Malaysia: 10 cumulative fatalities from Melioidosis & Leptospirosis in Bakun Dam area

[Ronan Kelly]

Mysterious deaths in Bakun Dam area
Joseph Tawie | August 1, 2011

Despite being notified of several mysterious deaths in the Bakun area, the Sarawak Health Department has done nothing.
KUCHING: Ten people who were hired by the Sarawak Forest Corporation (SFC) to ?save? animals from being drowned, following the impoundment of the Bakun Dam, are now dead.

The dam was impounded in October last year. The 10 dead were allegedly killed by a mysterious disease.

Although the Health Depatment has been notified, it has done nothing, Bakun Community Safety Committee chairman Dr Ellie Luhat said today.

Luhat said the latest such death was 28-year-old Larry Kiding, a SFC worker who worked on the project.

Kiding?s father, Jugah Anak Kudi, told FMT that his son fell gravely sick after returning from Bakun Dam.

?We sent him to the hospital, but the hospital did not know what caused his sickness. We sent him to a private clinic. Again, we were told that the doctor could not determine what made him sick.

?Two days later he passed away,? said Jugah.

Angry and dissatisfied, Jugah asked for a post-mortem to be conducted on his son.

According to him, the doctors again could not determine the cause of his death.

The death of Jugah?s son came to light after Luhat called for an investigation into the death of the 10 SFC workers.

He believes they could have been exposed to infectious and deadly diseases such as melioidosis and leptospirosis (known locally as ?penyakit kencing tikus?).

?So far 10 persons have died from the mysterious diseases and a number of others have been infected,? said Luhat.

Also in critical condition is the village penghulu (chief) who is in Bintulu Hospital.

More deaths

The penghulu was transported to the Bintulu Hospital when he collapsed during the recent visit of Deputy Chief Minister Alfred Jabu Anak Numpang to the dam.

?They (the 10 workers) were involved in moving large animals from the Bakun Dam water catchment area to higher ground and fell sick upon completion of the work.

?There have also been several mysterious deaths over the years in that area including a cousin of mine.

?Because of this, we want the government to confirm and identify the diseases, so that immediate and remedial actions can be taken.

?This may include vaccination,? Luhat said.

Melioidosis is caused by a bacterium (burkholderia pseudomailei) found in soil, rice fields and stagnant waters.

Victims acquire the disease when the contaminated soil comes in contact with an abraded area of the skin.

Leptospirosis is caused by bacteria called spirochete and is transmitted through contact with infected soil or water.

...

http://www.freemalaysiatoday.com/2011/08/01/mysterious-deaths-in-bakun-dam-area/

Leptospirosis and melioidosis fatalities were reported from this area last year.
http://www.flutrackers.com/forum/showthread.php?p=368419
http://www.flutrackers.com/forum/showthread.php?t=149080

 

[alert]

Re: Malaysia: 10 fatalities in Bakun Dam area - Melioidosis? Leptospirosis?

Re: Malaysia: 10 fatalities in Bakun Dam area - Melioidosis? Leptospirosis?

I have to wonder whether this is an echo story or a cumulative report. The last posts of the thread:

http://www.flutrackers.com/forum/showthread.php?t=149080&page=2

from last year clearly identify nine known fatalities, and indicate a tenth fatality as an unidentified laborer, which would be consistent with the above article. There are no dates at all in the new story. Apparently, the dam itself is going to open in a few days on August 6 (http://thestar.com.my/news/story.asp?file=/2011/7/7/sarawak/9043968&sec=sarawak), and rehashing the deaths might be a way of protesting it.

Still no new reports in any other Malaysian sources.

 

[Ronan Kelly]

Re: Malaysia: 10 fatalities in Bakun Dam area - Melioidosis? Leptospirosis?

Re: Malaysia: 10 fatalities in Bakun Dam area - Melioidosis? Leptospirosis?

Deadly diseases strike fear in resettlement
by By Samuel Aubrey, reporters@theborneopost.com. Posted on July 30, 2011, Saturday

KUCHING: Apart from bad road conditions, there is now a new problem affecting the residents of Bakun resettlement in Sungai Asap ? the risk of being exposed to infectious and deadly diseases such as melioidosis and leptospirosis (known locally as ?penyakit kencing tikus?).
Bakun Community Safety Committee (BSCS) chairman Dr Elli Luhat said yesterday the recent fatal cases involving four Sarawak Forestry staff, suspected to be caused by one of the diseases, has been a cause of concern and constant worry among the people there.

According to Elli, he was informed of the deaths two weeks ago. The deceased staff members were involved in moving large animals from the Bakun Dam water catchment area to higher ground and fell sick upon completion of the work.

This fear has been intensified after a penghulu was warded at the ICU unit at the Bintulu Hospital (BH) after becoming critically ill from suspected melioidosis or leptospirosis infection, he stated.

The penghulu was transported by helicopter to BH when he collapsed during a visit by a state minister to that area recently.

...
http://www.theborneopost.com/2011/07/30/deadly-diseases-strike-fear-in-resettlement/

Friday July 30, 2010
No reports of outbreaks in Bakun
By STEPHEN THEN
stephenthen@thestar.com.my


MIRI: There is no information blackout of health tragedies or a disease outbreak in the Bakun hydro-electric dam project site in the Belaga district, state leaders and the developer of the project said yesterday.

Deputy Chief Minister Tan Sri Dr George Chan Hong Nam, who is State Disaster Relief Committee chairman, said he had not received any information of nine workers in Bakun dying from melioidosis and leptospirosis (caused by rat urine bacteria) infection or that 50 other workers had contracted the disease while working at the site.

?Someone had asked me about this. Personally, I have not received any information from the health authorities about such deaths or of a disease outbreak in Bakun,? he told The Star yesterday.

...

Hulu Rejang MP Datuk Billy Abit Joo said he had not heard about any outbreak in Bakun, which is under his parliamentary constituency. Environmental watchdog group Borneo Resources Institute director Raymond Abin said his institute had not received any report about the outbreak either.

?We have not received news of fatalities in Bakun but there is currently an outbreak of chikugunya and malaria in the region. Anyway, the Bakun dam site is out of bounds to outsiders, so we do not know the condition of the workers in the Bakun and Murum areas,? Abin said.

An online news portal had claimed that nine Bakun workers had died and 50 others infected by melioidosis and leptospirosis and that a high-ranking government officer in Sarawak had barred the release of any such information.

...

http://thestar.com.my/news/story.asp?file=/2010/7/30/nation/6763314&sec=nation

Saturday July 30, 2011
Villages concerned over mystery deaths
By SHARON LING
sharonling@thestar.com.my


KUCHING: Villagers in the Bakun resettlement area are concerned about the possible occurrence of me-lioidosis and leptospirosis, two infectious bacterial diseases, in their area.

Bakun Community Safety Committee chairman Dr Elli Luhat said several ?mystery deaths? had occurred in the area recently while a village headman was currently warded at the Bintulu hospital.

?The symptoms appear similar to melioidosis, which is an infectious disease caused by bacteria in contaminated water and soil.

...

http://www.thestar.com.my/metro/story.asp?sec=sarawak&file=/2011/7/30/sarawak/9204755

One response to the story above; (machine translated)

belagakini Says:

August 1, 2011 at 3:53 am

Head of our society (Headman Moses Talik) is still lying stiff in Bintulu Hospital ICU. The results showed that he was attacked early diagnosis Bekteria Estate (Meliodosis). Belagakini on 29 July 2010 last year to report the possibility of secret Meliodosis disease in Bakun. Teryata is true, why the disease is kept still a question mark?

If I am not mistaken Malasiakini online news portal has also revealed the disease that attacks people Meliodosis Belaga. Yet all of these reports looked deserted by the government.

If I have power, I will ask the help of experts from several local and international universities to uncover all the mysteries of this membigungkan. To me, safety and health of the Bakun is more important than politics and business.

What people should continue to be silent Belaga and just waiting for the deadly bacteria invites us .????


...

http://belagakini.wordpress.com/2011/07/30/villages-concerned-over-mystery-deaths/

 

[Ronan Kelly]

Re: Malaysia: 10 fatalities in Bakun Dam area - Melioidosis? Leptospirosis?

Re: Malaysia: 10 fatalities in Bakun Dam area - Melioidosis? Leptospirosis?

Melioidosis suspected in Belaga deaths
2011/08/03
By Lian Cheng
news@nst.com.my


KUCHING: Belaga, especially in areas around the Bakun hydroelectric project, has been rumoured of mysterious deaths and attack of acute sickness which Sarawak Health Department believes could be melioidosis.
Statistics released by the department stated that until July 23, there were 31 cases of melioidosis in Sarawak, with the highest concentration found in Kapit with 15 cases, and Belaga with 8 cases.

Elsewhere there were two cases in Tatau and one case each in Kuching, Serian, Sri Aman, Lubok Antu, Selangau and Bintulu.


There were already five fatalities due to melioidosis this year, with two deaths each in Belaga and Kapit and one in Tatau.


...

Last year, there was a total of 343 reported cases out of which 17 were fatalities -- Tatau 3, Selangau 2, Song 2, and one each in Kuching, Serian, Saratok, Mukah, Sibu, Kapit, Belaga, Bintulu, Lawas and Miri.

"This year, two clusters have been reported. The first cluster was 3 cases in Belaga and the second cluster was 3 cases in Iron Wall Logging Camp, Kapit.

...

Land Development Minister Tan Sri Dr James Masing urged the relevant authorities to take the cases seriously.

Masing testified that his brother-in-law, Penghulu Musa Talek, who is a resident of Belaga, was admitted to Bintulu Hospital last week suspected of suffering from medioidosis. Musa is now in recovery and has been reacting positively to the medication.



Read more: Melioidosis suspected in Belaga deaths http://www.nst.com.my/nst/articles/9mellos/Article#ixzz1Tu1nO9qX

 

[alert]

Re: Malaysia: 10 fatalities in Bakun Dam area - Melioidosis? Leptospirosis?

Re: Malaysia: 10 fatalities in Bakun Dam area - Melioidosis? Leptospirosis?

Here's a ProMED post. Can you send the above post on melioidoisis suspected to ProMED, RoRo? The mention of the recovering case in Bintulu Hospital rules this out as an echo/cumulative story.

Some of the speculation in the comments below seems unwarranted.

And the editors at ProMED may have further confused the matter by inserting "1 Aug 2010" as a date into the article where it is almost certainly incorrect.

http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,89606

Archive Number 20110802.2329
Published Date 02-AUG-2011
Subject PRO/EDR> Undiagnosed illness - Malaysia: (SK) RFI

UNDIAGNOSED ILLNESS - MALAYSIA: (SARAWAK) REQUEST FOR INFORMATION
*****************************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Mon 1 Aug 2011
Source: Free Malaysia Today (FMT) [edited]
<http://www.freemalaysiatoday.com/2011/08/01/mysterious-deaths-in-bakun-dam-area/>


A total of 10 people who were hired by the Sarawak Forest Corporation
(SFC) to "save" animals from being drowned, following the impoundment
of the Bakun Dam, are now dead. The dam was impounded in October last
year [2010]. The 10 dead were allegedly killed by a mysterious
disease. Bakun Community Safety Committee chairman Dr Ellie Luhat said
today [1 Aug 2010] that the latest such death was a 28-year-old SFC
worker who worked on the project. His father told FMT that his son
fell gravely sick after returning from Bakun Dam. "We sent him to the
hospital, but the hospital did not know what caused his sickness. We
sent him to a private clinic. Again, we were told that the doctor
could not determine what made him sick. 2 days later he passed away,"
said [the father]. Angry and dissatisfied, he asked for a post-mortem
to be conducted on his son. According to him, the doctors again could
not determine the cause of his death.

The death came to light after Luhat called for an investigation into
the death of the 10 SFC workers. He believes they could have been
exposed to infectious and deadly diseases such as melioidosis and
leptospirosis (known locally as "penyakit kencing tikus"). "So far 10
persons have died from the mysterious disease and a number of others
have been infected," said Luhat.

Also in critical condition is the village penghulu (chief) who is in
Bintulu Hospital. The penghulu was transported to the Bintulu Hospital
when he collapsed during the recent visit of deputy chief minister
Alfred Jabu Anak Numpang to the dam.

"They (the 10 workers) were involved in moving large animals from the
Bakun Dam water catchment area to higher ground and fell sick upon
completion of the work. There have also been several mysterious deaths
over the years in that area including a cousin of mine. Because of
this, we want the government to confirm and identify the diseases, so
that immediate and remedial actions can be taken. This may include
vaccination," Luhat said.

Melioidosis is caused by a bacterium (_Burkholderia pseudomallei_)
found in soil, rice fields, and stagnant waters. Victims acquire the
disease when the contaminated soil comes in contact with an abraded
area of the skin. Leptospirosis is caused by a bacterium called a
spirochete [_Leptospira interrogans_] and is transmitted through
contact with contaminated soil or water.

Luhat, who is a retired Sarawak Timber Development Corporation (STIDC)
officer, has been actively involved in the dam. He believes that the
change of biodiversity could have resulted in the spread of the
diseases. Local people believed that the "spirits" of the jungles are
angry over the construction of the dam and the destruction of the
surroundings. They believed their dead ancestors are also angry that
their graves (pendam) have been submerged by the dam water.

Luhat said that he is sending letters to the relevant authorities to
alert them of the mysterious deaths. "These diseases can affect the
tourism industry apart from the lives of the workers and the local
people. The diseases can also affect the government's plan to
introduce aquaculture of 'empurau', which is Sarawak's most famous and
expensive fish," he said, adding that the death of several tonnes of
fish early this year [2011] could have been due to these diseases.

[Byline: Joseph Tawie]

--
Communicated by:
Merritt Clifton
Editor, Animal People
PO Box 960
Clinton, WA 98236
USA
<anmlpepl@whidbey.com>
<http://www.animalpeoplenews.org>

[Very little information is given in this news release as to the
clinical manifestations, epidemiology, or laboratory findings to make
a differential diagnosis, other than a fatal illness following
exposure to soil and water in construction of a dam in a tropical
region of the world and diagnoses of melioidosis and leptospirosis
were being considered, in which case, the illness was presumably
febrile. There were non-fatal cases, but their number is not given.
Many etiologic agents could be responsible for an undifferentiated
febrile illness.

The following has been extracted from moderator ML's comments on the
possible etiologies of an acute non-specific febrile illness in
ProMED-mail post Undiagnosed illness - Mexico: (SL) RFI
20110720.2190:

"Acute undifferentiated febrile illnesses, that is, occurring in the
absence of an obvious focus of infection, have several possible
etiologies that vary with the geographic region in which they occur
(1-3). Some are rodent-associated, such as, leptospirosis,
_Hantavirus_ infection, _Bartonella_ infection, tularemia, and murine
typhus. …. Other possible etiologies include scrub typhus, dengue,
chikungunya, malaria, brucellosis, enteric fever, and melioidosis.

The clinical manifestations and the epidemiological features of
_Hantavirus_ infection and leptospirosis can be strikingly similar
(4). Tularemia and leptospirosis can be acquired from contact with
water contaminated by the urine of infected reservoir host animals;
melioidosis is also acquired by contact with contaminated water.
However, melioidosis is usually endemic in parts of Southeast Asia and
northern Australia ….

"Scrub typhus is restricted to a region that extends from northern
Japan and far-eastern Russia in the north, to northern Australia in
the south, and to Pakistan and Afghanistan in the west."

References
----------
1. Manock SR, Jacobsen KH, de Bravo NB, et al: Etiology of acute
undifferentiated febrile illness in the Amazon basin of Ecuador. Am J
Trop Med Hyg. 2009; 81(1): 146-51. Available at
<http://www.ajtmh.org/content/81/1/146.long>.
2. Suttinont C, Losuwanaluk K, Niwatayakul K, et al: Causes of acute,
undifferentiated, febrile illness in rural Thailand: results of a
prospective observational study. Ann Trop Med Parasit. 2006; 100 (4):
363-70. Available at
<http://www.ingentaconnect.com/content/maney/atmp/2006/00000100/00000004/art00008>.
3. Chrispal A, Boorugu H, Gopinath KG, et al: Acute undifferentiated
febrile illness in adult hospitalized patients: the disease spectrum
and diagnostic predictors -- an experience from a tertiary care
hospital in South India. Tropical Doctor 2010; 40(4): 230-4. Abstract
available at
<http://td.rsmjournals.com/cgi/content/abstract/40/4/230>.
4. Clement J, Neild G, Lemos Hinrichsen S, et al: Urban leptospirosis
versus urban hantavirus infection in Brazil. Lancet 1999; 354(9194):
2003-4. Available at
<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)76782-9/fulltext>.

Specifically for Malaysia, _Bartonella_ have been detected in animal
ectoparasites in Malaysia
(<http://www.msptm.org/conference/program/47-Student-Oral.pdf>).

Large numbers of patients with potentially fatal _Plasmodium knowlesi_
infection (simian malarial species) have been reported in Sarawak
(Cox-Singh J, et al: _Plasmodium knowlesi_ malaria in humans is widely
distributed and potentially life threatening. Clin Infect Dis. 2008;
46(2): 165-71;
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2533694/>); and tick
typhus has been reported to be the most common rickettsial infection
in rural Sarawak
(<http://www.thaiscience.info/journals/Article/Research%20note-%20rickettsial%20infection%20in%20five%20remote%20orang%20ulu%20villages%20in%20upper%20rejang%20river,%20sarawak,%20malaysia.pdf>).
A more detailed description of the clinical manifestations,
epidemiology, and laboratory data in the outbreak at the Bakun Dam is
clearly needed.

The controversial (see <http://www.malaysiakini.com/news/130982>)
hydroelectric Bakun Dam, the 2nd tallest concrete-faced rock-fill dam
in the world, is under construction on the Balui River in Sarawak,
Malaysia (<http://en.wikipedia.org/wiki/Bakun_Dam>). The Bakun dam
flooding began on 13 Oct 2010.

Sarawak can be located on the HealthMap/ProMED-mail interactive map at
<http://healthmap.org/r/15-V> - Mod.ML]

[The crew of 10 that died was hired to "save" animals from drowning
following the closure of the Bakum dam. The denominator is not given,
but as you don't need many people to move cattle it was probably near
100% mortality, and they were working in a flooded environment.
Considering the frequency of leptospirosis in adventure racers in
backcountry areas it could have been leptospirosis, though the reports
list no animal deaths or illness. But we have both wild and domestic
animal shedders and in the right conditions the organism can persist &
multiply in shallow water. But such high mortality rates are unusual
with this disease, and it would be relatively straightforward to
diagnose.

On the other hand Nipah virus was recorded in pigs, dogs and cats in
Kuching, Serian and Sibu districts of Sarawak, which were consequently
declared Nipah virus-infected areas in 1999. And this infection
carries a high mortality risk. The absence of Nipah reports in Sarawak
during the past 10 years can be interpreted in many ways, but one
might be clinical unawareness. See 19990606.0957, and also
20000722.1214, 20000710.1148, 20000707.1127.

-Mods. AS & MHJ]

 

[Ronan Kelly]

Re: Malaysia: 10 fatalities in Bakun Dam area - Melioidosis suspected

Re: Malaysia: 10 fatalities in Bakun Dam area - Melioidosis suspected

No mystery in deaths
by Peter Sibon, reporters@theborneopost.com. Posted on August 3, 2011, Wednesday


Bakun Dam - Photo from File
State Health director confirms deaths in Bakun caused by melioidosis and leptospirosis debunking claims of ancestral curses
KUCHING: State Health director Dr Zulkifli Jantan put an end to speculations on mysterious diseases and curses from angry spirits in the Bakun area by confirming that three deaths reported in the Bakun area recently were caused by melioidosis and leptospirosis in a press statement yesterday.

A news portal claimed the people of Bakun believed that the deaths were caused by spirits of the jungle who are angry over the construction of the dam and the destruction of the surroundings.

They also believed that their dead ancestors are also very angry that their graves have been submerged by the dam water.

Dr Zulkifli added that the claim by the news portal that ten people hired by the Sarawak Forestry Corporation (SFC) to save animals from being drowned following the impoundment of the Bakun Dam had died from the mysterious disease was wrong.

He clarified that the ten fatalities were actually the total number of people in the state who died from melioidosis and leptospirosis from January to July
23.

The online report said that the latest victim of the disease was one Larry Kiding, a 28-year old SFC worker who worked on the project.

The father of the deceased, Jugah Kudi was quoted to have said that his son fell gravely ill after returning from Bakun Dam and died two days later.

Besides the Bakun area, two fatal cases from melioidosis were reported in Kapit and one fatal case reported in Tatau.

Apart from the deaths reported in Bakun area, one fatal case was reported in Kuching, Sri Aman, Betong and Limbang during the same period.

?To date, two clusters have been reported on melioidosis, namely in Bakun Hydroelectric project (Belaga) and the second was in Iron Wall Logging Camp in Kapit,? said Dr Zulkifli.

There were 31 cases of positive melioidosis detected in Sarawak since the beginning of the year to July 23 compared to 343 reported cases in 2010.

As for leptospirosis, there were 51 positive cases reported from the beginning of the year to July 23 compared to 49 total cases last year.

Dr Zulkifli disclosed that under the Preventive and Control of Infectious Disease Act and Regulations 1988 might close the contaminated areas or sources of the diseases.

?We will alert the public regarding the possible hazards from the contaminated area. Health hazard warning signage will be erected in specific areas that are confirmed to be sources of infection,? he said.

He added that the department was giving health education talks on the two diseases to the public.

Dr Zulkifli also advised members of the public who were at risk to seek treatment early if they had symptoms such as fever, cough, chest pain, body ache, chronic ulcer/wound and had a history of exposure to outdoor water.

http://www.theborneopost.com/2011/08/03/no-mystery-in-deaths/

 

[alert]

Re: Malaysia: 10 cumulative fatalities from Melioidosis & Leptospitosis in Bakun Dam area

Re: Malaysia: 10 cumulative fatalities from Melioidosis & Leptospitosis in Bakun Dam area

http://www.freemalaysiatoday.com/2011/08/03/‘mysterious-deaths’-due-to-two-diseases/

?Mysterious deaths? due to two diseases
Joseph Tawie | August 3, 2011 The Sarawak Health Department has dismissed allegations that the 10 workers who died were directly linked to the Bakun dam project.
KUCHING: After months of silence, the Sarawak Health Department has finally admitted that the ?mysterious deaths? of ?some? of the 10 people working in the Bakun dam area was due to fatal diseases known as melioidosis and leptospirosis.

Sarawak Medical Services director Dr Zulkifli Jantan said not all of those dead were from the Bakun dam.

Responding to an FMT news report, he said the10 fatalities were actually the total number of people who died from melioidosis and leptospirosis from January to July 23 in the state.

?The 10 persons are not exclusively from the Bakun area.

?The deaths were also from Kuching, Limbang, Betong, Tatau, Belaga, Kapit and Sri Aman.

?Apart from the deaths reported in Bakun area, one fatal case was reported in Kuching, Sri Aman, Betong and Limbang during the same period.

?To date, two clusters have been reported on melioidosis namely in Bakun hydroelectric project (Belaga) and the second was in Iron Wall logging camp in Kapit,? said Zulkifli in a statement.

But the statement did not clarify if the ?few? who died from the diseases were those who worked in the Bakun area.

Thousands of workers from all over the state have been working in the Bakun project.

According to Zulkifli there were 31 cases of positive melioidosis detected in Sarawak since the beginning of the year to July 23 compared to 343 reported cases in 2010.

There were 51 positive cases of leptospirosis reported from the beginning of the year to July 23 compared to 49 total cases last year, he said.

Affected areas may be closed

Zulkifli said that under the Preventive and Control of Infectious Disease Act and Regulations 1988, the affected areas might be closed to the public.

He said that the department will alert the public regarding the possible hazards from the contaminated areas.

FMT had reported on Monday that 10 people hired by the Sarawak Forest Corporation (SFC) to ?save? animals from being drowned, following the impoundment of the Bakun Dam, were dead as a result of a mysterious disease.

The latest victim was Larry Kiding, a 28 year old SFC worker. He died in Kuching after returning from the dam.

Local villagers have speculated that the deaths were a result of angry ?spirits? in the junge which have cast a curse on the area. They claimed the ?spirits? were upset that their jungle was destroyed and their ancestors graves submerged by the dam water.

Dismissing these claims, Zukifli said: ?The deaths were caused by the two diseases."

 

[alert]

Re: Malaysia: 10 cumulative fatalities from Melioidosis & Leptospitosis in Bakun Dam area

Re: Malaysia: 10 cumulative fatalities from Melioidosis & Leptospitosis in Bakun Dam area

http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,89621

Archive Number 20110803.2341
Published Date 03-AUG-2011
Subject PRO/AH/EDR> Undiagnosed illness - Malaysia (02): (SK) leptospirosis, melioidosis

UNDIAGNOSED ILLNESS - MALAYSIA (02): (SARAWAK) LEPTOSPIROSIS,
MELIOIDOSIS
*************************************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Wed 3 Aug 2011
Source: Borneo Post [edited]
<http://www.theborneopost.com/2011/08/03/no-mystery-in-deaths/>


Re: ProMED-mail Undiagnosed illness - Malaysia: (SK) RFI
20110802.2329
----------------------------------------------------------------------
State health director Dr Zulkifli Jantan put an end to speculations on
mysterious diseases and curses from angry spirits in the Bakun area by
confirming that 3 deaths reported in the Bakun area recently were
caused by melioidosis and leptospirosis, in a press statement
yesterday 2 Aug 2011].

A news portal claimed the people of Bakun believed that the deaths
were caused by spirits of the jungle who are angry over the
construction of the dam and the destruction of the surroundings. They
believed that their dead ancestors are also very angry that their
graves have been submerged by the dam water.

Dr Zulkifli added that the claim by the news portal that 10 people
hired by the Sarawak Forestry Corporation (SFC) to save animals from
being drowned following the impoundment of the Bakun Dam had died from
the mysterious disease was wrong. He clarified that the 10 fatalities
were actually the total number of people in the state who died from
melioidosis and leptospirosis from January to July 23 [2011].

The online report said that the latest victim of the disease was a
28-year old SFC worker who worked on the project. The father of the
deceased, was quoted to have said that his son fell gravely ill after
returning from Bakun Dam and died 2 days later.

Besides the Bakun area, 2 fatal cases from melioidosis were reported
in Kapit and one fatal case reported in Tatau. Apart from the deaths
reported in Bakun area, one fatal case was reported in Kuching, Sri
Aman, Betong and Limbang during the same period.

"To date, 2 clusters have been reported of melioidosis, namely one in
Bakun Hydroelectric project (Belaga) and the 2nd in Iron Wall Logging
Camp in Kapit," said Dr Zulkifli. There were 31 cases of positive
melioidosis detected in Sarawak since the beginning of the year to 23
Jul 2011 compared to 343 reported cases in 2010. As for leptospirosis,
there were 51 positive cases reported from the beginning of the year
[2011] to 23 Jul 2011 compared to 49 total cases last year [2010].

Dr Zulkifli disclosed that under the Preventive and Control of
Infectious Disease Act and Regulations 1988 [he] might close the
contaminated areas or sources of the diseases. "We will alert the
public regarding the possible hazards from the contaminated area.
Health hazard warning signage will be erected in specific areas that
are confirmed to be sources of infection," he said. He added that the
department was giving health education talks on the 2 diseases to the
public.

Dr Zulkifli also advised members of the public who were at risk to
seek treatment early if they had symptoms such as fever, cough, chest
pain, body ache, chronic ulcer/wound, and had a history of exposure to
outdoor water.

[Byline: Peter Sibon]

--
Communicated by:
Ronan Kelly
for FluTrackers.com
<ronankelly@comcast.net>

[Both melioidosis and leptospirosis are acquired from contact with
contaminated water. For a discussion of leptospirosis see ProMED post
Leptospirosis, fatal - Malaysia (02): (KH) 20100824.2971, and for
melioidosis, see Melioidosis - Australia (02): (NT) 20100325.0952.

The controversial hydroelectric Bakun Dam, (see
<http://www.malaysiakini.com/news/130982>) the 2nd tallest
concrete-faced rock-fill dam in the world, is under construction on
the Balui River in Sarawak, Malaysia
(<http://en.wikipedia.org/wiki/Bakun_Dam>). The Bakun dam flooding
began on 13 Oct 2010.

Sarawak can be located on the HealthMap/ProMED-mail interactive map at
<http://healthmap.org/r/15-V>. - Mod.ML]

 

[Ronan Kelly]

Re: Malaysia: 10 cumulative fatalities from Melioidosis & Leptospirosis in Bakun Dam area

The following comment [edited] was provided by Prof. TJ John, former Chair of the Department of Clinical Microbiology and Department of Virology, Christian Medical College, Vellore, Tamil Nadu, India;

"Perhaps this is a good opportunity to elaborate a bit on melioidosis for the education of readers. As a true soil saprophyte, moisture is not necessary for infection -- inhalation of dust can be one mode (remember VietNam tuberculosis in those related to helicopters). Rice cultivators get it from paddy fields -- yes they are man-made swamps.

Incubation period can be days to years; clinical disease may look like pyogenic, with abscesses anywhere from skin to brain, at one end of spectrum to granulomatous lesions -- looking very much like TB lesions, but without AFB [acid-fast bacilli] in tissue, and mistaken for TB not responding to treatment. Septicemic spread from old latent infection or pneumonia during acute infection -- both are associated with fatality, unless diagnosed quickly -- for that good microbiology is necessary -- (and at first look it may be mistaken for pseudomonas and discarded as contaminant).

Naturally resistant to many antimicrobials -- ceftazidime seems to work well in most cases. The contrast with leptospirosis are too obvious."

FluTrackers thanks Prof. John for this information and for his continuing work on strengthening healthcare in India and elsewhere