VECTOR BORNE DISEASE CONTROL UNIT
Set off from Pejabat Kesihatan Daerah (though we reached there earlier…)
More than 6 of staff members of the Vector unit departed in their vans, while we pursued them in cars.
Reached site at Kg Nelayan, Kuala Kedah.
Here we were split into two groups ,one of 5 and the other of 4 members respectively.
The two groups took samples from different houses in Kuala Kedah.
One of the staff sprayed Abate (liquid) in drains. Within housing area where water samples were taken for larvae, packets with Abate were dissolved. Abate is a liquid based insecticide(composition-1ml Abate in 8L water).
Permission is first obtained from the house owner before sample is taken. There were some houses without people in which case a notice is stuck in front of their house, informing them that their house will be surveyed the following day.
A sample may be taken from a house just for indexing purposes, in the event the larvae turn out to be Aedes larvae.
Water samples are taken from a house with stagnant water collections from the outside of house-flower pots and other places.
Water is sampled by a pipette to obtain a sample of at least 5 larvae.
The sample can be concentrated by draining off excess liquid in order to collect more larvae.
Sampling either done in areas where Aedes is endemic or from where dengue cases have been reported in the past or where there has been a report of a case of dengue. Even a single case of dengue reported warrants a sampling from that site.
Fogging is done later in the evening.
We came to know how to differentiate Culex larvae from Aedes larvae -Culex larvae swim at the top while Aedes swim at the bottom in the water sample taken.(it was interesting to peer at the water sample seeing a majority of them swimming at the top).
Also, only houses, stalls, other premise owners with Aedes larvae alone are fined, those found with culex larvae aren’t subject to it.
Also sampled was a nearby lake area which had sacks of cans left for disposal and lots of larvae were found swimming on top of sample.
Hence our morning passed by…
Our day resumed after staff and we had lunch. We assembled in the vector unit which had fascinating models of the different mosquito vectors and their distinct features such as the stripes on their body.
We were briefed by a busy female member of Vector unit about Vekpro.
Each case’s particulars were entered in detail in this data base including:
Details of time –year, week and what time, Person who registered it-Medical assistant, doctor or nurse.
Details of person-Patient details-address, IC
Details of place- the registration no. of district are taken
Also present are details of the hospital where the patient registered- hosp. registration no., ward name. There are three hospital codes-
HK-Hosp. Kerajaaan-govt. hosp
HS-Hospital Swasta- private hosp
KS-Klinik Swasta- private clinic
The lab result of patient’s blood profile such as PC, Prothrombin time, Platelet count bleeding and Clotting time present
Each patient is assigned to be treated by his district. Investigation is done about the recent movements of the patient- if he traveled to an Aedes endemic area and acquired the case there then he is treated as an imported case-kes import while if he caught dengue from his own place of stay where dengue is /is not prevalent-he is classified as a local case-kes tempatan.
Dengue cases are classified into three- dengue fever, dengue hemorrhagic fever, death due to dengue.
Based on patient details 3 places in Kedah were identified to have dengue outbreaks-data for which is being compiled.
We were given information leaflets on dengue.
Next we were briefed by a member of fogging unit.
He told us about the water based and oil base mixtures used for fogging
Aqua Resijen=0.16 L Aqua + 8L water
Acettellic= 0.32LAcetellic + 8L diesel
Abate500E = 0.001L Abate + 8L water
Acetellic= 0.16L in 1 case
Aqua res=0.08L in 1 case.
These are in 1 case used for foggers who fog manually. This is practiced usually and covers a perimeter of 200m.
If the workers aren’t enough then ULV is used this mans that the vehicle does the fogging. This spans a perimeter of 400m. This has a composition of 10L acetellic+15 L diesel.
We set off for fogging and reached College cum hostel of trainee medical assistants (female), Alor setar- Kolej Asrama Penolong Pegawai perubatan at 6.20pm.
A female candidate was reported to have dengue here hence the fogging.
The officers garbed themselves with the protective equipment- orange overalls, yellow caps, face masks, ear muffs and protective boots
The fogging tanks are known as Agrofogs. These agrofogs had gone through several startup trials at the PKD itself. They were unloaded from the trucks and some of them were filed with water base formulae while others were filled with oil based formulae after filtering the formulae. The former were for spray within the hostel premises while the latter for the area surrounding it. 4 areas were targeted for fogging.
The staff kindly demonstrated how to carry these heavy Agrofogs upon seeing our interest. Some of our heroes and heroines posed for pics with the machines as you may see(pictures to be uploaded later).
The strong (Ahem…) boys were selected to help the foggers with their equipment while we girls stood aside to watch. Unfortunately the staff didn’t have any spare protective equipment for us so even the boys found themselves running off the smoke…
So ended a tiring, informative but fun day