Outbreaks of leptospirosis after a flood in Thung Song District, Nakhon Si Thammarat, January 2017
DOI:
https://doi.org/10.14456/dcj.2019.30Keywords:
outbreak, leptospirosis, floodAbstract
Outbreaks of leptospirosis occurred in Thung Song district, Nakhon Si Thammarat in January 2017. In response to the outbreaks, Surveillance and Rapid Response Team (SRRT) from the Office of Disease Prevention and Control Region 11, Nakhon Si Thammarat, together with SRRT from the Bureau of Epidemiology (BOE), the provincial SRRT and Thung Song SRRT jointly conducted an outbreak investigation during February 1-3, 2017. The outbreak investigation aimed to confirm the diagnosis and the existence of the outbreaks, explore the source of infection and provide prevention and control measures. A descriptive epidemiological study was conducted. OPD cards and charts of those diagnosed with leptospirosis in Thung Song Hospital were reviewed. We interviewed patients, their relatives and cases in the community. Case definitions were defined. Risk behaviors, laboratory and sanitation practices were examined in the area where confirmed cases had been identified. The results showed 21 cases of leptospirosis, including 10 confirmed cases, three probable cases, and eight suspected cases, without fatal cases. Sixteen cases were males and five were females. The highest number of cases was found in Pakpraek sub-district. The peak occurred during 2 weeks after flooding. The most common sign and symptom was fever, followed by severe headache, chill, severe muscle pain and oliguria. High-risk groups are those aged 25-34 years. Casual laborers were found to be the most vulnerable group. Microscopic Agglutination Test (MAT) detected 12 serovars of Leptospira among cases. Dominant serovars were Shermani and Sejroe. Dogs, cats, cattle and rats were suspected to be the primary source of infection in this study. Identified risk factors included exposure to paddy fields/muddy areas, direct contact with the flood water, wound/skin cuts especially at the legs and feet, and high risk activities such as moving household items and house cleaning. A rubber stamp for suspected leptospirosis cases by documenting clinical signs and symptoms and health risk factors can be used for early detection, diagnosis, treatment and rapid control of the disease.
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