MrBallen’s Medical Mysteries - Ep. 13 | Village of Death

Episode Date: January 2, 2024

In September of 1998, people throughout Malaysia start dying of a disease that attacks their brains. The authorities think they know what it is, but one scientist believes they are making a d...angerous mistake. It’s up to him to convince his superiors before the outbreak spirals out of control.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

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Starting point is 00:00:00 Hey Prime members, you can binge episodes 49 to 56 right now and ad-free on Amazon Music. Download the app today. One morning in the spring of 1999, gunshots rang out in a tiny village in Malaysia. Once they stopped, a shopkeeper slowly opened his door to see what was going on. He watched in confusion as a convoy of military vehicles rolled down the street, filled with soldiers carrying rifles slung across their backs. Then the soldiers stopped in front of a farm
Starting point is 00:00:37 just down the road. The owner of that farm came outside and met the soldiers at the door, and then very solemnly, this farm owner walked the soldiers around to the back of the property, where there was this big thicket of fruit trees. The shopkeeper, who was watching this from a distance, was so curious as to what they were doing behind this farm, that the shopkeeper stepped out onto the road, and suddenly he had a clear view of behind this farm. And what he saw was these soldiers taking up positions,
Starting point is 00:01:06 raising their rifles, and shooting at something just below these fruit trees. And after the gunfire stopped, the shopkeeper began hearing all these terrible squeals and screams, and then the air began to smell like blood. Terrified, the shopkeeper turned around and ran back inside his shop, hoping that whatever was going on here would be over soon. However, the shopkeeper would be terribly wrong. Have you ever wondered who created that bottle of sriracha that's living in your fridge? Or why nearly every house in America has at least one game of Monopoly?
Starting point is 00:01:45 Introducing The Best Idea Yet, a brand new podcast about the surprising origin stories of the products you're obsessed with. Listen to The Best Idea Yet on the Wondery app or wherever you get your podcasts. I'm Marsha Clark, host of Informance Lawyer X. Join me as we tell the shocking true story of a lawyer who wasn't just representing some of Australia's most dangerous gangland criminals. She was informing on them to the police. Informants Lawyer X is available exclusively on Wondery Plus. Join Wondery Plus for access to this and more Exhibit C true crime podcasts. From Ballin Studios and Wondery, I'm Mr. Ballin, and this is Mr. Ballin's Medical Mysteries, where every week we will explore a new baffling mystery originating from the one place we all can't escape, our own bodies. If you enjoyed today's story, be sure to train your cat to chew on electrical cords and then release the cat into the follow button's house.
Starting point is 00:03:01 Today's story is called Village of Death. On a hot fall morning in 1998, a 57-year-old cabinetmaker named Kiam Beng stood outside of a shop in a rural Malaysian village waiting for a friend to pick up an order. Kiam Beng swatted away mosquitoes and looked down the road. His friend, Ash, was an hour late. He had promised to be there when the shop opened, but there was still no sign of him. In front of his workshop, Kiam Beng could see an orchard that grew durian, which is a popular fruit in Southeast Asia. Next to the orchard, another farm raised hundreds of pigs. Their familiar grunting echoed through the dense canopy of trees. Nearly everyone in town made a living as farmers, and Kiam Beng could smell the earthy aroma of freshly tilled soil and manure in the humid air. Kiam Bing eyed the empty road again and turned back to his shop.
Starting point is 00:03:51 He didn't have a phone, otherwise he would have called to see where Ash was. But until Ash showed up, Kiam Bing was content to go back to his work while his dogs ran in and out of the workshop. But as the hours ticked by, Kiam Bing started to think that his friend might not come to pick up his cabinets at all. Finally, as Kiam Bing prepared to close up at the end of the day, a messenger arrived with a note from Ash. He had a headache and he was vomiting, so he wasn't able to go anywhere.
Starting point is 00:04:19 Kiam Bing thanked the messenger and then finished closing up his shop and then started walking home with his dogs. The sun was setting over the lush green valley and he could just barely see bats fluttering in the durian trees. Kiam Bing was worried about his sick friend. The symptoms he listed were painfully familiar. There was a serious illness going around this town that the local doctors called Japanese encephalitis. Other people had become so sick
Starting point is 00:04:45 that they couldn't move or speak, and still others had seizures and went into comas. Kiam Bing prayed that Ash wouldn't be one of the unlucky ones. As Kiam Bing kept walking down the road, he saw a giant truck slowly drive by that was billowing white fog into the air behind it. Kiam Bing had read that the Malaysian government was spraying the area to kill mosquitoes, which was how Japanese encephalitis was spread. The sight of the truck made Kiam Bing feel a little more at ease. Once the mosquitoes were gone, the disease would go away too.
Starting point is 00:05:21 The next day, Kiam Bing spent the morning painting cabinets and playing fetch with his two dogs. Later in the afternoon, he heard a car rumbling down the road, and he looked up hopefully. The road wasn't usually very busy, and he'd checked every car that passed to see if it was ash. But as this car got closer, he could see that it was the same messenger from the day before. The messenger pulled up and then got out of the car and walked up to Kianbing's shop. His expression was grim as he handed Kianbing the paper with the message. This time, it was written by Ash's wife. Kianbing's heart sank as he read. Ash had been taken to the hospital, but he was too sick and the doctors there couldn't help him. He had died from this Japanese encephalitis.
Starting point is 00:06:06 Kianbing felt a sense of dread. He'd known how dangerous the disease was, but now that his friend was dead, it felt much more real. He hurried back to his shop and called his dogs inside. Then he closed the door. Kianbing realized that he hadn't been taking the disease seriously enough. Now he was determined to do whatever was necessary to avoid being bit by a mosquito, even if that meant staying inside basically all the time and shutting down his business for a while. The government was spraying pesticides to kill all the mosquitoes, but Kiam Bing knew the insects would not disappear completely. Several months later, on February 27th, 1999, a young scientist named Ka Bing Chua steadied his hands as he swabbed a viral culture onto a petri dish. Dr. Chua was studying virology
Starting point is 00:06:57 at the University of Malaya Medical Center in Kuala Lumpur, Malaysia's largest city. Dr. Chua was investigating the outbreak of a disease that the government had been calling Japanese encephalitis. Roughly 200 people in Malaysia had gotten sick so far, and close to 100 had been admitted to Dr. Chua's hospital. Most of them exhibited the same symptoms, swelling of the brain, which led to an inability to talk or walk. Many of the patients became fully paralyzed or fell into comas. The fatality rate was staggering. Two out of every five people who became infected died, making the outbreak almost as lethal as the bubonic plague,
Starting point is 00:07:36 which wiped out a third of Europe's entire population during the Middle Ages. Dr. Chua's university had conducted a variety of tests to confirm that all the sick patients were positive for Japanese encephalitis. However, the results of these tests were inconclusive. There were at least a few researchers who felt they couldn't be exactly sure what was making all these people sick. However, the symptoms were highly similar to Japanese encephalitis, and there were no other known diseases in the area that could explain the outbreak. But Dr. Chua was uncomfortable settling on this sort of uncertain evidence. He had a nagging feeling that there was something else going on.
Starting point is 00:08:18 Dr. Chua was also getting mounting pressure from his lab director to come up with better answers soon. Right now, the government was investing all its efforts in killing mosquitoes. But what if this outbreak wasn't being spread by mosquitoes after all? One of Dr. Chua's colleagues, who had been studying the question of which people were most likely to get sick, had pointed out an interesting fact. No Muslims had been infected with this virus, even though Islam is Malaysia's leading religion. This was strange because Japanese encephalitis is transmitted
Starting point is 00:08:50 through mosquito bites, and there was no reason why people of a particular religion would be immune to mosquitoes. This made Dr. Chua even more skeptical that the patients they were studying had Japanese encephalitis. So he decided to run his own tests. He was going to isolate the disease right there in his lab so he could get a better look at it. Dr. Chua hand-selected cerebrospinal fluid and serum samples from patients whose symptoms most closely resembled Japanese encephalitis. Then he put each one in a sealed dish and tucked it into an incubator that warmed it to the temperature of a human body, 98.6 degrees Fahrenheit. Then Chua waited. He hoped that the warmed-up fluid samples would create the perfect environment for the
Starting point is 00:09:38 disease to show itself. If successful, Dr. Chua would eventually be able to cultivate highly concentrated and highly lethal dishes full of the disease that he could study. Nearly one week later, Dr. Chua pulled the cultures from the incubator. While the samples had been incubating, five more patients had been admitted to a nearby hospital with the same deadly symptoms. Their fluid samples were sent to Dr. Chua's department. Dr. Chua knew that every second counted. If this disease was not Japanese encephalitis, and Dr. Chua was able to identify what it
Starting point is 00:10:14 really was, then doctors might be able to find a cure and save everyone who was already sick. Dr. Chua slid the samples under his microscope and then stooped down to look through the eyepiece. His experiment with the incubator had worked. The dish was jammed full of invading microbes. But when this virus was exposed to animal cells, the nature of its deadly effect was unexpected. Dr. Chua wasn't sure what he was looking at, but it definitely was not Japanese encephalitis. Dr. Chua knew he needed to show his boss, who was the head of the department at the university, right away, and so Dr. Chua
Starting point is 00:10:52 sprinted out the door to find him. 20 minutes later, Dr. Chua's boss was examining the same culture under the microscope. Dr. Chua stood nearby, his stomach churning with anxiety. He knew his finding was significant and they could save lives if they acted fast. But after a long moment, Dr. Chua's boss finally stood and just shook his head. He interpreted the results differently and didn't see enough evidence to prove that the virus was new. He argued that the virus's strange behavior could be due to normal variations in the culture, or even that the culture could be contaminated. He still believed that the results were consistent with this being Japanese encephalitis. He told Dr. Chua to throw
Starting point is 00:11:37 the sample away. Dr. Chua was shocked. He knew that his experiment was not contaminated, but he also knew better than to outright challenge his superior. However, Dr. Chua knew he could not back down completely. There was too much at stake. He just needed to find the right moment to convince his boss. Four days later, on March 9th, Dr. Chua got his chance. He was driving with his boss and two other colleagues, returning from a meeting. The rain was coming down in sheets, and their car was inching forward in heavy traffic. It gave Dr. Chua a captive audience. Dr. Chua glanced at the men and then leaned forward in his seat, making sure he had his boss's attention. Dr. Chua cleared his throat and then quickly launched into his
Starting point is 00:12:25 theory. He emphasized the virus's unique effect on animal cells and said the variation was enough to prove that they were dealing with something unknown. The disease they were fighting was caused by an entirely new virus, he said, and they needed to take action immediately. The sickness had already spread to several other Malaysian states and hopped the border into Singapore. As Dr. Chua described his findings, his colleagues' expressions showed signs of concern, but Dr. Chua's boss remained neutral. He pressed on, explaining that while he was sure they had discovered a new virus, their lab's equipment was not yet powerful enough to identify it. He argued that they really needed to send the
Starting point is 00:13:05 cultures to the Centers for Disease Control and Prevention in the United States. The CDC had the right equipment, and it was in their best interest to help. This wasn't simply an outbreak affecting people in Malaysia. It had the potential to become a global pandemic with devastating consequences if they didn't control it quickly. The air in the car was thick with tension as Dr. Chua waited for his boss to react. Finally, his boss cleared his throat and spoke. Dr. Chua's theory had merit, he said, and he would think about it overnight. Then the car they were in pulled up to Dr. Chua's boss's home,
Starting point is 00:13:45 and his boss climbed out and walked away in the pouring rain. The next morning, Dr. Chua woke up to the sound of his phone ringing. It was his boss. He told Dr. Chua that he'd made some calls, and a travel visa was being expedited for Dr. Chua to get to the United States. Dr. Chua was so relieved, and he thanked his boss, and then he rushed to the hospital to prepare the virus samples for a trip to America. Four days later, Dr. Chua stood in the CDC's research lab in Fort Collins, Colorado. Dr. Chua peered through a powerful electron microscope at his slides. This awesome device was literally thousands of times better than anything Dr. Chua was using at magnifying samples, giving Chua a much more intimate look at his adversary.
Starting point is 00:14:38 Underneath the lens of the microscope, his virus cultures revealed tiny ring-like formations covering the slide. He blinked and looked again to make sure. Now, Dr. Chua knew for certain that the scientists in Malaysia had misidentified the virus. But Dr. Chua did not feel excitement or pride that he had been right. Instead, at that moment, he felt terror. The type of virus on that slide was far deadlier than Japanese encephalitis, and it wasn't spread by mosquitoes. But based on the virus' unique characteristics, Dr. Chua was almost positive he knew what
Starting point is 00:15:12 was spreading it. He needed to report his findings immediately. Dr. Chua flagged down one of the CDC's scientists and asked for the nearest telephone. After he finished his call to his boss in Malaysia, he showed his discovery to CDC officials. They were instantly alarmed and agreed with Dr. Chua's assessment. The outbreak in Malaysia had the potential to kill millions of people. I know you're as obsessed with true crime as I am, And that's why I'm excited to tell you about a new app for iPhone called StoryRabbit.
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Starting point is 00:16:18 or exploring crime stories worldwide, these captivating audio stories educate you on the darker side of history. Download the StoryRabbit app now for a free trial. That's StoryRabbit, all one word, or go to StoryRabbit.ai to learn more. In a quiet suburb, a community is shattered by the death of a beloved wife and mother. But this tragic loss of life quickly turns into something even darker. Her husband had tried to hire a hitman on the dark web to kill her. And she wasn't the only target. Because buried in the depths of the internet is The Kill List,
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Starting point is 00:17:31 Wondery+. Check out Exhibit C in the Wondery app for all your true crime listening. Back in Malaysia, a few days after Dr. Chua's discovery, the 57-year-old cabinetmaker, Kiam Bing, watched from the doorway of his workshop as soldiers put up barricades at the end of the main road in his town. Kiam Bing was staying inside as much as possible to avoid the mosquitoes that he believed were carrying this virus. The only time he went outside was to run between his home and his shop. By now, it seemed like almost every family in town had lost a loved one to this terrible disease. They'd all died painful and horrifying deaths, and residents were in a panic. The disease was showing no signs of slowing down
Starting point is 00:18:16 either, and so the government was barricading the road into town to keep residents there quarantined. Kiam Bing had lived here his entire life, and he couldn't remember any other time when travel in or out of the area had been restricted. The road was usually bustling with people going to and from work at this time of the day, but now it was deserted. The only sound was the fluttering of these red banners
Starting point is 00:18:40 that people hung outside of their houses to ward off death. The silence frightened Kiam Bing. Even his dogs seemed different. Instead of jumping around and playing with their ball, they curled up quietly on the floor. And then, as Kiam Bing was watching all this strangeness unfold in front of him, Kiam Bing began to hear the sound of gunshots. When Kiam Bing heard these gunshots, he instinctively hid behind his counter. Once it stopped, Kianbing stood up and slowly opened his front door to see what was going on outside. And what he saw was a group of soldiers with rifles slung across their backs, marching out
Starting point is 00:19:20 from behind a farm down the road and heading towards the next one. Also, there were all these military vehicles full of dozens more soldiers that were driving down the road and they were all heading for different farms. Jiang Bing watched as some of the soldiers stopped in front of the farm right across the street and they went around to the back of the property. Jiang Bing stepped out of his store to get a better look, and he peered around the corner of the farm across the street, and he could see the soldiers now pointing their rifles towards the trees, and also the pig pens below the trees. Kiam Bing knew what was coming next, and he couldn't bear to watch it.
Starting point is 00:19:57 He ran back to the doorway of his shop, and then a few moments later, he heard more gunfire and the terrible sound of pigs squealing in agony. Kiam Beng could literally smell the coppery stench of blood as it wafted through the thick hot air. And then moments later, the soldiers emerged from behind the farm and began marching down the street towards the next farm. And the farm's owner from across the street followed the soldiers out onto the road, and the owner just sat down on the sidewalk and put his face in his hands. Once the soldiers had marched down the road and were gone, Kian Bing hustled across the street and knelt down next to the farmer who still had his face in his hands. After making sure this
Starting point is 00:20:41 farmer was okay, Kian Bing gently asked, you know, what happened? What's going on? And the farmer just shook his head in disbelief. And in a shaky voice, he told Kiam Bing that the government had issued an order for all the pigs in this village to be slaughtered and buried. They told him that this would stop the terrible disease that had been killing people for months. Kiam Bing was shocked. He remembered that the government had sprayed the town for the mosquitoes to stop the disease. Now they were saying it came from the pigs? Kianbing returned to his shop and closed the door.
Starting point is 00:21:16 He smiled at his dogs, who hadn't moved since he left. Kianbing felt badly for his neighbors, but at the same time, he was grateful that the mystery of this disease seemed to be solved and that now Kianbing really was safe. It was nearly impossible to avoid all mosquitoes like Kianbing had been trying to do, but he had no reason to interact with pigs, which apparently were the reason this disease was spreading, and so Kian Bing really felt like he was going to be okay. Two days later, Kian Bing woke up feeling feverish. His head was pounding and he couldn't pull himself from the bed. His skin felt like it was on fire. In a panic, he realized that he must be sick with this mysterious disease. Kian Bing didn't understand how this was happening to him.
Starting point is 00:22:04 He hadn't gone near any pigs. But Kian Bing didn't understand how this was happening to him. He hadn't gone near any pigs. But Kiam Bing didn't have time to worry about that. He needed to get to a hospital. He managed to drag himself out of bed and stumbled over to a neighbor's house where he knew there was a phone. He begged the neighbor to please call him an ambulance and then Kiam Bing collapsed to the ground. A few minutes later, the paramedics arrived and took Kiam Bing to the nearest major hospital, which was about 50 miles to the north, at the University Hospital in Kuala Lumpur. The intake nurse in the emergency room asked Kiam Bing to describe his symptoms and when they started, and Kiam Bing, who had been strapped to a gurney for
Starting point is 00:22:42 the entire ambulance ride, felt his voice stick in his throat. To his horror, he couldn't respond. He tried to swallow, but it was no use. He was totally paralyzed. Kianbing could see the nurse's eyes widen in alarm. He watched, terrified, as the nurses wheeled him through the hospital, helpless as he felt his body lock around him. It didn't take long to confirm that
Starting point is 00:23:05 Kianbing's sickness was indeed the same virus that Dr. Chua had identified in Colorado at the CDC research lab. But that knowledge didn't help Kianbing's doctors. Shortly after he was admitted, Kianbing fell into a vegetative state and then died. In early June of 1999, around three months after Kianbing died, Dr. Chua was back at his office in Kuala Lumpur. It seemed like the mystery virus had been defeated, all thanks to Dr. Chua's quick thinking. But Dr. Chua wasn't sure if the mystery really was completely solved. The virus he had identified at the CDC's lab was called a paramyxovirus. This virus is transmitted from livestock animals to people, and many of the patients who had caught it worked with pigs. It wasn't affecting Muslims because they didn't eat pork. But many people in the country did eat pork,
Starting point is 00:24:06 so Dr. Chua and a team of experts had advised the Malaysian authorities that if they wanted to stop the disease, they would have to make the difficult decision to kill as many pigs as possible in the affected areas. The government reacted quickly and sent squads of soldiers to eliminate over a million pigs. And after they did that, sure enough, cases of this mysterious disease started to dwindle. When it came to naming the virus, officials looked to the small pig farming town it had originated in and where Kiam Bing, the cabinetmaker, was from, Nipah. They would call it the Nipah virus. But something kept bothering Dr.
Starting point is 00:24:46 Chua. Most of the Nipah virus victims were farmers who had direct contact with infected pigs, which made sense. But nearly 20% of the patients had minimal or no contact with the animals, but they still got this disease. Kiam Bing, the cabinetmaker, was one of those unlucky 20%. Dr. Chua knew that Qianbing must have caught this disease somewhere, and if it wasn't from pigs, then where did he get it from? Could it be that another animal was spreading the Nipah virus in addition to the pigs? Chua started to wonder if pigs really were the source of the virus or if they were just a carrier. Maybe, he thought, the true source of the virus was another creature altogether. And so now that the outbreak was under control following the elimination of all these pigs,
Starting point is 00:25:38 the Malaysian government deployed a team of researchers to try to determine the true source of the Nipah virus. As the scientists investigated, they found that the Nipah virus was closely related to another virus that had caused a small outbreak in Australia a few years earlier. At the time, researchers had been able to identify the source of the outbreak. It was fruit bats. So now, Malaysian researchers quickly zeroed in on an extraordinary type of bat called the flying fox, which lived near the village of Nipah and throughout the country. These animals, among the largest bats in the world, can have wingspans of up to five feet, but they're not normally harmful to humans.
Starting point is 00:26:20 They mostly mind their own business, feeding on fruit trees like durian, which was one of the primary crops grown in Nipah. But when researchers captured some flying foxes for study, they found that a large number of them tested positive for Nipah virus. The virus did not seem to harm the animals at all, but the researchers suddenly realized that the bats themselves were doing enormous harm to the people all around them. The bats, not the pigs and not the bats themselves were doing enormous harm to the people all around them. The bats, not the pigs and not the mosquitoes, were the real source of this terrible disease. Here's how it worked. The bats came out at night to feed on the durian flowers,
Starting point is 00:26:57 and as they did that, their droppings and urine would fall to the ground below them. When morning came, the pigs were let out of their pens and they came into contact with the bat droppings and the bat urine that was contaminated with the Nipah virus. And so did other animals, like horses and dogs, and in turn, these animals passed it on to their owners. That's how people who did not work with pigs became infected, and that's how Kiam Bing, the cabinetmaker, got the virus. At some point, his dogs must have sniffed around some durian trees and come into contact with infected droppings, and then when Kian Bing went to play with them and the dogs licked his face, they passed the virus on to him. In the past, there had never been a Nipah virus outbreak
Starting point is 00:27:41 because fruit trees like durian and the bats were far from any industrial animal farms. But as farming expanded in Malaysia, fruit orchards were planted right next to pig farms and other commercial areas, which allowed the disease to spread. The discovery that fruit bats were the real spreader of the virus allowed the researchers to truly understand how the Nipah virus operated. But it also meant that future outbreaks would be impossible to stop. The fruit bats responsible for the Nipah virus live throughout Africa, Asia, and the Pacific Islands. There's no way to effectively control their population or to stop them from eating fruit from commercial farms.
Starting point is 00:28:23 So the only way to truly stop the Nipah virus is to create a vaccine for it. But scientists haven't figured out how to make one yet. In recent years, there have been more outbreaks around the world striking fear into scientists and public health officials. The World Health Organization has labeled this virus as being a virus with catastrophic global pandemic potential. If the virus ever becomes airborne, it could be transmitted through coughs, sneezes, or contaminated surfaces. If that happens, millions of lives will be at risk. And we might not be able to do anything about it. To be continued... We use aliases sometimes because we don't know the names of the real people in the story. And also, in most cases, we can't know exactly what was said, but everything is based on a lot of research.
Starting point is 00:29:31 And a reminder, the content in this episode is not intended to be a substitute for professional medical advice, diagnosis, or treatment. This episode was written by Kinsey Clark. Our editor is Heather Dundas. Sound design is by Ryan Patesta. Coordinating producer is Sophia Martins. Our senior producer is Alex Benidon. Our associate producers and researchers are Sarah Vytak and Tasia Palaconda.
Starting point is 00:29:55 Fact-checking was done by Bennett Logan. For Ballin Studios, our head of production is Zach Levitt. Script editing is by Scott Allen and Evan Allen. Our coordinating producer is Metub Zare. Executive producers are myself, Mr. Ballin, and Nick Witters. For Wondery, our head of sound is Marcelino Villapondo. Senior producers are Laura Donna Palavoda and Dave Schilling. Senior managing producer is Ryan Moore. Our executive producers are Aaron O'Flaherty and
Starting point is 00:30:23 Marshall Louis for Wondering. This woman is so adept at being a criminal, it's not funny. I've never seen a shit show quite like the story of Sarah King. She conned people out of $10 million.
Starting point is 00:30:47 But infamy comes with a price. If we don't have our money by tomorrow morning, you will be gutted like a fish in Newport Harper. Lady Mafia. Available now on The Binge. Search for Lady Mafia wherever you get your podcasts to start listening today.

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