Published Date: 2011-11-27 21:03:04
Subject: PRO/MBDS> Leptospirosis - Thailand (04)
Archive Number: 20111127.3462
LEPTOSPIROSIS - THAILAND (04)
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Wed 23 Nov 2011
Source: Bangkok Post [edited]
Poor sanitation and garbage disposal in Bangkok's flood-hit communities
could result in an outbreak of leptospirosis, a health expert has warned.
Sumet Ongwandee of the Disease Control Department (DCD) said people
should take precautions against leptospirosis and wear protective gear
if they want to return home after the waters recede. "The waterborne
disease can be hazardous to people," he said.
Leptospirosis can be transmitted to both humans and animals by direct
contact with the urine of infected rodents in contaminated flood water.
The disease gets into the body through cuts and wounds as well as the
eyes, nose and mouth, Dr Sumet told the Bangkok Post.
Symptoms are a high fever, severe headache, muscle pain, chills, redness
of the eyes, abdominal pain, jaundice, skin haemorrhages, vomiting,
diarrhoea and a rash. Severe cases can be fatal if not treated
immediately, he said.
"Leptospirosis is very worrying, as the floodwater has hit crowded urban
communities in the capital. So garbage disposal management is needed,
for it is the 1st measure that will help control rodents infected with
the bacteria from spreading the disease to people," he said.
Dr Sumet said people should carefully protect themselves by wearing
rubber boots, gloves and masks when wading through contaminated
floodwater and dispose of garbage to help prevent themselves and others
from catching the waterborne disease.
Apart from Bangkok's flood-hit communities, health authorities are
speeding up monitoring for leptospirosis in 46 flood-hit provinces
nationwide. Surveillance teams of the Bureau of Epidemiology found a
leptospirosis case in Nakhon Sawan after the floodwaters receded there.
Another case with similar symptoms to leptospirosis was reported on [18
Nov 2011] in Ayutthaya's Pachi district and is still under
investigation, the bureau said.
Bangkok has in the past experienced 3 leptospirosis outbreaks after
flooding. The last outbreak in the capital was reported in 1964, said
Wirongrong Jirakul of Mahidol University's faculty of tropical medicine.
Dr Wirongrong said major outbreaks in the country were reported between
1997 and 1999. Up to 15 000 cases and 400 deaths were reported.
In Thailand, an estimated 2000-3000 people are infected with
leptospirosis every year.
The disease is endemic in the northeast, where farmers work in fields
and rice paddies without proper protection. Leptospirosis cases usually
peak during the monsoon season.
[The newswire above reports leptospirosis cases in Thailand after the
flood water had receded. One confirmed case was reported in Nakhon
Sawan, and one suspected case was reported in Ayutthaya province.
According to the Thai Ministry of Public Health, Bureau of Epidemiology
(BOE) report on leptospirosis, available in Thai at
between 1 Jan 2011 and 18 Nov 2011, a total of 3137 cases and 62
fatalities were reported from 69 provinces. The attack rate was 4.94 per
100 000 population. The case fatality rate (CFR) was 0.10 percent. Of
these, 33 cases and one death were reported from Nakhon Sawan province;
8 cases and no deaths were reported from Bangkok, and 11 cases and no
deaths were reported from Ayutthaya province. Between 1 Oct 2011 and 18
Nov 2011, 12 cases were reported in Nakhon Sawan province; 3 cases were
reported in Bangkok, and 3 cases were reported in Ayutthaya province.
The highest percentage of cases was reported in the 45-54 year-old age
group (23.08 percent), followed by the 35-44 year-old age group (21.39
percent), and 25-34 year-old age group (15.46 percent). The northeastern
region has the highest attack rate (per 100 000 population) of
leptospirosis (9.13), followed by the south region (5.31), north region
(5.06) and central region (0.52). High attack rates (per 100 000
population) were reported in the provinces of Nong Bua Lamphu (31.74),
Surin (23.95), Phangnga (23.84), Loei (22.39) and Nan (20.82).
In 2010, a total of 4944 cases and 43 fatalities attributed to
leptospirosis were reported in Thailand. The attack rate was 7.78 per
100 000 population. The case fatality rate (CFR) was 0.07 percent.
For maps showing Thailand's regions, see
http://www.thailand-map.net/thailand_provinces/; for provinces, see
http://en.wikipedia.org/wiki/Provinces_of_Thailand. For the
interactive HealthMap/ProMED-mail map of Thailand with links to other
recent ProMED-mail and PRO/MBDS postings, see
http://healthmap.org/r/1l5W. - Mod.SCM]