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Published Date: 2011-11-09 09:11:46
Subject: PRO/AH/EDR> Leptospirosis - Thailand: flood related
Archive Number: 20111109.3327

LEPTOSPIROSIS - THAILAND: FLOOD RELATED
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A ProMED-mail post
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International Society for Infectious Diseases
http://www.isid.org

Date: Tue 8 Nov 2011
Source: The Nation [edited]
http://www.nationmultimedia.com/national/Health-warnings-stepped-up-30169434.html

Health hazards are becoming a major concern as contamination of
floodwater caused mainly by uncollected garbage is widespread -- while
warnings against waterborne zoonoses [diseases transferred from
animals to humans] and food poisoning have been issued.

The Public Health Ministry's Department of Medical Sciences yesterday
[7 Nov 2011] warned of possible leptospirosis in flooded areas and
against consuming ice and iced drinks from unknown production sources.
In a recent survey, 21 food samples, collected in 4 flooded provinces
including Bangkok, yielded food poisoning manifestations, while 17 out
of 57 samples of drinking water possessed germs which caused
diarrhoea.

The minister reported one leptospirosis case in Khon Kaen and 20
suspected cases. The bacterial disease, which is found usually in
flooded areas up to 3 weeks after a flood recedes, is potentially
fatal if not properly treated.

In Bangkok, residents are encouraged to sort and separate rubbish,
with decaying foodstuff and materials tightly sealed, as only 30 per
cent of daily garbage can now be collected while more than 100 garbage
trucks are undergoing modification to enable them to travel through
high water.

As Bangkok governor Sukhumbhand Paribatra admitted, an understaffing
problem has resulted in increasing garbage accumulation. District
offices are hiring contractors to collect up to 70 per cent of garbage
during flooding, while boats are being used to collect rubbish in
badly flooded areas.

The Senate yesterday [7 Nov 2011] discussed contamination and hygiene
issues and called on the government to immediately begin water
treatment and other public health concerns including possible
post-flooding outbreaks. The senators, mostly those who sought to open
yesterday's session, said the city administration and the government
Flood Relief Operations Centre [FROC] had overlooked health issues
while concentrating too much on flood prevention and drainage. Senator
Surachai Liangbunlertchai proposed that FROC set up a special panel to
oversee measures relevant to disease prevention and treatment of
spoiled water.

Senator Nillawan Phetchara-booranin, of the Senate commission on
science and technology, said she admired volunteers' dedication in
making disinfectant EM [effective microorganism] balls but expressed
skepticism over their effectiveness. A number of university lecturers
have questioned use of the medicinal balls, even though charity groups
who made and used them claim their effectiveness as a water
disinfectant.

Dr Anant Ariyachaiphanich, head of the Senate commission on public
health, called on diabetics to avoid wading in floodwater or against
wounding themselves, and raised awareness of leptospirosis and
mosquito-borne dengue fever.

A retired Army commander, Phichet Wisaijorn, who has had experience
disinfecting wastewater with EM balls, said he had been assigned by
General Prayuth Chan-ocha to promote the use of the balls and to boost
their production among Army units. He said the EM balls would be most
effective when used together with a liquid disinfectant, with the
balls working underwater while the liquid is sprayed on the floodwater
and works on the surface. He said the space ratio of EM balls used
under his supervision is one ball per square metre, compared to 1 to 4
claimed by charity groups.

Examples of success with EM balls' use are in tackling contamination
of Pattani Bay a few years ago, and in spoiled water in vast areas of
rice paddies in Nakhon Ratchasima during a major flood last year
[2010]. Phichet said Prayuth had already ordered Army units to make EM
balls, even before this year's flood, and now wanted a large number
produced by Army units for immediate use.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[GIDEON (Global Infectious Disease & Epidemiology Network) data
previously posted on ProMED-mail indicate that: _Leptospira
interrogans_ serovar bataviae predominates in Bangkok, and serovar
autumnalis in rural areas of Thailand. Leptospirosis outbreaks occur
with some regularity during periods of flooding in Thailand as a
result of people wading through contaminated water. Most cases occur
among agricultural workers, notably rice producers. The principal
reservoirs in Thailand are chronically infected rats and dogs that
excrete _Leptospira_ in their urine (see ProMED-mail posts
Leptospirosis - Thailand (02) 19971121.2345 and Leptospirosis -
Thailand (Nan)(02): background 20060913.2592).

EM (effective microorganism) mudballs are made of local dirt kneaded
with: "Activated EM-1(R) (AEM), molasses, EM(TM) Bokashi (fermented
organic material made from EM, molasses, water and rice or wheat
bran), [and] EM-X(R) Ceramics Powder"
(http://emrojapan.com/about-em/em-products/activated-materials/howtomakeballs.html).
EM-1(R) is said by its manufacturer to contain harmless lactic acid
bacteria, yeast, and phototrophic bacteria: "EM-1(R) consists only of
safe microorganisms that have been used, either intentionally or
unintentionally, since ancient times"
(http://emrojapan.com/about-em/microorganisms-in-em.html). EM
mudballs are used, according to its manufacturer, for sewage treatment
and water purification, and "to clean up bodies of water such as
rivers, lakes, and oceans where there are concentrated deposits of
sludge and slime"
(http://emrojapan.com/about-em/em-products/activated-materials/howtomakeballs.html).
Its effectiveness in preventing leptospirosis from exposure to
contaminated floodwater is not known
(http://www.nationmultimedia.com/national/EM-balls-and-water-safety-30169472.html).
Pictures of EM mudballs can be found at
http://www.google.com/search?q=em+mudballs+picture&hl=en&client=safari&rls=en&prmd=imvns&tbm=isch&tbo=u&source=univ&sa=X&ei=DPC5TrbgPISgtwf1xuSZBw&ved=0CB4QsAQ&biw=1155&bih=605&sei=%20VfC5TuygJaXq2QW13s2dBw.

The HealthMap/ProMED-mail interactive map of Thailand can be found at
http://healthmap.org/r/1pXO. - Mod.ML]

See Also