19 Semarang residents died of leptospirosis

Antara News, Tuesday, January 12, 2010 01:51 WIB

Semarang (ANTARA News) - As many as 19 Semarang city residents died of leptopsirosis in the past two years, Joko Mardijanto, head of Central Java`s health office`s disease control and environmental sanitation section, said here on Monday.

Semarang was the region in Central Java with the highest incidence of the disease caused by bacteria transmitted by the urine of rats over the past two years, the Central Java public health official said.

In 2008, a total of 231 leptopsirosis cases happened in the city with 15 of them ending in the sufferer`s death. In 2009, there were 151 cases with four fatalities.

The fatalities occurred mainly because of belated treatment, Djoko said, adding that the disease was associated with flooding.

"We call on residents in flood-prone areas to be extra alert when their neighborhoods are under flood waters because the risk of contracting leptopsirosis will then increase," he said.

Djoko said beside Semarang, the Demak and Pati regions of Central Java province were also vulnerable to the disease.

People living in regions where floods often happen must not only guard against dengue fever but also against leptopsirosis, he said.

Rat threat looms as flooding recedes

Prodita Sabarini, THE JAKARTA POST, JAKARTA | Sat, 02/14/2009 2:05 PM 
 

 Underground Jakartans: An officer observes rats caught during a mass raid in Kampung Bali, Tanah Abang, Central Jakarta, in this file photo. JP/P.J. Leo
 

The sight of them is deemed repugnant, and they can make a grown person wince or turn hysterical. But, no one in this metropolitan capital of Indonesia can escape living side by side with these rodents. Rats! 

Either one notices or one does not; black rats are a part of daily life in Jakarta. 

The lucky ones see only glimpses of rats running the city’s open gutters or crossing the streets, or the occasional flattened corpse in the middle of the road. The less fortunate have to deal with rats scourging for leftover food in their kitchens at night. 

Wild and humongous, even a spoiled house cat can be intimidated by black rats.

With the rainy season, the rodents are becoming more than an unpleasant sight.

The Jakarta Health Agency has warned residents to brace for a number of water-borne diseases, including those spread by water contaminated by rats’ urine. 

Already, two Jakartans have contracted Leptospirosis. They are currently being treated at Tarakan Hospital. 

With the high population of rats in the city combined with the wet season and the city’s bad sewerage system leaving parts of the city flooded after heavy rains, residents are at risk of the deadly disease. 

The bacteria can stay alive in water for up to a month and can easily enter the body through open wounds, eyes, nose and skin. 

The incubation period in humans ranges between four to 19 days, with symptoms including fever, headache, fatigue, vomiting, sore eyes, leg pain and back pain. 

The bacteria can trigger sudden death if it enters the heart. It can also attack the liver, turning a patients’ skin yellow, and lungs, causing a patient to cough up blood and experience chest pains. 

Head of the health agency Tini Suryanti said residents should visit the local health center if they experience the symptoms. 

“Residents should also avoid walking barefoot in puddles of water,” she said.   

In 2002, during one of the largest floods in Jakarta, 113 patients were infected with leptospira germs according to the agency’s data. Twenty of the patients died. 

Tini said there were 184 cases in 2007 and 41 in 2008. 

Tini said her office did not have a rat population control agenda. 

“Who is actually responsible for that?” she asked. 

During the big flood of 2002, a joint team from the Jakarta Health Agency and the Health Ministry implemented a rat population control program. 

Tini said that in 2002, the city experienced a big break out of Leptospirosis due to the flooding, while this year the threat was not as big. 

Mammal expert Ken Aplin from Australia’s Commonwealth Scientific and Industrial Research Organisation (CSIRO) said in an email that to protect a city from diseases carried by rats, the only possible measures were to reduce rat populations, to protect drinking water sources from contamination and to tell people to avoid walking barefoot in water, especially in still pools in areas where many rats live. 

He said population control should be a preventive measure rather than a responsive measure because rats breed quickly. 

A female rat gives birth after a three-week pregnancy, and can fall pregnant again one day after birth. Weaning only takes three weeks as well, so the next litter can be born straight after weaning, although a longer gap in birth of litters is more usual. 

A new generation of rats is able to start breeding at around four months of age, Aplin said.

Aplin studied the DNA of black rats and found six different lineages, each one coming from different areas in Asia. 

The study raises the possibility that the different lineages of black rats carry a different set of diseases. 

“Two of the black rat lineages are known from Jakarta, one might be native to Java and other parts of western Indonesia. The other probably came from Thailand or southern China hundreds or even thousands of years ago,” he said. 

Both probably carry leptospirosis, but we do not know which carry particular types of leptospire.”

From his study, the six lineages appeared in India, Taiwan, the Himalayas, Thailand, the Mekong Delta and Indonesia. 

The Indian black rats spread to the Middle East around 20,000 years ago, and from this area they spread to Europe. 

Human voyages during recent centuries transported this rat to Africa, the Americas and Australia. The Taiwanese breed moved to Japan, the Philippines and Indonesia, reaching Micronesia 3,500 years ago. The other 4 lineages are not so widespread. 

He said trapping and poisoning were not effective methods at controlling rat populations because of rapid breeding and the fact that black rats were wary and difficult to kill using these methods. 

“Rat populations can be limited by denying them access to food – by keeping areas clean of spilled grain, waste food etc. – and access to shelter.”

Residents told to brace for leptospirosis in rainy season

The Jakarta Post, JAKARTA | Tue, 02/10/2009 11:01 AM  

During the rainy season, Jakarta residents have to brace for the spread of several water-borne diseases, an official said Monday. 

Leptospirosis is one of them. 

Jakarta has seen two cases of leptospirosis this year, said Tini Suryanti, the head of the city health agency. 

In 2002, during one of the largest floods in Jakarta, 113 patients were infected with leptospira germs according to the agency’s data. Twenty of the patients died. 

Tini said there were 184 cases in 2007 and 41 in 2008. 

“The leptospira bacteria comes from the urine of rats  and is spread by flooding,” she said.

The bacteria easily enters through small wounds, eyes, nose and skin. 

The disease can easily spread at temporary shelters for flood victims because of poor hygiene and sanitation, Tini said. 

“We have conducted information sessions, educating flood victims on personal and public hygiene to prevent the spread of this disease.” 

Wearing closed footwear like boots to wade through floodwater is also recommended. 

According to the June 2007 edition of the University of Indonesia’s health journal, Makara, every animal can potentially be infected with the disease. 

Water sources require special care to prevent contamination. 

The bacteria cannot survive long in salt water, but can live in freshwater for up to a month.

In humans, the incubation period ranges from four to 19 days. Symptoms include fever, headaches, fatigue, vomiting, sore eyes, leg pain and back pain 

If the bacteria enters the liver, a patient’s skin will appear yellow. If the bacteria enters the heart, it could trigger sudden death. 

If the bacteria attacks the lungs, the patient may cough up blood and experience chest pains.

Medical association prepares for floods

The Jakarta Post, Jakarta

In anticipation of an outbreak of flood-related disease in Jakarta, the Indonesian Medical Association (IDI) is working to attract new volunteers to join its team.

IDI chairman Fahmi Idris said Thursday volunteers would be deployed to offer medical treatment to flood victims across the city if such a tragedy was to strike again.

He said if areas of the city were badly flooded, the association would establish a number of health posts headed by medical professionals.

Common flood-related diseases to have hit the city in recent years are tetanus, leptospirosis, diarrhea, dengue fever and dermatitis.

People suffering from severe forms of these conditions require medical treatment.

The team of volunteers is part of the IDI's Disaster Mitigation Committee, which was established at the end of 2006 to help people directly affected by disasters.

When floods inundated the city in February this year, the committee set up 10 posts across the city, which were manned by a team of 30 doctors working in shifts.

Fahmi said the association's focus would remain on providing patients with medical treatment. However, she said it would also provide food, medicine and clothing to members of the community if a disaster struck.

The IDI will also work to provide clean water to flood victims through its partnership with the Bandung Institute of Technology's Indonesian Research Affiliation Institute and the Public Works Ministry.

"We realized after last February's floods that clean water was very crucial to flood victims but was very hard to find," said Fahmi.

The association's Disaster Mitigation Committee is also currently mapping out areas vulnerable to floods, enhancing partnerships with other institutions and organizations, expanding its networks and conducting familiarization activities about its programs.

Fahmi said the association's 363 branch offices throughout the country had started recruiting volunteers. It was hoped some 3,000 people would be recruited, with both medical and non-medical backgrounds, he said.

The volunteers would receive training and be sent to any area of the country hit by a disaster in the future, he said.

"We'll organize a training camp for these volunteers in Bontang (East Kalimantan) in December. We'll teach them how to work in disaster situations so they will be ready to help people when they are needed," Fahmi said.(wda)