DENGUE FEVER
There are 2 common species of Aedes mosquito which is A. albopictus and A. aegypti. A. aegypt is more commonly found outdoors and associated with Dengue fever while the other species is more common indoors and is often associated with Chikungunya . The life cycle of an Aedes mosquito from the eff to an adult mosquito only takes a gesticulation period of 7 days( egg-->larva --> pupae -->adult mosquito).
Incidence of Dengue Fever in Sik ***accurate statistics were not fully disclosed as it was confidential***
2006 --> 200+ cases
2007 -->200+ cases
2008 -->200-300+ cases
2009 --> <100 cases
The cases were more common in months of January, May, September and October.
Strategies
Notified from the hospital -->prepare the Investigation Form --> go to hospital or field --> interview patient --> Classify case as local/ imported case.
If local --> register case -->notify state Vector Unit (JKN) --> prepare investigation report -->further action
If imported -->notify state Vector Unit (JKN)
For routine action, an aedes survey is carried out everyday. It is done to see if there are potential breeding spots for the Aedes mosquitos and preventive fogging will be done if the results at the end of the survey indicates potential for mosquito breeding.
During the Aedes survey, the results are based on specific indexes.
>Aedes Index:
The percentage of houses in a specific location that has a positive breeding ground for Aedes. (In percentage
= Num. of houses positive for Aedes x 100%/
Num. of houses investigated in the specific location
If > 1%, sensitive for Outbreak of Dengue
Breteau Index
The number of containers that is positive for Aedes mosquito breeding in 100 houses. ( in numbers)
Num. of containers positive for Aedes x 100/
Num. of houses investigated in a specific location
If > /= 5 , sensitive for Outbreak of Dengue
Container Index
The percentage of containers in a specific location that is positive for Aedes mosquito breeding. ( In percentage)
= Num. of containers positive for Aedes x 100%/
Number of containers investigated in a specific location
If >/= 5, sensitive for Outbreak of Dengue
During the Aedes survey, the number of containers is noted and the number of it which contains larva. Abate 1.1G will be put into the containers that contain larva. A sample of the water which contains larvae will be sent to the Entomologist in Alor Star. If its confirmed that the larvae is an Aedes, a compound will be imposed at RM100 for housing area, RM150 for government sectors ,and RM500 for factories. The payment is to be made at the District Health Office. If failed to do so, a warning will be given and if persistent failure to pay, a court order will be sent out. If the container does not contain any larva, advise to remove that container will be given to the residents. A warning notice of 5 days will be given and if still present after 5 days, compound will be imposed.
For an outbreak of Dengue fever, an Aedes survey is to be done as above and then fogging is done.
Fogging
Before fogging is done, the families will be informed beforehand and asked to cover all food as well as leave the door open. Those who rear birds and chickens are asked to keep them out of the sight and smell of the fog.
It is usually done for a radius of 200 metres and usually done in the morning or evening around 6 pm-7 something when the mosquitos are known to be out. If there is an outbreak of Dengue fever,fogging will be done 4 times consecutively with an interval of 7-10 days between each fogging. If there is a confirmed case of Dengue Fever but no outbreak, fogging will be done 3 times consecutively with an interval 7-10 days between each fogging. For routine fogging, it is only 2 times consecutively with an interval of 7-10 days between each fogging. The reason for the interval of days is due to the life cycle of the Aedes mosquito.
The normal equipment used for fogging is the Thermofog and the Ultra Low Volume(ULV)machines. A mixture ofpoison and diesel is needed to make it appear as fog. The common poisons used are
• Malathion
• Resigen
• Aqua resigen – to be put into ULV
• Abate 1% - distributed to the public( 1 time )
• Abate 500 Emulsion- only for larvaciding ( 1ml Abate mixed with 1000 ml of water) *not poisonous to humans nor animals*
MALARIA
It is transmitted by a female Anopheles mosquito. It is a mosquito common from streams, jungle area, seaside, paddy fields. There are no specific seasons for Malaria and no specific areas.
Most of the cases in Sik are all imported cases.
Incidence Of Malaria in Sik * accurate statistics were not fully disclosed as it was confidential*
2006 --> ~3 cases
2007 --> ~ 6 cases
2008 --> ~ 7 cases
2009 --> ~ 1 case
Strategies
a. Routine hunt for foreign workers from Myanmar, Thailand, Bangladesh, India, Indonesia. It is done everyday and targeted 80% of foreign workers. Blood smears will be taken from every single foreign worker and slides are sent to Alor Star Hospital. There are around 4400 slides in one year. This was implemented since year 2000.
b. Fogging will be done only if there is a confirmed case of Malaria. The time done for fogging is usually done from 9-12pm 3 nights in a row. Other than the normal types of fogging as for dengue, there is another specific type of fogging for Malaria and that is the Focal Spray where the fog containing the poison is sprayed onto the walls. This is so that when the mosquito rests on a wall, the poison absorbs through its legs into its body killing it slowly.The type of poison is K- Othrine and is available in 2 forms ; the powder form and the liquid form. The liquid form is the one most commonly used in the Focal Spray.
c. Night trapping is also done but mostly in Alor Star.
d. Medicated Mosquito Nets is given to the residents with incidence of Malaria. These nets are soaked with K-Othrine and then dried up.
e. Flyers, brochures and posters on Malaria are also given out to schools, housing areas periodically. Talks and advice will be given at the Malaria-prone areas to educate the residents on Malaria and the prevention methods. This is done in conjunction with the Health Promotion Department
FILARIASIS
There is one case of filariasis in Sik this year and it is an imported case from India. There are no endemic cases of filariasis in Sik. It is transmitted by the Mansonia mosquito from the infected individual. The strategies for controlling Filariasis are the same as for Malaria except that the fogging done for Filariasis is usually done at 5 something in the evening. The blood smears for Filariasis can only be taken from 9pm- 12 pm as the antigen only appears in the bloodstream during that time.
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