Medical Journal of Malaysia

MJM, Vol 70 Supplement 1 September 2015

Leptospirosis outbreak in a high school following camping activities in Hulu Langat.

Nurul Farhana MA*, Abdul Halim MT**, Normal S**, Rohani I*

*Kuala Lumpur and Putrajaya Federal Territory Health Department, *Lembah Pantai District Health Office

ABSRACT

Introduction: Leptospirosis is caused by Leptospirae interrogans which is subdivided into more than 200 serovars that are naturally carried in the renal tubules of rodents, wild and domestic animals. This paper describe the investigation of a case notified to district health office.

Methods: This is a case-control study among 110 teachers and students from a high school who had the camping activities in Hulu Langat from 15 to 17 August 2014, and experienced one of the symptoms of Leptospirosis, i.e., fever, bodyache, headache, respiratory or gastrointestinal symptoms one week after the camping activities. Laboratory investigations includes blood samples from symptomatic respondents, water and soil samples from the camping areas; i.e., water from river bank and water tank, and soil from where crawling activities occurred were collected.

Results: Out of 110 respondents, 31 (attack rate 28.2%) were defined as cases. Blood serology IgM for Leptospirae and Microscopic Agglutination Test (MAT) were taken from 17 cases and all were positive for both tests (100%). Ten water and soil samples taken showed two positive soils samples for Leptospirae. Most common symptom was respiratory symptoms (40%) followed by fever (27.3%), headache (22.7%) and bodyache (21%). All cases were involved with crawling activities and had accidentally drank river water while swimming.

Conclusion: In conclusion, there was an outbreak of Leptospirosis among 110 camping participants. The sources of infection were from the soil at the area for crawling activities at the camp site. Letter to Ministry of Education was given informing about the outbreak and reminding them to avoid having any recreational activities nearby the affected area. Risk assessment for Leptospirosis was done with help from Hulu Langat District Heath Office and suggestion for improvement was advised to the camp authorities.