anddiseaseinSingaporestoppedwhenimportationofpigsfromMalaysiawashalted.Atotalof283humancaseswith109fatalities(39%fatality)wasrecorded.AkeyplayerinthediscoveryofthecauseofthisoutbreakwasKawBingChua,whoatthetimewasworkingattheUniversityofMalaya.Chuahadbeenworkingasamedicaldoctoruntilhis40swhenhebecamefrustratedwiththeprofession.HewasgivenalaboratorypositionattheUniversityofMalayaandwastherewhenthepigepidemicbroke.HissuperiorsthoughtthecausativeagentwasJEvirusbutChuathoughtotherwise.Howeverbecausehehadlittlevirologicalexperiencehewasignored.Chuainoculatedcellcultureswithcerebrospinalfluidfromonepatientandobservedtheformationofsyncytia,whichwouldnotbeexpectedofJEvirus.HebroughtthevirustotheCDCatFt.Collins,CO,whichhadresponsibilityforarboviruses.WorkdonethereshowedthattheviruswasnotJE,andanelectronmicrographsuggestedthepresenceofapar

Nipah virus was first identified in 1999 following a large outbreak affecting Malaysia and Singapore. The virus is one of eight categories of ...SkiptomaincontentAblackflyingfox(Pteropus)feedingonapalmtreeinQueensland,Australia.BatsandpalmscanbothcarryNipahvirustohumans.(AndrewMercerviaWikimediaCommons)SharethisstorySharethisstoryonfacebookSharethisstoryontwitterSharethisstoryonredditSharethisstoryonlinkedinGetthisstory'spermalinkPrintthisstoryLekshmySreekumar@dukenusSINGAPORE--NipahvirusexpertsandstakeholdersgatheredataninternationalconferenceinSingaporeDec.9and10tocommemoratethe20thanniversaryofthevirus’discoveryandtodiscussinnovativeandeffectivesolutionstocombatthethreattoglobalhealthsecurityposedbyNipah.Thetwo-daysessionwasco-hostedbyDuke-NUSMedicalSchool(Duke-NUS)andtheCoalitionforEpidemicPreparednessInnovations(CEPI).Nipahviruswasfirstidentifiedin1999followingalargeoutbreakaffectingMalaysiaandSingapore.ThevirusisoneofeightcategoriesofdiseasesthattheWorldHealthOrganizationhasidentifiedasepidemicthreatsinneedofprioritization.Overthepast20years,thevirushascontinuedtospreadoverthousandsofkilometerstoBangladeshandIndia.Theviruscausesseveredisease,includingrespiratorysymptomsandinflammationofthebrainleadingtocomaanddeath.RecordedmortalityratesinMalaysia,BangladeshandIndiaarebetween40and90percent.In2001,theviruswasdetectedinBangladeshandsincethen,frequentoutbreakshaveoccurredinthecountry.AnoutbreakinKerala,India,in2018claimed17lives.“TherearecurrentlynospecificdrugsorvaccinesforNipahvirusinfection,eventhoughtheWHOhasidentifiedNipahasaprioritydiseasefortheWHOResearchandDevelopmentBlueprint,”saidProfessorWangLinfa,directorofDuke-NUS’emerginginfectiousdiseases.“Throughtheconference,weaimtostimulatedialoguebetweenexpertsandstakeholderstobringaboutinnovativeandeffectivesolutionstoboosteffortsinfightingNipahvirus.”Nipahisazoonoticvirus,whichmeansthatitcanbespreadtohumansfromanimals.Itisspreadprimarilybybats(specificallyPteropusfruitbats)andpigs.Itcanalsobetransmittedthroug

SkiptomaincontentThankyouforvisitingnature.com.YouareusingabrowserversionwithlimitedsupportforCSS.Toobtainthebestexperience,werecommendyouuseamoreuptodatebrowser(orturnoffcompatibilitymodeinInternetExplorer).Inthemeantime,toensurecontinuedsupport,wearedisplayingthesitewithoutstylesandJavaScript.AdvertisementnaturenpjvaccinesarticlesarticleAsingledoseinvestigationalsubunitvaccineforhumanuseagainstNipahvirusandHendravirusDownloadPDFSubjectsProteinvaccinesViralinfectionAbstractNipahandHendravirusesarehighlypathogenicbat-borneparamyxovirusesrecentlyincludedintheWHOBlueprintprioritydiseaseslist.Afullyregisteredhorseanti-HendravirussubunitvaccinehasbeeninuseinAustraliasince2012.Basedonthesameimmunogen,theHendravirusattachmentglycoproteinectodomain,asubunitvaccineformulationforuseinpeopleisnowinaPhaseIclinicaltrial.WereportthatasingledosevaccinationregimenofthishumanvaccineformulationprotectsagainstotherwiselethalchallengesofeitherHendraorNipahvirusinanonhumanprimatemodel.TheprotectionagainsttheNipahBangladeshstrainbeginsassoonas7dayspostimmunizationwithlowdoseof0.1 mgproteinsubunit.OurdatasuggestthishumanvaccinecouldbeutilizedasefficientemergencyvaccinetodisruptpotentialspreadingofNipahdiseaseinanoutbreaksetting.DownloadPDFIntroductionNipahvirus(NiV)andHendravirus(HeV)areenveloped,single-strandednegative-senseRNAvirusesandtheprototypemembersofthegenusHenipavirusinthefamilyParamyxoviridae1.NiVandHeVarebat-bornedisease-causingzoonoses,andPteropusbats(flyingfoxes)aretheirmajornaturalreservoirhostsalthoughevidenceinotherbatsexists2.Inseveralanimalspeciesandinpeople,themajorpathologicalobservationsofNiVandHeVinfectionisaseveresystemicandoftenfatalneurologicand/orrespiratorydisease3,4,5.Inaddition,bothNiVandHeVcanalsocauserelapsingencephalitis,fromseveralmonthstomorethan10yearslater,followingarecoveryfromanacuteinfectionasaresultofrecrudescenceofvirusreplicationinthecentralnervoussystem(CNS)6,7.NiVandHeVarealsodistinguishedbytheirexceptionallybroadspeciestropismandcancausedisea

No new cases reported in Singapore or Malaysia since then. Further outbreaks of Nipah virus infection have occurred elsewhere, mainly in western Bangladesh ...SharePointFollowContactUsFeedbackSitemapAboutNCIDNewsandEventsFacilities&ServicesCareersForPatientsandVisitorsForHealthcareProfessionalsForGeneralPublicForPatientsandVisitorsVisitaSpecialistAdmissionGettingtoNCIDFacilities&ServicesCost&FinancingPatients’Rights&ResponsibilitiesNCIDDoctorsForHealthcareProfessionalsDiseasesandConditionsResourcesonCOVID-19JointMOH/NCIDGuidancesInfectionControlGuidelinesforHealthcareFacilitiesCommunicableDiseasesSurveillanceinSingaporeWeeklyInfectiousDiseasesBulletinPandemicPreparednessUpdatesontheHIV/AIDSsituationinSingaporeSeminarsandConferencesGrantsandFellowshipsArticlesAntimicrobialResistanceForGeneralPublicDiseasesandConditionsFAQsonCOVID-19StayHealthyTravelHealth3DecadesofHIVTreatmentandCareattheCommunicableDiseaseCentreAntimicrobialResistanceNCIDYouTubeNCIDResearchStudiesA-AA+NCID>ForHealthcareProfessionals>DiseasesandConditions>NipahNipahNipahDiseasesandConditionsResourcesonCOVID-19JointMOH/NCIDGuidancesInfectionControlGuidelinesforHealthcareFacilitiesCommunicableDiseasesSurveillanceinSingaporeWeeklyInfectiousDiseasesBulletinPandemicPreparednessUpdatesontheHIV/AIDSsituationinSingaporeSeminarsandConferencesGrantsandFellowshipsArticlesAntimicrobialResistancePageContentCausativeAgentNipahvirus,Paramyxoviridaefamily.IncubationPeriod4-45daysInfectiousPeriodPossiblehuman-to-humantransmissionreportedinBangladesh.TransmissionViadirectcontactwithsecretions,tissuesorrespiratorydropletsofsickpigs.IngestionofrawfruitscontaminatedwithurineorsalivaofinfectedfruitbatsreportedinIndiaandBangladeshoutbreaks.ContactwithsecretionsandexcretionsofpatientsreportedasprobablemodeoftransmissioninBangladeshEpidemiologyAnewlydescribedhumanpathogen.ThefirsthumancasesoccurredinazoonoticencephaliticoutbreakbetweenSeptember1998andJune1999inMalaysiaandSingapore.Mortalitywasupto40%.BatsofthegenusPteropusar

No new cases of febrile illness associated with Nipah virus infection have been identified in Singapore since March 19, 1999, when abattoirs ...Personsusingassistivetechnologymightnotbeabletofullyaccessinformationinthisfile.Forassistance,pleasesende-mailto:mmwrq@cdc.gov.Type508Accommodationandthetitleofthereportinthesubjectlineofe-mail.Update:OutbreakofNipahVirus--MalaysiaandSingapore,1999DuringMarch1999,healthofficialsinMalaysiaandSingapore,incollaborationwithAustralianresearchersandCDC,investigatedreportsoffebrileencephaliticandrespiratoryillnessesamongworkerswhohadexposuretopigs(1).Apreviouslyunrecognizedparamyxovirus(formerlyknownasHendra-likevirus),nowcalledNipahvirus,wasimplicatedbylaboratorytestinginmanyofthesecases.FebrileencephalitiscontinuestobereportedinMalaysiabuthasdecreasedcoincidentwithmasscullingofpigsinoutbreakareas.NonewcasesoffebrileillnessassociatedwithNipahvirusinfectionhavebeenidentifiedinSingaporesinceMarch19,1999,whenabattoirswereclosed.ThisreportsummarizesinterimfindingsfromongoingepidemiologicandlaboratoryinvestigationsinMalaysiaandSingapore.MalaysiaAsofApril27,1999,257casesoffebrileencephalitiswerereportedtotheMalaysianMinistryofHealth(MOH),including100deaths.Laboratoryresultsfrom65patientswhodiedsuggestedrecentNipahvirusinfection.SinceApril4,newencephalitiscaseshavebeenreportedinthestatesofNegeriSembilanandSelangor.However,thenumberofnewcasesreporteddecreasedfromapeakof46duringMarch13-19tofourduringApril10-16(Figure_1).Theapparentsourceofinfectionamongmosthumancasescontinuestobeexposuretopigs.Of65serologicallyconfirmedcasesofNipahvirus-associatedencephalitisinNegeriSembilan,56(86%)case-patientsreportedtouchingorhandlingpigsbeforeonsetofillness.Ofthe56case-patients,36(64%)reportedcontactwithpigsthatappearedtobeill.Human-to-humantransmissionofNipahvirushasnotbeendocumented.Inasurveyofnursesandphysicianswhocaredforencephalitispatientsduringtheoutbreakandpathologistswhoconductedpostmortemexaminationsofcase-patients,nonedevelopedanencephalitic

Singapore banned the import of all live pigs from Malaysia from 1999 to 2017 due to the previous Nipah outbreak Experts are warning of the ...SkiptomaincontentMainMenuHomeHighlightsResearchCOVID-19PressReleasesNewsReportsPressRoomStaffAwardsQuicklinksNUSHomeEmailLibraryStudentStaffAlumniHomeHighlightsResearchCOVID-19PressReleasesNewsReportsPressRoomStaffAwards 16December2019|21:41Asia/SingaporeNipahviruscouldcausethenextmajorepidemicSingaporebannedtheimportofalllivepigsfromMalaysiafrom1999to2017duetothepreviousNipahoutbreakExpertsarewarningofthere-emergenceoftheNipahvirus,some20yearsafteritsweptthroughMalaysiaandSingaporeduringa1999outbreak.Thepathogen’sreturncouldresultanevenmoredeadlyepidemic,accordingtoarecentconferencehostedbyDuke-NUSMedicalSchool(Duke-NUS)andtheCoalitionforEpidemicPreparednessInnovations(CEPI).TheWorldHealthOrganization(WHO)hasidentifieditasanepidemicthreatinneedofprioritisation.TheNipahvirusisspreadprimarilybypigsandbats—specificallyPteropusfruitbats.Itcanalsobetransmittedthroughcontaminatedfoodanddirectlyfrompersontoperson.Withglobaltravelbeingmoreprevalentthanever,thediseasecanspreadrapidlyacrossborders.Overthepast20years,ithasspreadtoBangladeshandIndia,evenasitdroppedofftheradarofmostSingaporeans.“OutbreaksofNipahvirushavesofarbeenconfinedtoSouthandSoutheastAsia,butthevirushasseriousepidemicpotential,”saidRichardHatchett,CEOofCEPI,aNorway-basednon-profitorganisationthatdevelopsvaccinesagainstpotentialepidemicdiseases.“Pteropusfruitbatsthatcarrythevirusarefoundthroughoutthetropicsandsub-tropics,whicharehometomorethantwobillionpeople.Nipahviruscanalsobetransmittedfrompersontoperson,sointheoryitcouldspreadintodenselypopulatedtemperateareastoo.”FruitbatsareoneofthemaincarriersoftheNipahvirus,whichcanalsobespreadthroughpigsTheconsequencesaredeadlyforthoseinfected.DatafromMalaysia,BangladeshandIndiashowsthatbetween40percentand90percentofvictimswilldiefromthedisease.SingaporebannedtheimportofalllivepigsfromMalaysiafrom1999to2017inthewakeofthe1999o

Discussion. The Nipah virus outbreak in Singapore was associated with importation and slaughter of infected pigs from Malaysia. Evidence for a causal ...SkiptoMainContentAdvertisementSearchMenuAccountMenuMenuSignInRegisterNavbarSearchFilterThisissueAllTheJournalofInfectiousDiseasesAllIDSAJournalsAllJournalsMobileMicrositeSearchTermSearchSignInRegisterIssuesMoreContentAdvancearticlesEditor'sChoiceSupplementArchiveCoverArchiveIDSAJournalsClinicalInfectiousDiseasesOpenForumInfectiousDiseasesPublishAuthorGuidelinesSubmitOpenAccessPurchaseAdvertiseAdvertisingandCorporateServicesAdvertisingMediakitReprintsandePrintsSponsoredSupplementsBrandedBooksJournalsCareerNetworkAboutAboutTheJournalofInfectiousDiseasesAbouttheInfectiousDiseasesSocietyofAmericaAbouttheHIVMedicineAssociationIDSACOIPolicyEditorialBoardAlertsSelf-ArchivingPolicyForReviewersForPressOfficesIssuesMoreContentAdvancearticlesEditor'sChoiceSupplementArchiveCoverArchiveIDSAJournalsClinicalInfectiousDiseasesOpenForumInfectiousDiseasesPublishAuthorGuidelinesSubmitOpenAccessPurchaseAdvertiseAdvertisingandCorporateServicesAdvertisingMediakitReprintsandePrintsSponsoredSupplementsBrandedBooksJournalsCareerNetworkAboutAboutTheJournalofInfectiousDiseasesAbouttheInfectiousDiseasesSocietyofAmericaAbouttheHIVMedicineAssociationIDSACOIPolicyEditorialBoardAlertsSelf-ArchivingPolicyForReviewersForPressOfficesClosesearchfilterThisissueAllTheJournalofInfectiousDiseasesAllIDSAJournalsAllJournalssearchinputSearchAdvancedSearchSearchMenuSkipNavDestinationArticleNavigationClosemobilesearchnavigationArticleNavigationVolume181Issue5May2000ArticleContentsAbstractMethodsResultsDiscussionAcknowledgmentsReferencesArticleNavigationRiskFactorsforNipahVirusInfectionamongAbattoirWorkersinSingaporeMadeleineH.L.Chew,MadeleineH.L.Chew1InstituteofEnvironmentalEpidemiology,MinistryoftheEnvironment,SingaporeSearchforotherworksbythisauthoron:OxfordAcademicPubMedGoogleScholarPaulM.Arguin,PaulM.Arguin4DivisionofViralandRickettsialDiseas