Person-in-charge: Mr Ooi Tean Look (PPKP U29)
Main Objective
To break the chain of the incidence of all communicable diseases via food/drink, air, droplets, contact and so on by carrying out investigations as well as identifying the source of contamination and to take preventive measures in order to control the spread of those diseases so as not to create any health problem to the public
Specific objectives
1. to reduce the endemic of communicable diseases to a minimum level
2. reduce the frequency and duration of outbreak diseases
3. to increase the awareness among the community regarding communicable diseases and preventive measures through health education
Strategy
1. strengthen the surveillance system
2. create proper control and preventive measures
3. to identify the more effective integration in controlling communicable diseases in health care services
4. to identify and use the latest technology in controlling communicable diseases
5. to enforce the law with regards to communicable diseases
6. develop a relationship between agency in controlling and preventing communicable diseases
7. to involve the community directly in communicable disease control programs through effective health educations
Duties in prevention and control of communicable diseases
Health inspector who carries out prevention and control of communicable disease (CD) is firstly elected as Pegawai Diberi Kuasa under part 1 section 2(1) Prevention and control of communicable diseases Act 1988.
1. to record all cases of communicable diseases for investigation and to identify their status daily, weekly, monthly and yearly.
2. to prepare daily, weekly, monthly, half yearly, and yearly reports about cases of CD as per order from time to time
3. to carry out immediate investigation on all cases of CD which are reported to health officer to identify the cause and to control the disease from spreading
4. to carry out disinfection and disinfestations
5. to analyse all the cases and recommend control and preventive measures to district health officer
6. to give immunization to contacts to prevent the spread of diseases
7. to take samples such as blood, stool, sputum, vomitus, left over food, and so on for investigation and to determine the cause of infection
8. to be part of the health team in carrying out jobs related to outbreak and natural disaster
9. to prepare and update all graphs, maps and important datas related to CD
10. to analyse all the datas collected and prepare reports to district health officers
11. to search and do contact tracing as well as carry out control and preventive measures to prevent the spread of disease
12. to prepare and take legal actions on cases related to CD
13. to carry out epidemiological studies in control and surveillance of CD
14. to observe and quarantine the family members or contacts for the control and prevention of CD
15. to give talk on CD to the community so that they are able to understand more about CD and help in the process of controlling the spread of CD
A Rapid Response Team will be formed if it is necessary
The namelist for Rapid Response Team of Kota Setar District is as below
1. Dr. Abu Hashim Ahmad – District Health Officer(DHO) 1
2. Dr. Nor Azian Abd. Wahab – DHO 2
3. Mr. Mansor Yunus – PPKP U36
4. Mr. Hasan Abidin – PPKP U32
5. Mr. Mohd. Fauzi Mohd. Noor – PPKP U32
6. Mr. Abdullah Ahmad – PPKP U32
7. Mr. Ooi Tean Look – PPKP U29
8. Mr. Heazie Mazuar Mustaffa – PPKP U29
9. Mr. Redhuwan Md. Noor – PPKP U29
10. Mdm. Azilah Ismail – Sister U36
11. Mdm. Azizah Ariffin – Sister U32
12. Mr. chong koy seng – Medical assistant U36
13. Mr. Azman Ahmad – Health education officer U41
When an outbreak has occurred, an operation room will be activated
The operations rooms is activated when an infectious disase outbreak is confirmed. The nature of the infectious disease outbreak is when
- occurrence of infectious disease with high mortality
- unusual ocurances of disease/death in any area
- bioterrorism threats
- global alert on any relevant infectious disease
- when ordered by higher authority
At this district, the officers below involves in setting up the operation room
- district medical officer of health
- hospital director state deputy director of health
- state director of health
In Kota Setar district, the most important outbreaks will be Food Water Borne diseases, Hand Foot Mouth disease, and currently H1N1
Food poisoning outbreak
Defined as two or more individuals who experience a similar illness after eating a common food or different food from a common place
The notification form of Food water borne diseases: FWBD/UMU/BG/001
Aims
To identify the cause, the risk factor(s), or source of infection
To implement interventions, or corrective actions, to prevent others from becoming ill
To evaluate existing recommendations or strategies for preventing similar outbreaks
To learn more about the public health implications of foodborne pathogens
Steps in Food poisoning investigation
1. Determine that an outbreak has occurred
2. Contact and coordinate with key personnel
3. Obtain human and food samples for laboratory testing
4. Implement control and prevention measures
5. Organize the information related to the outbreak
6. Develop possible hypotheses
7. Plan and conduct the epidemiologic outbreak investigation
8. Analyze the data collected
9. Interpret the results and form conclusions
10. Report investigation methods and findings
The flow chart of controlling Food poisoning is as below. However, the flow chart can be apply to investigation of outbreak for cholera, thyphoid, B. Cereus and other food borne diseases
Influenza A/H1N1
A patient under investigation of Influenza A/H1N1 virus infection is defined as an individual presented with
1. fever
2. cough, sore throat, body ache, difficulty in breathing
3. close contact with person diagnosed as H1N1 or within 7 days of travel to an area reporting cases of confirmed H1N1
* All patients diagnosed to be affected by H1N1 virus are required to fill in the KKM/BKP/SF/2009/1 form, which is shown below
Screening
All patients fulfilling criteria for PUI should be screened at
1. the emergency departments of designated hospitals (e.g Hospital selayang, serdang, and Ampang)
2. screening sites at the Point of Entry of the country
Management of patient.
a) hospital admission
- patient with suspected complications related to H1N1 infection
- patient with significant co-morbidities (e.g. COPD, pregnant women, Chronic diseases, Immunosuppressed patient)
b) 24 hour home quarantine
- patients fulfilling the case definition of PUI will have their throat/ nasopharyngeal swabs taken at the screening sites.
- They will be sent home for quarantine for 24 hours while awaiting their throat swab results
- Those who have been exposed in United States of America, Melbourne and Manila will also be provided with 2 days of influenza antiviral
- If results are positive, they will be brought to hospital
* the patients from these 3 destinations can return home in their own vehicles. If the patient return home with public transportation, they should be given a mask and counseling regarding its proper usage
The flow chart for investigation of H1N1 case in the whole Kedah state is as below
Hand Foot Mouth Disease
Hand foot mouth diseases (HFMD)
HFMD is a very common disease in Kota Setar district. The outbreak is defined as the occurrence of two or more cases in the same locality within the incubation period.
When a suspected outbreak is reported, it is important to determine rapidly whether a true outbreak is occurring based on the definition above. Steps taken are listed as below:
1. Ensure that the infected children remain away from the institution for at least ten days after onset of symptoms and must be certified free from infection by a registered medical practitioner prior to returning to school
2. An assessment of the number of cases and susceptible population involved shall be made, and the overall attack rate and ate-specific attack rate computed
3. Active case detection shall be carried out among contacts in the institution and family, and all those with illness shall be referred for treatment at the nearest health clinics
4. when a case is observed or suspected to have unusual signs and symptoms e.g seizures, weakness or limbs, profound lethargy, refusal to play, the case shall be immediately referred to hospital
5. Swabs from oral ulcers and vesicular lesions on the hands and feet shall be collected for virus isolation at identified laboratories (IMR). If these ulcers and vesicles are no longer present, stool specimens shall be sent.
6. Principals, teachers and supervisors shall be alerted to look out for children with signs and symptoms
7. If closure is necessary, just close the affected class. Closure of the whole school is unnecessary as HFMD in older children (primary schools) is usually very mild. For younger children (such as in nursery), premise should be closed for two incubation period (10 days) from the date of onset of the last case
The form below has to be filled up by the health officer in charge with the outbreak.
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