title: Nipah virus infection among abattoir workers in Malaysia, 1998-1999.
abstract: BACKGROUND
  An outbreak of encephalitis primarily affecting pig farmers occurred during 1998-1999 in Malaysia and was linked to a new paramyxovirus, Nipah virus, which infected pigs, humans, dogs, and cats. Because five abattoir workers were also affected, a survey was conducted to assess the risk of Nipah infection among abattoir workers.
  
  
  METHODS
  Workers from all 143 registered abattoirs in 11 of 13 states in Malaysia were invited to participate in this cross-sectional study. Participants were interviewed to ascertain information on illness and activities performed at the abattoir. A serum sample was obtained to test for Nipah virus antibody.
  
  
  RESULTS
  Seven (1.6 %) of 435 abattoir workers who slaughtered pigs versus zero (0%) of 233 workers who slaughtered ruminants showed antibody to Nipah virus (P = 0.05). All antibody-positive workers were from abattoirs in the three states that reported outbreak cases among pig farmers. Workers in these three states were more likely than those in other states to have Nipah antibody (7/144 [4.86%] versus 0/291 [0%], P < 0.001) and report symptoms suggestive of Nipah disease in pigs admitted to the abattoirs (P = 0.001).
  
  
  CONCLUSIONS
  Nipah infection was not widespread among abattoir workers in Malaysia and was linked to exposure to pigs. Since it may be difficult to identify Nipah-infected pigs capable of transmitting virus by clinical symptoms, using personal protective equipment, conducting surveillance for Nipah infection on pig farms which supply abattoirs, and avoiding handling and processing of potentially infected pigs are presently the best strategies to prevent transmission of Nipah virus in abattoirs.
authors.affiliation: Institute for Medical Research, Kuala Lumpur, Malaysia.
authors.forename: M
authors.initials: M
authors.lastname: Sahani
authors.forename: U D
authors.initials: UD
authors.lastname: Parashar
authors.forename: R
authors.initials: R
authors.lastname: Ali
authors.forename: P
authors.initials: P
authors.lastname: Das
authors.forename: M S
authors.initials: MS
authors.lastname: Lye
authors.forename: M M
authors.initials: MM
authors.lastname: Isa
authors.forename: M T
authors.initials: MT
authors.lastname: Arif
authors.forename: T G
authors.initials: TG
authors.lastname: Ksiazek
authors.forename: M
authors.initials: M
authors.lastname: Sivamoorthy
mesh_terms: D000003:Abattoirs; D000328:Adult; D000818:Animals; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D018184:Paramyxoviridae Infections / Q000453:epidemiology*; D018098:Paramyxovirinae; D013552:Swine