Pantai Hill Dengue Alert

Dengue - Aedes mosquito

Dengue – Aedes Mosquito

In Malaysia, most people are aware of the Aedes mosquito spreading dengue. It is worth a mention because this (mainly) urban disease has reared its ugly head here – on Pantai Hill Orchard, Seremban

In 2014 and 2015 two families living on different parts of Pantai Hill contracted dengue. Although there were no deaths, we are very concerned with its presence here and would like to alert visitors to Pantai Hill of this problem.

We associate the presence of dengue to the proliferation of trash and indiscriminate dumping of building materials from visitors, workers and increased construction activities on Pantai Hill. This behaviour by Pantai Hill contractors and workers needs to be urgently addressed, before more dengue cases happen on the hill.

The Star newspaper recently published an article on dengue by Dr. Milton Lum – here are its salient points:

According to the World Health Organisation (WHO), dengue is the fastest spreading mosquito-bourne viral disease in the world. Its spread has been alarming with an increase from nine affected countries in 1970 to more than 100 countries today.

A study by Brady et al in 2012 estimated that 3.9 billion people in 128 countries are at risk of infection. The surge in dengue has been most marked in Asia which accounts for 75% of the world’s population, with an estimated 1.8 billion people at risk of dengue.

Rapid urbanisation has resulted in millions of people moving to the cities,with insuficient housing and basic infrastructure such as water supply, sewer and waste management, providing ideal conditionsfor the breeding of mosquitoes and dengue transmission.

The description below is highly correlated to what is happening on Pantai Hill.

Negative habits like littering, illegal dumping of garbage, apathy, poor environmental cleanliness and lack of adherence to guidelines in construction sites have to be addressed.

info-graphic on dengue

info-graphic on dengue

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Leptospirosis Alert for Pantai Hill Visitors

Leptospirosis rat

This posting comes from a personal experience of leptospirosis in 2014 on Pantai Hill Orchard resort itself. Although i cannot identify or accurately pin where i contracted this disease from on Pantai Hill, i can however reduce its possibilities to a few places: 1. My pond, 2. The river just outside the gates of Pantai Hill 3. Area surrounding my own house in Pantai Hill.

After living here for a few years now, I realise that Pantai Hill is full of jungle rats. (and several species too) Although leptospirosis is not only a rat related disease, but can be carried by other animals too, i post this as a precautionary warning to all visitors of Pantai Hill Orchard. (Please remember that as more trash accumulates on Pantai Hill, due to unchecked and irresponsible behaviour of visitors and workers – it directly promotes a higher rat population on the hill)

Some links to the rising number of Leptospirosis cases in Malaysia:

Number of leptospirosis cases on the rise in the last 5 years
21 Aug 2010 … PETALING JAYA: The number of leptospirosis infections, a rat-borne disease, has been steadily increasing over the last five years. According …

Growing popluation reflected by spike in Leptospirosis cases
1 Jun 2013 … An 85.5% rise in cases of leptospirosis, commonly called the ‘rat urine … to be desired despite Malaysia having some of the best infrastructure.


 Nine Deaths from ‘rat urine disease’
from: The Borneo Post – Online

On precautionary measures, Dr Zulkifli advised members of the public to drink only boiled water and well-cooked food.

As for residents staying near river banks or those depending on rain water as their source of drinking water, they must ensure that the water is properly boiled to kill harmful micro-organisms, he further advised

He pointed out that a person could become infected with leptospirosis by wading in floodwaters contaminated with the urine of rats or other animals such as pigs, cows, dogs, or any wild animals infected by the leptospira bacteria.

“Henceforth, it is crucial to note that in times of flooding, parents must ensure that their children do not play near the drains or wade in floodwaters as they may be contaminated with animals’ urine such as rats,” he said.

Meanwhile, information obtained from the department’s website stated that humans become infected when exposed to water, food, or soil contaminated with urine of infected animals such as rats, cats, dogs, cows, goats, pigs, horses and wild animals.


The Malaysian Health Ministry published this paper in 2011:

View the pdf:<<GUIDELINES FOR THE DIAGNOSIS, MANAGEMENT, PREVENTION AND CONTROL OF LEPTOSPIROSIS IN MALAYSIA>>

Leptospirosis info-graphicBelow are some highlights of the paper:

Leptospirosis is usually a seasonal disease that starts at the onset of the rainy season and declines as the rainfall recedes. Sporadic cases may occur throughout the year with outbreaks associated with extreme changing weather events such as heavy rainfall and flooding

Leptospirosis is also known as “the Great Mimicker” and may be overlooked and underdiagnosed due to its varied clinical presentations.

 

FACTORS RESPONSIBLE FOR THE EMERGENCE OF LEPTOSPIROSIS
The conditions that are favourable for maintenance and transmission of Leptospirosis are:

a) Reservoir and carrier hosts Leptospirosis has a very wide range of natural rodent, and non-rodent reservoir hosts especially rats, cattle, dogs, foxes, rabbits, etc. The animals act as carriers of the leptospires and excrete large number of leptospires in their urine, thus responsible for the contamination of large and small water bodies as well as soil.

b) Flooding, drainage congestion Flooding and drainage congestion may be risk factors for contamination of water bodies with infected animal urine. Water logged areas may force rodent population to abandon their burrows and contaminate the stagnant water by their urine.

c) Animal-Human Interface The potential for infection increases through exposure from occupational or recreational activities without proper protection. Poor cleanliness/sanitation in recreational areas may attract animal host such as rodent thus increases the risk of contamination. These may be due to poor maintenance of facilities, improper disposal of waste and public attitude/ apathy.

d) Human host risk factors Several sections of the population are more susceptible to infection such as those not previously exposed to the bacteria in their environment (naïve immunities), and those with chronic disease and open skin wounds.

MODES OF TRANSMISSION
Infection is acquired from contact through skin, mucosa/ conjunctiva with water or soil contaminated with the urine of rodents, carrier or diseased animals in the environment. Ingestion of contaminated water may also cause infection. There is no documentation of human to human transmission.

HIGH RISK GROUPS
Exposure depends on chance contacts between human and infected animals or a contaminated environment through occupational and/or recreational activities. Some groups are at higher risk to contract the disease such as:
• Workers in the agricultural sectors • Sewerage workers • Livestock handlers • Pet shops workers • Military personnel • Search and rescue workers in high risk environment • Disaster relief workers (e.g. during floods) • People involved with outdoor/recreational activities such as water recreational activities, jungle trekking, etc. • Travelers who are not previously exposed to the bacteria in their environment especially those travelers and/or participants in jungle adventure trips or outdoor sport activities • People with chronic disease and open skin wounds.