Methanol outbreak in the district of Hulu Langat, 2018

Introduction: A methanol outbreak occurred in the district of Hulu Langat on 16 September 2018. The Hulu Langat District Health Office received 25 notifications of a suspected methanol poisoning from Kajang and Ampang Hospital. An outbreak investigation was done to determine the source followed by a preventive and control measure. Method: Active case detection was done on cases living quarters and workplaces. Patients were interviewed, and their blood and urine samples were sent for methanol analysis. Samples of suspected alcoholic beverages were also sent for analysis. A suspected case was defined as any person presented with clinical symptoms with a history of consuming alcoholic beverages within five days before symptoms and high anion gap metabolic acidosis. A confirmed case was defined as a suspected case with positive blood and urine methanol. Results: In total, there were 25 suspected cases, of which 12 cases were confirmed. The calculated attack rate was 48%. There were six mortalities (50%) secondary to severe metabolic acidosis. The most common presenting symptom was vomiting (75%) and abdominal pain (41.7%). These cases were linked to consumption of illicitly produced alcohol. Samples of the alcoholic drinks were positive containing high level of methanol. Conclusion: The methanol outbreak in the Hulu Langat was successfully managed. Appropriate control and prevention measures were taken, including health promotion and joint enforcement activities. Steps were taken successfully through collaborations with multiple agencies and cooperation with Selangor Health Departments and the Ministry of Health. Continuous surveillance on the product of liquor, and health promotion are essential to prevent a similar outbreak from happening again in future

The changing incidence of dengue fever in Hulu Langat, Selangor: a 5-year registry-based analysis

INTRODUCTION: Dengue fever, a mosquito-borne disease that occurs in tropical and subtropical areas of the world, is a significant threat for the mankind in both developing and developed countries. Dengue virus infection is a systemic disease and has dynamic change in clinical phase. This research aimed to study the epidemiology of dengue with reference to demographic profile, circulating serotypes and complications. METHOD: A literature survey was conducted and demographic data between 2014 and 2018 in e-Dengue registry were analysed to describe the epidemiology of dengue cases in Hulu Langat. RESULTS: The highest incidence rate, 254.3 per 100,000 population was recorded in 2015 (n=14,939). Urban subdistricts (88.3%), male (57%), Malay (61.5%), age group 18-40 years old (51%) and landed house (61%) contributed most of the cases. Case-fatality rate increased from 2014 to 2017 (0.0018 to 0.0022) but decreased in 2018 (0.0014). Out of 114 mortality, majority were male (53%), age 18-40 years old (46%) and Malay (63%). Complications recorded were liver failure (60%), renal failure (51%), encephalitis (18%) and myocarditis (18%). In year 2014-2015, DEN-1 serotype was dominantly reported (52.2% and 56.5%), shifted to DEN-3 in year 2016-2017 (34.8% and 43.4%) and DEN-2 in year 2018 (49.5%). DISCUSSION: Hulu Langat, being hyperendemic, the occurrence of multiple organ involvement following dengue infections has become a frequent finding. The study emphasizes the need of epidemiological and entomological surveillance to monitor trends in dengue distribution, seasonal patterns and circulating serotypes to guide dengue control activities, especially in rapidly growing urban and suburban areas

The changing incidence of dengue fever in Hulu Langat, Selangor: a 5-year registry-based analysis

INTRODUCTION: Dengue fever, a mosquito-borne disease that occurs in tropical and subtropical areas of the world, is a significant threat for the mankind in both developing and developed countries. Dengue virus infection is a systemic disease and has dynamic change in clinical phase. This research aimed to study the epidemiology of dengue with reference to demographic profile, circulating serotypes and complications. METHODS: A literature survey was conducted and demographic data between 2014 and 2018 in e-Dengue registry were analysed to describe the epidemiology of dengue cases in Hulu Langat. RESULTS: The highest incidence rate, 254.3 per 100,000 populations was recorded in 2015 (n=14,939). Urban sub-districts (88.3%), male (57%), Malay (61.5%), age group 18-40 years old (51%) and landed house (61%) contributed most of the cases. Case-fatality rate increased from 2014 to 2017 (0.0018 to 0.0022) but decreased in 2018 (0.0014). Out of 114 mortalities, majority were male (53%), age 18-40 years old (46%) and Malay (63%). Complications recorded were liver failure (60%), renal failure (51%), encephalitis (18%) and myocarditis (18%). In year 2014- 2015, DEN-1 serotype was dominantly reported (52.2% and 56.5%), shifted to DEN-3 in year 2016-2017 (34.8% and 43.4%) and DEN-2 in year 2018 (49.5%). DISCUSSION: Hulu Langat, being hyperendemic, the occurrence of multiple organ involvement following dengue infections has become a frequent finding. The study emphasizes the need of epidemiological and entomological surveillance to monitor trends in dengue distribution, seasonal patterns and circulating serotypes to guide dengue control activities, especially in rapidly growing urban and suburban areas

Urbanisation effect on dengue cases in Hulu Langat, Selangor (2014-2018)

INTRODUCTION: The frequency and magnitude of epidemic disease continued to increase in tandem with rapid urbanization. Mosquitoes carrying the dengue virus can increase following unplanned and unhealthy urbanization. In the large urban regions, crowded human populations live in intimate association with equally large mosquito populations provides the ideal home for maintenance of the viruses and the periodic generation of epidemic strains. METHOD: Data from e-Dengue registry including the urban sub-districts, between 2014 to 2018 were reviewed. Descriptive analysis was conducted to examine the epidemiology of Dengue fever in the urban regions of Hulu Langat district, Selangor which consist of Kajang, Cheras and Ampang sub-districts. RESULTS: Total incidence rate of Dengue in urban sub-districts in year 2014 was 1,060 per 100,000 populations (n=10,254) while in year 2018 the incidence decreased to 691 per 100,000 populations (n=6,762). Most of the cases were contributed by sub-district Kajang (43%) and Ampang (23%). Meanwhile the cases were most recorded from premises of landed houses (61%) and strata (21.1%). Case-fatality rate was increasing in trend from year 2014 to 2017 (0.18% to 0.22%) however noted to decrease in 2018 with 0.15%. Most of the death were from Kajang sub-district (37%),followed by Ampang (36%). DISCUSSION: Dense population in urban regions contributed to Dengue hyperendemicity in Hulu Langat. Orchestrated holistic approach in controlling Dengue outbreak in urban regions must be conducted wisely

Urbanisation effect on dengue cases in Hulu Langat, Selangor (2014-2018)

INTRODUCTION: The frequency and magnitude of epidemic disease continued to increase in tandem with rapid urbanisation. Mosquitoes carrying the dengue virus can increase following unplanned and unhealthy urbanisation. In the large urban regions, crowded human populations live in intimate association with equally large mosquito populations provides the ideal home for maintenance of the viruses and the periodic generation of epidemic strains. METHODS: Data from e-Dengue registry including the urban sub-districts, between 2014 to 2018 were reviewed. Descriptive analysis was conducted to examine the epidemiology of Dengue fever in the urban regions of Hulu Langat district, Selangor which consist of Kajang, Cheras and Ampang sub-districts. RESULTS: Total incidence rate of Dengue in urban sub-districts in year 2014 was 1,060 per 100,000 populations (n=10,254) while in year 2018 the incidence decreased to 691 per 100,000 populations (n=6,762). Most of the cases were contributed by sub-district Kajang (43%) and Ampang (23%). Meanwhile the cases were mostly recorded from premises of landed houses (61%) and strata (21.1%). Case-fatality rate was increasing in trend from year 2014 to 2017 (0.18% to 0.22%) however noted to decrease in 2018 with 0.15%. Most of the death were from Kajang sub-district (37%), followed by Ampang (36%). DISCUSSION: Dense population in urban regions contributed to Dengue hyperendemicity in Hulu Langat. Orchestrated holistic approach in controlling Dengue outbreak in urban regions must be conducted wisely