Investigation of Leptospirosis death NaChuak district MahaSarakhamprovince, 9-30 June 2015

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พรสิทธิ์ ทวยนันท์
เอมอร สุทธิสา
ชยานนท์ สุคุณา

Abstract

                 The Surveillance and Rapid Response Team (SRRT) of Na Chueak District and MahaSarakham Provincial Public Health Office joined to investigate the cause of death from Leptospirosis at a village in NongMek, Na Chueak District, MahaSarakham in order to confirm the diagnosis, to find out risk factors for infection and cause of death, and to define the measures of disease prevention and control.


          This study was the descriptive epidemiology study. The method of the study consist of review medical history data, interview on illnesses, treatments and risk behaviors from physicians, his wife and his relatives who looked after him, survey on the environment, surveillance someone whom there were risk behaviors together with a deceased, collect sample rodent from a suspected water source and his cattle’s urine for examining a laboratory to prove Leptospirosis infection in this area.


The findings indicated that 46 years old Thailand male patient, who was an agriculturist. He began getting ill on June 6, 2015, with a fever, chills, fatigue and body pain. After that, his wife brought him to a medical clinic in Na Chueak District. Doctor treated with antipyretic, analgesics, and antibiotics for taking at home, but these symptoms were not better. On June 9, 2015, at 7:46 am, his wife took him to the emergency room of Na Chueak hospital with fever, chills, pain, epigastric pain, body pain, and respiratory congestion for two hours before arriving in hospital. The result of the prior physical examination found the vital signs as body temperature was 36.5 °C, pulse 110 times /minute and blood pressure 70/40 mmHg. The patient had not underlying medical conditions. While, Preliminary results of laboratory tests were Leptospirosis positive, blood test as Hct 41.9%, WBC 1,700 cell / mm3, Platelets 73,000 cell /mm3, Neutrophils 79%, Lymphocytes 18%, BUN 32.6, Creatinine 3.58, Electrolyte Na 133.5, K 3.02, CO2 24.3, Cl 91.9. The result of IGM Leptospirosis was positive. The result of specimens as cattle’s blood and lymph tests were Leptospirosis negative, the cattle’s urine test was positive, the water from the containers of cattle test found the genetic ofLeptospirosis, the water from the cornfield around the corral of cattle and Lampung Choo gully did not found the genetic of Leptospirosis. However, the team could not specimen collection of rodent and patient’s cattle, so we could not identify pathogenic from Leptospirosis. Absolutely, the doctor diagnosed Leptospirosis and referred the patient to MahaSarakham hospital on June 9, 2015, at 09.13 am. The patient’s symptom after that did not better. There was diarrhea a time at 04.49 pm. Doctor took a tube and CPR, but it could not better. Consequently, the patient died at 05.45 pm on June 9, 2015


           The recommendation from this investigation was a container for cattle to drink or various containers at barn nearby fields or corral should be cautious. There may be contaminated with Leptospirosis germs or other pathogens owing to the contamination of rodent’s urine, particularly the high prevalence rodent areas.

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1.
ทวยนันท์พ, สุทธิสาเ, สุคุณาช. Investigation of Leptospirosis death NaChuak district MahaSarakhamprovince, 9-30 June 2015. jdpc7kk [Internet]. 2019Jan.2 [cited 2020Jun.7];23(3):86-. Available from: https://he01.tci-thaijo.org/index.php/jdpc7kk/article/view/164388
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Research Article