Fan Favorite | Village of Death

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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 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, 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.

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From Balin Studios and Wondry, I'm Mr.

Balin, and this is Mr.

Balin'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 enjoy 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.

Today's story is called Village of Death.

On a hot fall morning in 1998, a 57-year-old cabinet maker named Kyam Bing stood outside of a shop in a rural Malaysian village, waiting for a friend to pick up an order.

Kiombing 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, Kyam Bing 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 Kyam Bing could smell the earthy aroma of freshly tilled soil and manure in the humid air.

Kyambing eyed the empty road again and turned back to his shop.

He didn't have a phone, otherwise he would have called to see where Ash was.

But until Ash showed up, Kyambing was content to go back to his work while his dogs ran in and out of the workshop.

But as the hours ticked by, Kyambing started to think that his friend might not come to pick up his cabinets at all.

Finally, as Kyambing 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.

Kyambing 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.

Kyung 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 that they couldn't move or speak, and still others had seizures and went into comas.

Kyumbing prayed that Ash wouldn't be one of the unlucky ones.

As Kyombing kept walking down the road, he saw a giant truck slowly drive by that was billowing white fog into the air behind it.

Kyambing 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 Kyambing feel a little more at ease.

Once the mosquitoes were gone, the disease would go away too.

The next day, Kyambing 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 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 Kyombing's shop.

His expression was grim as he handed Kyambing the paper with the message.

This time, it was written by Ash's wife.

Kyambing'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.

Kyambing 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.

Kyambing 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 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, 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.

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 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 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 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 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 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 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 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, 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 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.

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 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's unique characteristics, Dr.

Chua was almost positive he knew what 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.

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Back in Malaysia, a few days after Dr.

Chua's discovery, the 57-year-old cabinet maker, Kyambing, watched from the doorway of his workshop as soldiers put up barricades at the end of the main road in his town.

Kyambing 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 either, and so the government was barricading the road into town to keep residents there quarantined.

Kiang 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 that people hung outside of their houses to ward off death.

The silence frightened Kyambing.

Even his dogs seemed different.

Instead of jumping around and playing with their ball, they curled up quietly on the floor.

And then, as Kyambing was watching all this strangeness unfold in front of him, Kyambing began to hear the sound of gunshots.

When Kyambing heard these gunshots, he instinctively hid behind his counter.

Once it stopped, Kyambing 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 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.

Kyambing watched as some of the soldiers stopped in front of the the farm right across the street and they went around to the back of the property.

Kyambing 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.

Kyambing knew what was coming next and he couldn't bear to watch it.

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 Bing 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, Kiam Bing hustled across the street and knelt down next to the farmer who still had his face in his hands.

After making sure this farmer was okay, Kyambing 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 Kyambing 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.

Kyam 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?

Kyambing returned to his shop and closed the door.

He smiled at his dogs who hadn't moved since he left.

Kyambing 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 Kyambing really was safe.

It was nearly impossible to avoid all mosquitoes like Kyambing 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 Kyambing really felt like he was going to be okay.

Two days later, Kyambing 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.

Kyambing didn't understand how this was happening to him.

He hadn't gone near any pigs.

But Kiombing 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 Kiombing 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 Kiambing to describe his symptoms and when they started.

And Kiambing, who had been strapped to a gurney for 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.

Kiambing 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 Kyambeng'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 Kyambing's doctors.

Shortly after he was admitted, Kyambing fell into a vegetative state and then died.

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In early June of 1999, around three months after Kiambing 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 paramexavirus.

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, 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 cabinet maker, was from, Nipah.

They would call it the Nipah virus.

But something kept bothering Dr.

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.

Kiambing, the cabinet maker, was one of those unlucky 20%.

Dr.

Chua knew that Kiambing 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, 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.

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 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, 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 Kyung Bing, the cabinet maker, 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 Kiam 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 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.

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.

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From Balin Studios and Wondry, this is Mr.

Balin's Medical Mysteries, hosted by me, Mr.

Balin.

A quick note about our stories.

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.

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 Batesta.

Coordinating producer is Sophia Martins.

Our senior producer is Alex Benedon.

Our associate producers and researchers are Sarah Vitak and Teja Palaconda.

Fact-checking was done by Bennett Logan.

For Ballin Studios, our head of production is Zach Zach Lebitt.

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On Boxing Day 2018, 20-year-old Joy Morgan was last seen at her church, Israel United in Christ, or IUIC.

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