leptospirosis betul2
TRANSCRIPT
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BODY CONTENT
BIL TITLE PAGE
1 INTRODUCTION 3
2 DEFINITION 4
3 ETIOLOGY 5
4 EPIDEMIOLOGY 6 - 10
5 CLINICAL MANIFESTATION 11-14
6 TREATMENT 15
7 PREVENTION
i. PRIMODIAL
ii. PRIMARY
iii. SECONDARYiv. TERTIARY
16-21
DEVELOPMENT CYCLE 22-26
! CONCLUSION 27
10 REFERENCE 2
INTRODUCTION
T"#$# %$# v%$i&'( )&**'+i)%,# i(#%(#(/ "i)" %$# "# *%&$ )%'(# & *&$%i %+
*&$,ii %*&+ "'*%+ ,#i+( i+ "# &$ i#/ %*&+ "#(# i(#%(#( (&*#/ %$# &&+&i)/
*&('i& ,&$+# i(#%(#( %+ (&*# %$# 8$i*%$i i+#)i+ "# *%+ "i*(#.
A*&+ "# 9&&+&i) i(#%(#( #8&(8i$&(i( i( &+# & "# ,%)#$i% i(#%(#(/ "i)"
%#)( "'*%+( %+ %+i*%(. :#i i( )$#i# i" i$( #()$i,i+ #8&(8i$&(i( %( % '+i'#
i(#%(# 8$&)#(( i+ 16/ "#$#&$# i i( %(& ;+&+ %( :#i%(%v%+"%88%/ 200?
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9&&+&( i( )%'(# , (8i$&)"##( & "# #+'(/ L#8&(8i$%. Fi$( #()$i,# , A& :#i i+
16 ‘an acute infectious disease with enla!e"ent of s#leen$ %aundice and ne#hitis&
• O+# & "# #*#$i+ i+#)i&'( i(#%(#( (i+)# "# %# 1!!0(
• 1!!5@ Ni)%$%'% #8i#*i) & (#v#$# 8'*&+%$ "%#*&$$"%# (+$&*# =SPS?
• 1!!0
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L#8&(8i$&(i( i( %+ #((#+i% %+i*% i+#)i&+ , (#v#$% (#$&8#( & #8&(8i$% =%
(8i$&)"##? %+ $%+(*i# & *%+ '+#$ )#$%i+ #+vi$&+*#+% )&+ii&+( -.E. P%$;/ 200.
L#8&(8i$&(i( i( % ,%)#$i% i(#%(# "% ##)( "'*%+( %+ %+i*%. I i( )%'(# , ,%)#$i% &
#+'( #8&(8i$%)#%# %+ &$#$ (8i$&)"%#%#(.
ETIOLOGY
L#8&(8i$&(i( i( )%'(# , "# spirochete Leptospira Interrogan, "i)" i+#)(
*%**%( (')" %( $%. L#8&(8i$#( %$# i" )&i# (8i$&)"##( 5-15 * &+. T"# ("&
%)iv# $&%i&+% *&v#*#+ %+ "%v# & %#%/ &$ii+%i+ % #%)" #+ ,' &)%# i"i+
"# )# %( i+ >&$$#i% . T"#i$ #i)%# &'i+# i( ,#( (##+ , %$; i# *i)$&()&8 ,#)%'(#
"# %$# +& v#$ # (%i+# , #(. T"#$# %$# *%+ (8#)i#(/ #%)" i" (#v#$% (#$&8#(.
T"# ,i#B% )&*8#B )&*8#B i( $##-ivi+/ "# i+#$$&%+( )&*8#B i( 8%"&#+i). T"# #+(
& L. i+#$$&%+( %$# ,#+ i+& % '#(i&+-*%$; ("%8#/ "#+)# "# (8#)ii) +%*#. T"i( (8#)i#(
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i+#)( *%+ &*#(i) %+ i *%**%( i+ v%$i&'( 8%$( & "# &$ =%,# 1.0?/ &( %+
$%( ,#i+ i*8&$%+ (&'$)#( & i+#)i&+.
Table 1.0 disease caused by the three main ser!ru"s # the le"ts"ira interr!ans cm"le$
Le#tos#ial
seo!ou#s
Ani"al host Disti(ution
C%+i)&% D& :&$i#
i)#$&"%#*&$$"%i%# R% :&$i#
#,&*%i( Mi)#/ v&#(/ $%/
)%#
%8%+/ E'$&8#
I+#)# %+i*%( #v#&8 % )"$&+i) ;i+# i+#)i&+ i" #B)$#i&+ & %$# +'*,#$(
& ,%)#$i% i+ '$i+#. T"# (8i$&)"##( %$# (&&+ ;i# &+ $i+/ "#%i+ %+ #B8&('$# &
##$#+( &$ i(i+#)%+(/ ,' "# $#*%i+ vi%,# &$ (#v#$% ##;( i+ (%+%+ %;%i+#
%#$ &$ # (&i. '*%+( %$# i+#)# , i+#(i&+ &/ &$ #B8&('$# &/ )&+%*i+%# %#$ &$
&&. T"# ,%)#$i%/ %i# , "#i$ *&ii/ #+#$ "$&'" ,$#%;( i+ (;i+ &$ *')&(%#/ (&
i+#)i&+ )%+ ,# %)'i$# , (i**i+/ &$;i+ &$ 8%i+ i+ )&+%*i+%# %#$.
T"#$#&$#/ *i+#$(/ %$*#$(/ (#%# &$;#$(/ %+ %#$ (8&$( #+"'(i%(( %$# #(8#)i% %
$i(;. T"#$# %$# %,&' 60 )%(#( #%$ i+ E+%+ %+ :%#(/ %+ %,&' 100 #%$ %$# $#8&$#
i+ "# USA. >%)#$i% %$# #B)$## i+ "'*%+ '$i+#/ ,' 8#$(&+- &- 8#$(&+ $%+(*i((i&+ i( $%$#.
I**'+i i( (#$&8# (8#)ii). R##$ & %88#+iB 1.
=Ri)"%$ V G$i+/ 200?
EPIDE*IOLOGICAL 'EATURE+
N& 8$#)i(# #(i*%#( & "# &,% ,'$#+ & "'*%+ #8&(8i$&(i(
>#)&*i+ % )&**&+ 8',i) "#%" 8$&,#* &$i#
E(i*%# %++'% i+)i#+)# =:O?
0.1 & 1 8#$ 100 000 8#$ #%$ i+ #*8#$%# )i*%#(
10 &$ *&$# 8#$ 100 000 8#$ #%$ i+ "# "'*i $&8i)(
E(i*%# )%(#-%%i $%#( i+ i#$#+ 8%$( & "# &$ "%v# ,##+ $#8&$# &
$%+# $&* H5 & 30
S#%(&+% 8#%; i+ ('**#$/ '$i+ $%i+*&+(&&+ (#%(&+
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Agent factors
A!ent@ L#8(8i$% i( % "i+/ *&i# (8i#&)"#%#/ "i)" i( 0.1 0.2 $"* i# %+ 5-15 $"* &+
i" "&&;# #+(. T"#$# %$# *&$# "%+ 23 i#$#+ ($%i+( & i#+ii# 8#(/ %*&+ "#*
#8&(8i$% i+#$$&%+( %$# "# 8%"&#+i).
+ouce of infection@ L#8&(8i$%# i( #B)$## i+ "# '$i+# & i+#)# %+i*%( &$ % &+ i*#.
'*%+( ,#)&*# i+#)# "$&'" )&+%) i" %#$/ && &$ (&i )&+%i+i+ '$i+# $&*
i+#)# %+i*%(.
Ani"al ese,ois@ L#8&(8i$&(i( %#)( i %+ &*#(i) %+i*%( &$i#/ #(8#)i%
$&#+( (')" %( $%( %+ *i)#/ &"#$ %+i*%( $#(#$v&i$( %$# Pi(/ &$(#(/ C%#/ S"##8/ G&%(/
:%#$ ,'%(/ &( #). i+#)i&+ *% (8$#% $&* i %+i*%( & &*#(i) iv#(&); %+
"#+ & "'*%+ ,#i+(.
=>%(%v%+"%88%/ 200?
Host factors
A!e- $#8&$( ("&( i i( *&$# )&**&+ %*&+ )"i$#+/ *&$# "%+ 40 & )%(#( #$#
&'+#$ "%+ 15#%$(. C"i$#+ %)'i$# i+#)i&+ $&* &( *&$# $#'#+ "%+ "# %'(.
+e.@ *%#( %$# *&$# 8$&+#/ 8$&,%, $#('i+ $&* &))'8%i&+% %+ $#)$#%i&+% #B8&('$#.
Occu#ation@ "'*%+ i+#)i&+( %$# '('% '# & &))'8%i&+% #B8&('$# & "# '$i+# &
i+#)# %+i*%(. F&$ #B%*8#/ %$i)''$% %+ iv#(&); %$*#$(. :&$;#$( i+ $i)# i#(/
('%$)%+# i#(/ '+#$$&'+ (##$(/ *#%/ %+ %+i*% "%+#$(/ v##$i+%$ &$;#$( #).
#i('$# i*# #B8&('$# (')" %( (i**i+ %+ i("i+ *% %(& )%$$ % $i(;.
I""unit)@ % (&i (#$&v%$ (8#)ii) i**'+i &&( "# i+#)i&+.
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=>%(%v%+"%88%/ 200?
*o(idit) and *otalit)
L#8&(8i$&(i( "%( +& ,##+ % +&ii%,# i(#%(# i+ "# U.S. (i+)# 1!!4/ %+ "# )'$$#+
i+)i#+)# i+ "'*%+( i( +& ;+&+ i" )#$%i+. F$&* 1!7 & 1!!3/ 43-!3 )%(#( #$#$#8&$# %++'%. C'$$#+/ "# U.S. C#+$#( &$ Di(#%(# C&+$& %+ P$#v#+i&+ =CDC?
#(i*%#( "% 100 & 200 )%(#( %$# i#+ii# i+ "# U.S. #%)" #%$. L#8&(8i$&(i( i( "&'" &
,# '+#$i%+&(# %+ '+#$$#8&$# (i+)# *%+ )%(#( %$# *i &$ %(*8&*%i) %+ (#-
i*ii+.
T"# i+)i#+)# & i+#)i&+ i( (#%(&+%/ i" *&( )%(#( (##+ '$i+ i+ "# ('**#$ %+
% i+ #*8#$%# $#i&+(. I+ $&8i)% )i*%#(/ "# 8#%; i+)i#+)# &))'$( '$i+ "# $%i+
(#%(&+. L%$# &',$#%;( "%v# ,##+ (##+ %#$ &&(.
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O))'8%i&+% #B8&('$# i( "&'" & ,# $#(8&+(i,# &$ 30-50 & )%(#(. O))'8%i&+(
i" % "i" $i(; & i+#)i&+ i+)'# (##$ &$;#$(/ )&% *i+#$(/ 8'*,#$(/ %$* &$;#$(/
v##$i+%$i%+(/ 8# ("&8 &+#$(/ %,%&i$ &$;#$(/ *#% "%+#$(/ (%'"#$"&'(# &$;#$(/
&$;#$( i+ "# i("i+ i+'($/ %+ "# *ii%$. F$&* -2! & "&(# "& &$; i"
iv#(&); "%v# %+i,&i#( & L#8&(8i$%. R#)$#%i&+% %)ivii#( "% i+)$#%(# "# $i(; &
#8&(8i$&(i( i+)'# %$#+i+ %+ %#$ (8&$( (')" %( )%+i+/ (i**i+ %+ "i#-
%#$ $%i+. R#(i#+( & (&*# '$,%+ %$#%( %$# #B8&(# vi% $% '$i+#.
M&( )%(#( & #8&(8i$&(i( %$# %(*8&*%i) &$ *i. T"# &v#$% )%(# %%i $%# i(
1-5. T"# *&$%i $%# v%$i#( i" "# &$*/ %+ i( "i"#$ i+ "# ##$. T"# %+i)#$i) &$*
i( $%$# %%. T"# i)#$i) &$*/ "i)" &))'$( i+ 5-10 & % 8%i#+(/ "%( %+ &v#$%
*&$%i $%# & 5- 15/ %+ % 54 )%(# %%i $%# i+ (#v#$# )%(#( i" *&)%$i%
i+v&v#*#+. M&( 8%i#+( i" ;i+# %i'$#/ "#8%i) i(#%(# &$ %+#$i&$ 'v#ii( #v#+'%
$#)&v#$ ;i+# &$ iv#$ '+)i&+/ %+ ' vi(i&+.
*AGNITUDE O' T/E PROBLE*
i. L#8&(8i$&(i( i( % &$i# &&+&(i(/ i i( )&+(i#$# & ,# "# *&( i#(8$#% &
"# i(#%(# $%+(*i%,# $&* %+i*% & *%+.
ii. I "%( "i" 8$#v%#+)# i+ %$* "'*i $&8i)% )&'+$i#(.
iii. %%ii i+ USA i( "# (%# i" "i"#( $#8&$# i+)i#+)# & L#8&(8i$&(i( =i+ 1!!-
1!!! %%ii $#8&$# 405 ('(8#)# )%(#(/ 61 & "&(# #$# )&+i$*#?.
iv. O"#$ "i"-$i(; %$#%( & "# &$ %$# )%$i,,#%+ i(%+(/ )#+$% %+ (&'" A*#$i)%/
(&'"-#%( A(i%/ %+ P%)ii) i(%+(.
v. O' ,$#%;( *&( &))'$ %( % $#(' & "#%v $%i+% %+ )&+(#'#+ &&i+.
In India
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i. I "%( ,##+ ;+&+ & &))'$ i+ I+i% (i+)# &+ %&. R#8&$( i+i)%# "% i i( %i$
i#(8$#% "$&'"&' I+i%.
ii. R#)#+/ "#$# %( &',$#%; & L#8&(8i$&(i( i+ O$i((% %#$ "# #v%(%i+ C)&+#
& 2!" O)&,#$ 1!!!.
iii. L%#$ &+ i+ "# *&+" & A''( 2000 "#$# %( )%(#( & L#8&(8i$&(i( i+ G'%$%/
J#$%%/ M%"%$%("$% %+ A+%*%+ K Ni)&,%$ i(%+(.
En,ion"ental factos
• L#8&(8i$&(i( i( %)'i$# "$&'" )&+%) i" %+ #+vi$&+*#+ )&+%*i+%# , '$i+#
%+ %#)#( $&* i+#)# &$ )%$$i#$ %+i*%(.
• L#8&(8i$% )%+ ('$viv# i+ %#$ &$ %( *%+ %( 16%( %+ i+ "# (&i &$ %( *%+ %(
24%(/(& #+vi$&+*#+% )&+%*i+%i&+ *% $#%)" "i" #v#( i+ %$#%( "#$# )%$$i#$
%+i*%( $#'#+ '$i+%#/ "# &"#$ #+vi$&+*#+% %)&$( i;# 8&&$ "&'(i+/ i*i#
%#$ ('88/ i+%#'%# *#"& &$ %(# i(8&(% % )&*,i+# & *%;# "# i(#%(#
(i+ii)%+ $i(; &$ 8&&$ 8&8'%i&+ ,&" i+ '$,%+ %+ $'$% %$#%(.
*ode of Tans"ission
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%? Diect contact@ #8&(8i$% )%+ #+#$ "# ,& "$&'" (;i+ %,$%(i&+(/ &$ "$&'" i+%)
*')'( *#*,$%+# , i$#) )&+%) i" '$i+# &$ i(('# & i+#)# %+i*%(.
,? Indiect contact@ "$&'" "# )&+%) & "# ,$&;#+ (;i+ i" (&i/ %#$/ &$
v##%i&+ )&+%*i+%# , '$i+# &$ i+#)# %+i*%(/ .&$ "$&'" i+#(i&+ & && &$
%#$ )&+%*i+%# i" #8&(8i$%#.
)? Do#let infection@ i+#)i&+ *% %(& &))'$ "$&'" i+"%%i&+ %( "#+ *i;i+
i+#)# )&( &$ &%( , ,$#%"i+ %i$ 8&'# i" $&8#( & '$i+#/ i$#) *%+ &
*%+ (8$#% & i+#)i&+ i( $%$#.
Incu(ation #eiod@ '('% 10 %( i" % $%+# & 4-20 %(.
Clinical 'indin!s
T"# )i+i)% *%+i#(%i&+( *% v%$ $&* *i #,$i# i+#(( & (#v#$# i+#((
(&*#i*#( *% ,# %% i(#%(# i" iv#$/ ;i+# %+ ,$%i+ i+v&v#*#+ #8&(8i$&(i(
(*8&*( *% ,# #B8%i+# i+ 2 8"%(#( '$i+ 1 8"%(#.
-i+#(( '('% ,#i+( %,$'8 i"@
F#v#$
C"i(
#%%)"#
M'()# %)"#( %+ $%("#(
V&*ii+ &$ i%$$"#%
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T"# 8%i#+ *% $#)&v#$ &$ % i*# ,' ,#)&*#( i %%i+/ i +& %;#+ 8$&8#$ $#%*#+.
I "# II 8"%(# &))'$(/ i i( *&$# (#v#$# i" "# i+v&v#*#+ & iv#$ %+ ;i+# %i'$#
%+ *#+i+ii( "i( 8"%(# i( )%# :#i&& &$ )''$#
U$i+# &$ )''$#
Ji+# ,i&8(. A "#(# #(( ("& $&"8$#(#+)# & &$%+i(*(.
>&& &$ > & $'# &' A+%#*i%
Ji+# '+)i&+ #((@ ,&& '$#% +i$&#+ %+ (#$'* )$#%i+i+# & $'# &' "#
%,+&$*%i i" ;i+# '+)i&+(.
Liv#$ '+)i&+ #((@ iv#$ #+*#(/ (#$'* ,ii$',i+ %+ %,'*i+/ '$i+#,ii$',i+/ ,i#
(%( %((#((*#+ %+ ,i# 8i*#+(.
C#$#,$&(8i+% 'i &$ )''$# & $'# &' *#+i+ii(
ELISA #( i( %(& &+# &$ #%$ i%+&(i( ,' #B8#+(iv#/ #8&-i8(i); i( %(&
%v%i%,# +&.
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Diffeential dia!nosis@ (i+)# "# #8&(8i$&(i( i( *%+i#(# i" *%+ (*8&*(/ i *% ,#
*i(%;#+ &$@
D#+'# #v#$
O"#$ "%#*&$$"%i) #v#$(
#8%ii(
Vi$% *#+i+ii(
M%%$i%
T8"&i #v#$
Teat"ent
M#i)% *%+%#*#+
Anti(iotics- P#+i)ii+ i( "# $' & )"&i)#.
A' &(%#@ 1.5 *ii&+ '+i( I.V. 6" "&'$ &$ 7 %(.
P#i%$i) &(%#@ 100/000 '+i(J% i+ 4 ivi# &(#( &$ 7 %(.
Othe anti(iotics- D&B))i+#
A' &(%#@ 100* >D &$ 7 %( &$ %'(.
C"i$#+ &(#@ H #%$( +& $#)&**#+#.
#%$( 4*;% i+ 2 ivi# &(#( &$ 7 %(.
A"#icilline- I )%+ ,# iv#+ &$ )"i$#+ %( % (#)&+ i+# & %+i,i&i) i 8%i#+ i( #(( "%+
#%$( i+ "&* &B))i+# i( )&+$%i+i)%#.
A' &(%#@ 750*6" "&'$ &$ 7 %( &$%.
C"i$#+@ 75-100*;% &$% i+ 4 ivi# &(#( &$ 7 %(.
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A"o.)cilline
A' &(%#@ 500*6" "&'$ &$ 7 %(.
C"i$#+ &(%#@ 50*;% i+ 4 ivi# &(#(.
F&$ "i" $i(; %'(/ %( % 8$&8"%Bi( D&B))i+# 200*/ &+# ##; i( !5 ##)iv#
i+ 8$#v#+i+ #8&(8i$&(i( ,' &$ )"i$#+ $&# & 8$&8"%Bi( "%( ,##+ +& ('i#. O"#$
8"%$*%)&&i)% *%+%#*#+ #8#+( &+ "# (*8&*(/ &$ #@ %+i8$#i)(/ & $#')# #v#$.
C&$i)&(#$&i/ i+ )%(# & (#v#$# "#*&$$"%i) ##)(. P%i#+ *% +## "#*&i%(i( i $#+%
%i'$# &))'$(. P%i#+ *% +## & 8' &+ v#+i%&$ i ARDS 8#$(i((.
Po!nosis
• T"# *&$%i $%# &$ 8%i#+( i" (#v#$# #8&(8i$&(i( i( %88$&Bi*%# 10 *&(
#%"( %$# $&* $#+% %i'$#/ *%((iv# "%#*&$$"%#/ &$ A)'# R#(8i$%&$ Di($#((
S+$&*# =ARDS?.
• A88$&Bi*%# 13$ & "# 8%i#+( i" *#+i+ii( *% )&+i+'# & )&*8%i+ &
8#$i&i) "#%%)"#(.
• S&*# 8%i#+( i" #8&(8i$% 'v#ii( "%v# 8#$(i(#+ vi('% %)'i &(( %+ ,'$$
vi(i&+.
Contol "easues
1. E+vi$&+*#+% *#%('$#(
• P$#v#+i+ #B8&('$# & 8&#+i% )&+%*i+%# %#$.
• R#')i+ )&+%*i+%i&+ , $&#+ )&+$&.
• P$&#)i&+ & &$;#$( i+ "%%$&'( &))'8%i&+(.
• M#%('$#( ("&' ,# %;#+ & )&+$& $&#+( %+ 8$&8#$ i(8&(% & %(#( %+
& 8$&vi# "#%" #')%i&+ & "# 8',i) i+ "i( $#%$.2. R&#+ )&+$& *#%('$#(
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• S&'+ #+vi$&+*#+% (%+i%i&+ i( "# *&( ##)iv# #%8&+ $%( $#'i$# 3
,%(i) "i+( &$ ('$viv% i;# &&/ %#$ %+ ("##$ i "#(# %$# #+i# $%(
i +%'$% 8#$i(" %+ "#i$ +'*,#$( )&+(i#$%,# $#')#.
3. P$&8#$ #+vi$&+*#+% *#%('$#(
S%+i%i&+ *#%('$#(@
• P$&8#$ (&$%#/ )&#)i&+ %+ i(8&(% & %$,%#.
• P$&8#$ (&$%# & &&('(.
• C&+($')i&+ & $% 8$&& ,'ii+/ &&+( %+ %$#"&'(#(.
• Ei*i+%i&+ & $% ,'$$&( , ,&);i+ "#* i" )&+)$##.
4. T$%88i+
• T$%88i+ & i( % (i*8# *#%('$# &$ $% )&+$&/ ,' $%( %$# ('(8i)i&'( %+i*%(
, *%'$# %+ i (&&+ ,#)&*# $%8-i(# %+ %v&i $%8(.
5. R&#+i)i#(
• R&#+i)i#( & & *%i+ 8#(
1? Si+# '(# =%)'#?
2? M'i8# '(# =)'*'%iv#?
• A+ #B8#$ )&**i## & :O $&'8# "# %)'# $&#+i)i#( %( ,#&/ "&(#
$#'i$i+ &$i+%$ )%$# i;#/
R# ('i
>$&*i#
9i+; 8"&(8"i#
• T"&(# $#'i$i+ *%Bi*% 8$#)%'i&+( i;#/
S&i'* '&$&)#%#
F'$&%)#%*i#
• T"&(#/ "i)" %$# && %+#$&'( &$ '(#/
A$(#+i) $i&Bi# P"&(8"&$&'(
T"%i'* ('8"%#
• M'i&(# 8&i(&+ '(#/
:%$%$i+
Pi+&+#
T"#(# %$# %+i)&%'%+(/ "i)" )%'(# i+#$+% "#*&$$"%# %+ (& #%" i+
4-10 %( %+ %v&i $% )%$)%(( i" i+ "# "&'(# +'i(%+)# &$ (8%$# & &"#$ i(#%(#(
i;# 8%'#.
13
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6. F'*i%i&+
• I i( %+ ##)iv# *#"& & #($&i+ ,&" $%( %+ $% #%(/ i i( &+# ,
'(i+ )%+i# %( i+ % )%+&%( 8'*8.
7. C"#*&($#$i#+(
•
I i( % )"#*i)% "% )%+ )%'(# #*8&$%$ &$ 8#$*%+#+ (#$ii i+ #i"#$ (# &$ ,&" (#B#( & R&#+( "i( #)"+i'# i( (i i+ #B8#$i*#+% (%#.
=>%(%v%+"%88%/ 200?
O(%ecti,es of #e,ention
1. T& 8$#v#+/ )&+$& %+ #$*i+%# &',$#%;( & i+#)i&'( i(#%(#(.
2. T& $#')# *&$,ii %+ *&$%i $%#( & i+#)i&'( i(#%(#(.
3. S$#+"#+i+ i+#)i&'( i(#%(# ('$v#i%+)# ((#*.
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*#%('$#(
Pi"odial #e,ention
P$i*&$i% 8$#v#+i&+ i( #%$ 8$#v#+iv# *#%('$#( ,#&$# "# "%88#+ "$&'" #')%i&+
#&$(/ "# i+'#+)# & #+vi$&+*#+% %)&$(/ (&)i% &$ i#(#. >%(# &+ &'$ $#(#%$)" "%
"%v# ,##+ &+# &+ "# 8$i*&$i% 8$#v#+i&+ & i(#%(# #8&(8i$&(i(.
Po!a""e@ Increasin! cmmunity a%areness
C%$$ #8i#*i&&i)% ('i#( & ##) 8%#$+( & i+#)i&'( i(#%(# %( % ,%(i( &$ &$*i+
#)"+i'#( %88$&8$i%# 8$#v#+i&+ %+ )&+$&.
Acti,ities-
• C&*8i# %%/ %+ )%(# $#8&$( %+ &',$#%;( & i+#)i&'( i(#%(#( & "# i($i) %+
8$&vi# %% %+ $#8&$ & "# (%#.
• A+%(# %% %+ $#8&$( & "# 8%)# & #%$ ##)i&+ & i+#)i&'( i(#%(#( %+
#8i#*i)(.
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i(#%(#( %+ & $#)&**#+ )&$$#)iv# *#%('$#( %+ i*8$&v#*#+(
14
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A %$i)''$#/ i$$i%i&+/ v##$i+%$ i#( *'( ,# i+v&v# i+ #)i(i&+. >#&$#
)&+')i+ %%$#+#(( 8$&$%*( &+ #8&(8i$&(i( "# i(#%(# ,'$#+ & "# %$#% ("&' ,#
i#+ii#. E')%i&+ & %$*#$( %+ &"#$( i+ vi(i $&'8( +##( & ,# )%$$i# &' , "#%"
(%. I )&' %(& ,# i($i,'# i$#) & 8#&8# "& *% ,# % $i(;. Ri(; )&**'+i)%i&+
& %$*#$( %+ vi%#$( , "#%" &i)#$(/ i" "# )&&8#$%i&+ & &"#$ (#)&$( #(8#)i% "#
%$i)''$# (#)&$ i "#8 & $%i(# "# #v# & %%$#+#(( i+ "# )&**'+i.
A vi%# #v#/ )&**'+i ("&' ,# %%$# & "# #Bi(#+)# & #8&(8i$&(i( %( % )%'(#
& #,$i# i+#(( i+ 8#&8# %+ "# ("&' ,# %%$# & "# i+ii% (*8&*( & #8&(8i$&(i(
%+ i*8&$%+)# & (##;i+ #%$ $#%*#+. I+)$#%(# %%$#+#(( & #8&(8i$&(i( %*&+
*#i)% &i)#$( ("&' ,# #(%,i("# &$ i*8$&vi+ #%$ ##)i&+ %+ *%+%#*#+ & "#
i(#%(#.
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Pi"a) #e,ention
T"i( #v# & 8$i*%$ 8$#v#+i&+ i( & %v&i "i+( $&* "%88#+i+@
Po!a""e@ #%" #')%i&+ %*&+ vi%#$( "i)" "i" $i(; )%+ %#)( "# i(#%(#
/ealth education
• I i( "# ($&+ #%8&+ &$ "# 8$#v#+i&+ & L#8&(8i$&(i(
• E')%# "# 8',i) $#%$i+ "& "# i(#%(# (8$#%(
• T# "#* & %v&i (i**i+ i+ %#$ "% i( )&+%*i+%# i" %+i*% '$i+#. Li;#
&8#+ 8&+(.
• P$&#)iv# )&"i+ &$ &&#%$ ("&' ,# &$+ , "&(# #B8&(# & )&+%*i+%#
%#$ &$ (&i/ ,#)%'(# & "#i$ &, &$ $#)$#%i&+% %)ivii#(
• A*i+i($%i&+ & v%))i+#( &$ "i"-$i(; $&'8(
• E')%i&+ $#%$i+ i**'+i%i&+ & 8#(
• EB8%i+ "# i*8&$%+)# & 8$&8#$ i(8&(% & %(#( %+ $&#+ )&+$& *#%('$#(
• T# "#* & ;##8 "# $&#+i)i#( &' & $#%)" & )"i$#+
• C&(# "# &'+ i" % %#$8$&& ,%+%# ,#&$# &' (%$ &$; %$* %$#+ &$
8%)#( i" 8&#+i% &$ #B8&('$# & "#(# ,%)#$i%
• :#%$ 8$&#)iv# )&"i+ (')" %( &v#(/ ## 8$&#)i&+ &$ &#( / %8$&+ %+ ,&&(
"#+ &$;i+ i+ "# i#( &$ &$;i+ i" %+i*%( 8&#+i% i+#)# i"L#8&(8i$% / #(8#)i% "#+ &' "%v# "# 8&#+i% & ,# #B8&(# & %+i*% '$i+#.
16
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• C#%+ '8 "%+( %#$ &i+ &$; i+ "# i#( %+ &$)"%$(.
• M%;# ('$# &' %$# +& #%i+ &$ (*&;i+ )&(# & %+i*%( "% *i" ,# i+#)# &$
"i# &$;i+ i+ "# %$#+ %$* &' *% ,# #B8&(# &+ %+ )&+%*i+%i&+ ,
,%)#$i%.
• Av&i (i**i+ i+ $#)$#%i&+% %)ivii#( &$ 8%)#( "% %$# i;# & ,# )&+%*i+%#
, %+i*% '$i+#.
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$i* && %(#/ i+ &$#$ & %v&i "# 8$#(#+)# & $%.
• >#&$# $i+;i+ &$ &8#+ )%++# &&(/ *%;# ('$# &' %(" $i+(# )%8 ,#&$#"%+ &
%v&i "# 8&((i,ii & )&+$%)i+ "# ,%)#$i%. T"#(# )%+( *% ,# #B8&(# & %+i*%
'$i+# L#8&(8i$% )%$$i#$ "#+ i+ "# (&$#.
• J##8 &'$ 8#( v%))i+%# %+ $##$ & "# V##$i+%$ Ci+i) & 8$#v#+ &'$ 8# $&*
,#i+ i+#)# , L#8&(8i$% ,%)#$i% .
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+econda) #e,ention
Pe,ention is (ette than cue i( % #$* "% i( %88$&8$i%# i+ &$#$ & *%i+%i+ % )#%+
#+vi$&+*#+ & 8$#v#+ "# (8$#% & v#)&$-,&$+# i(#%(#(.
Po!a""e@ 8$#v#+i&+ & i+#)i&+ i+ "'*%+
Acti,ities- C&+i+'i+ *#%('$#( i*8$&vi+ "#%" "$&'" #+vi$&+*#+% (%+i%i&+/ &&
"i#+# %+ 8#$(&+% "i#+#.
P$#v#+iv# *#%('$#( %$# #8#+#+ &+ #%i# ;+&## & "&/ "#$# %+ "#+
"'*%+( *% ,#)&*# i+#)# i+ % 8%$i)'%$ %$#%. I+)$#%(i+ %%$#+#(( %*&+ "#
8&8'%i&+/ $i(; $&'8( %+ "#%" )%$# 8$&vi#$( i "#8 i+ $#)&+ii+ %+ $#%i+ "#
i(#%(# 8$&*8. A*i+i($%i&+ & 8$&8"%Bi( $#%*#+ i( % ($%# i*8#*#+# , "#
Mi+i($ & #%" &$ L#8&(8i$&(i( )&+$&.
&'tn!(ryn!) %( i+#+# & )'$, "# (8$#% & "# i(#%(# #8&(8i$&(i( )$#%#
, "# (8$#% & #$*( ,%)#$i% "$&'" '$i+# & $%( & "'*%+ &')". T& 8$#v#+ &',$#%;( &
v#)&$-,&$+# i(#%(#( $&* (8$#%i+/ #+vi$&+*#+% (%+i%i&+ ("&' ,# 8$i&$ii#.
&'(i+ %+ $#(i#+i% )&**'+ii#( ("&' )&&8#$%# % "&'(i+ %+ $#(i#+i%
• R%i(i+ %%$#+#(( %*&+ "# 8',i) %,&' "# (8$#% & #8&(8i$&(i( %+ $% -,&$+#
i(#%(#( / #).
• C#%+i+ "# %$#% i( ,#i#v# & ,# % ,$##i+ $&'+ &$ $%( "% $%( )%+ ,# $#')#
• I+)$#%(# )&%,&$%iv# (8i$i ,###+ "# )&**'+i %+ &v#$+*#+ %#+)i#( &$ "#
,#+#i &
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• P$&vi# % "8&"#$*i) *#%('$#( & )&+$& #v#$
• O,(#$v# &$ '$i+# &'8'
• A*i+i(#$ *#i)%i&+( %( 8#$ 8$#()$i8i&+(
• P$&vi# 8()"&&i)% ('88&$
•
EB8%i+ "# i*8&$%+)# & i%(i( & 8%i#+ $#'i$#(• :%)" &$ *#+i+#% i$$i%i&+ (*8&*( vi('% &(( GI i('$,%+)#( %+ %;#
%88$&8$i%# *#%('$#( & 8$#v#+ )&*8i)%i&+(.
De,elo#"ent C)cle
DATE ACTI0ITIE+
30 %+ 2014
12 DE+INGNING T/E /EALT/ PRO*OTION
I. P%++i+• :# (%$ i" )$#%# "# )&**i## *#*,#$( & &$%+i# "i(
8$&$%**# %+ ivi# &'$ &$; %))&$i+ & "# #v#+(.
• I#+i "# i+#+ &$ "# %)ivi %+ "# 8$&)#(( &$ "& "#
%)ivi i ,# i*8#*#+# i;# # 8%+ & ,'# i$( &$ &'$
8$&$%**# %+ (#+ 8$&8&(% & "# (8&+(&$.
• :# 8%+ i+)'# "# %i* %+ &,#)iv#( "i)" "#8 '( & %)"i#v#
&'$ 8$&$%**# i" % (8#)ii) *&& %+ "#8 '( & iv# "#%"
#')%i&+ $#%$i+ & 8$#v#+ "# Le"ts"irsis.• :# %(& i+i+ &' "# %88$&8$i%# 8%)# %+ "#*# &$
8#$&$*i+ "i( 8$&$%**# (*&&".
F$&* "# 8%++i+ & "# #v#+/ # $ & i#+ii+ "# +##( &$
#v#&8i+ %+ "#%" 8$&*&i&+ 8$&$%**#. :# "&8# "% &'$ 8$&$%**#
i i*8$&v# "# (#-%%$#+#(( %*&+ "# )&**'+i %+ i*8$&vi+ "#
;+&## %+ (#-#*8&#$*#+ %*&+ "#*. A(&/ "#8 )"%+i+
%i'#( %+ ,#"%vi&'$ & "#*.
3 F#, 2014 O+ "# *&$+i+ % "# %/ "# 8$&$%* #%#$("i8 %+ "# %((i(%+ 8$&$%*
#+ & "# )i+i) S'+%i M%+i;. T"# 8'$8&(# & "# vi(i & i#+i
)&**'+i)%,# i(#%(# % "# %$#% & "# vi%#. T"# i(#%(# "i)" #B#+#
% "# %$#% i( Le"ts"irsis % S'+%i M%+i; Vi%#. R##$ & %88#+iB 1.
4 F#, 2014 A "# %/ # #$# "# % *##i+ i" "# )&**i## vi%# & #B8$#((
20
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%,&' &'$ 8$&$%**# & "#*. A "# (%*# i*#/ # %(& (## "#
#+vi$&+*#+% )&+ii&+ & i#+i %88$&8$i%# %)ivii#( &$ &'$
8$&$%**#. O"#$ "%+ "%/ # +&i)# "# $iv#$ %+ #+vi$&+*#+
('$$&'+i+ %$# i+ i$ )&+ii&+. S&/ # #)i# & %;# %+ %)i&+ &
i*8$&v# "# "#%" )&**'+i (%'(. T"# )&**i## & "# vi%# %(
%88$&vi+ &'$ ('#(i&+ 8$&$%**#. :# #)i# & )"&&(# 8$#v#+i&+ &
L#8&(8i$&(i( %( &'$ 8$&#) )&**'+i "#%".
5 F#, 2014 T"# +#B *##i+/ # i()'(( %,&' "# 8$&8&(% %+ #+%iv# 8$&$%**#
"% ,# "# '+#$ &'$ i+% )&**'+i 8$&#). T"# ('i%,# #+%iv#
8$&$%**# "% # #$# i()'(( %$#@
• A#$&,i)
• #%" %; 1 =8$#v#+iv# *#%('$# & Le"ts"irsis , ('#+
(#*#(#$ 4 RCMP?
• #%" %; 2 =$#%*#+ & Le"ts"irsis , "#%" &i)i%(?
• 'tn!(ryn! =)#%++#(( "# $iv#$?
:# #$# #)i# "% &*&$$& # i (## "# )&**i## & "# vi%# &
8$#(#+ &'$ 8$&8&(% %+ #+%iv# 8$&$%**#.
6 F#, 2014
32 DE0ELOPING AN ACTION PLAN
T"# 8$#(i#+/ Ai$%" ,i+i N%i* %+ "# (#)$#%$/ A%$'i+ ,i+ A,
R%%; #$# %#+ "# *##i+ % D#%+ R%;% S'+%i M%+i; i"
)&**i## *#*,#$( & "# vi%#. T"# *##i+ i" JJ %+ ADUN &
S'+%i M%+i; Vi%# & 8$#(#+ &'$ 8$&8&(% %+ #B8%i+ &'$ &,#)iv# %+
#+%iv# & %)"i#v# "#i$ %$##*#+ %,&' &'$ 8$&$%**#. T"# )&+$i,'i&+
"% # $#'#( $&* "#* %$#@
• F&&( %+ ,#v#$%#( &$ ,$#%;%(/ '+)" %+ "i-#%
• E'i8*#+ &$ )#%++#((
• E'i8*#+ & "# 8$&$%**# (')" %( ,%++#$/ PA ((#* %+
&"#$( =R##$ ,'# i+ "# 8$&8&(%?
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O'$ 8$&$%**# i ,# "# &+ 1( M%$)" 2014 %+ )&**'+i vi%# #$#
%$## i" &'$( 8$&$%**#. R##$ 8$&8&(% %+ #+%iv# &$ #%i(.
Ev%'%i&+@
T"i( 8$&$%**# i ,# ,#+#i)i% & "# )&**'+i 8#&8# "&
#%v# % S'+%i M%+i; Vi%# ,#)%'(# "#$# %$# $'$% %$#% 8#&8#
"& %); & ;+&## &+ "i( ;i+ & i(#%(#. >#(i#( "%/ "#
%(& %i+ i+&$*%i&+ "# %%$#+#(( & L#8&(8i$&(i( i(#%(#. F$&*
"i(/ # )%+ $#')# "# +'*,#$ & 8#&8# ##) &+ L#8&(8i$&(i(
i(#%(#. T"i( 8$&$%**# %(& "#8 "# ('#+( "& &$%+i#$ "i(
8$&$%**# & %i+ ;+&## %,&' "# i(#%(#. F$&* "i( ;i+ &
8$&$%**#/ "# )&**'+i )%+ 8$&$#(( "# i+&$*%i&+ & &"#$(.
:# %(& "&8# &'$ &,#)iv# $&* "# 8$&$%**# i %)"i#v#
8$&8#$.
10 F#, 2014 T& & &'$ *#*,#$( "i)" %$# N%,i"%" %+ N'$ F%i+ N%i$%" #$#
)&+(' "# "#%" *i+i($ (i# & i+vi# "#* &$ give information
through health talk about treatment of the Leptospirosis.
14 F#, 2014 T"# $#%('$# & "# )&**i##/ N'$ F%i+ N%i$%" %( )&#) "#
)&+$i,'i&+ "% # i*8&(# $&* "# ('#+ (#*#(#$ 4@
• RM 62.00 8#$ "#% Q RM 3/44.00
>#(i#( "%/ N%,i"%" %+ "#$ "#%" %; *#*,#$( #$# "% &+# "#i$
$#(#%$)" %+ #%,&$%# "i( i(('# (%+%$i(#. A#$ "%/ "#$# %$# $%+(#$
"# i+&$*%i&+ i+& % (i# ("&.
15 F#, 2014 A#$ % "# ('#+ *%;# "# 8%*#+/ "# )&**i## & '( #$# ivii+
22
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"# 'i#( &$ "# 8$#8%$%i&+ "# 8$&$%**#. R##$ %,# 1 ,#&.
NA*E DUTY
'(+% ,i+i M'(%% P$#8%$%i&+ & &&(
Sii R%+"*% ,i+i M&" Ai Gi%($i ,i+ S"%i# >%++#$
F%i$'% '(+% ,i+i >%("$i* E'i8*#+ & )#%++#((
Table 1
T"# #'i8*#+ "%v# &+# ,' %+ %( 8$#8%$# ,#&$# 22 F#,$'%$ 2014.
O"#$ "%+ "%/ "# "#%" %; #%* %( 8$%)i)i+ & 8$#(#+ "# (i#. :#
i *%;# ('$# &'$ )&**i## $#% & "%+# "i( 8$&$%*. :# "&8# "i(
8$&$%**# i $'+ (*&&".
22 F#, 2014 O+ "% *&$+i+/ F%i ,i+ F%i %+ A"*% Y%i*i #$# 8%(# "# ,%++#$
% % & S'+%i M%+i; Vi%# & %$%) "# 8#&8#( & &i+ &'$ 8$&$%**#
"% i ,# "# %$&'+ #+ %( *&$#. F'$"#$*&$#/ E* A*i$% %+ :%+
A(i$% 8%(# "# 8&(#$ %,&' 8$#v#+iv# *#%('$# %,&' L#8&(8i$&(i( %$&'+
"# vi%#.
1( M%$ 2014
42 I*PLE*ENTING T/E PROGRA*
T&%/ "# 8$&$%**# 8$&$#((i+ %( % 8%+. :# # v#$ #B)i# %+ "%88
,#)%'(# &'$ 8$&$%**# ( (*&&" && "# #+%iv#. :# "&8# 8#&8#
i 8$%)i)# "# 8$#v#+iv# *#%('$# & Le"ts"irsis. S& "%/ # )%+
#)$#%(# "# (%i(i) "# vi)i* & "# i(#%(#.
1( M%$ 2014 52 E0ALUABILITY A++E++*ENT
• R##$ & %88#+iB 2.
62 E0ALUATING T/E PROGRA*
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10" M%$ 2014 A#$ &+# ##;/ # & "# vi%# & &,(#$v# %+ #v%'%# "#"#$ &'$
8$&$%**# i( ##)iv# & "# vi%#$(. :# i+ &' "% "# $iv#$ %+
#+vi$&+*#+ ('$$&'+i+ "%( )"%+# )&*8%$# & "# ,#&$#. T"#
#+vi$&+*#+ & S'+%i M%+i; Vi%# ,#)&*# )#%+ %+ "# %i$ $#("#$. :#
%(('*# "% &'$ "#%" 8$&*&i&+ 8$&$%**#( %$# %)"i#v# , "# &,#)iv#
& "# 8#&8#. :# "&8# "% "# Le"ts"irsis i(#%(# )%+ ,# $#%# %+ )%+
8$#v#+ $%+(*i((i&+ & &"#$(. :# #$# v#$ "%88 ,#)%'(# &'$
8$&$%**#( %$# ('))#((' &$ "# )&**'+i.
R##$ %88#+iB 3.
Conclusion
L#8&(8i$&(i( i( % (i+ii)%+ &,% 8',i) "#%" 8$&,#* "% i(8$&8&$i&+%#
%#)( $#(&'$)# 8&&$ %$#%( & "# &$. T"# $'# ,'$#+ & "i( i(#%(# *% ,# (',(%+i%
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"i"#$ "%+ &'$ #(i*%#(/ '# & "# 8$#&*i+%+)# & 8%((iv# )&#)# "&(8i%-,%(# %%
i+ &'$ %+%(i(/ %+ '# & "# i+"#$#+ i+$%($')'$% $#'i$#*#+( %+ )"%#+#( &
%,&$%&$ i%+&(i( %+ $#8&$i+. C&+i+'# #&$( & i*8$&v# ('$v#i%+)# %+ $#8&$i+/
%+ & '+#$(%+ %+ *ii%# "# $i(; %)&$( &$ #8&(8i$&(i( ("&' $#*%i+ % 8$i&$i/ ,&"
i+ $#i&+( ;+&+ & "%v# % "i" ,'$#+/ %+ i+ "&(# i#+ii# , &'$ %+%(i( "& *% ,#
% $i(; & (i+ii)%+ '+*#%('$# ,'$#+. Uiii+ "# )&*8$#"#+(iv# i+i+( $&* LERG/
GLEAN %( #v#&8# i+ 8%$+#$("i8 i" i+#$+%i&+% &$%+i%i&+( %+ %)%#*i)
i+(i'i&+(/ & 8$&vi# i$#)i&+ %+ )&&$i+%i&+ & i "# *%+ %8( i+ #8&(8i$&(i(
;+&## i" "# 'i*%# &% & $%+(%i+ "# $#(#%$)" i+i+( i+& &8#$%i&+%
'i%+)# &$ )&**'+ii#( %+ )&'+$i#( %#)# , #8&(8i$&(i( &',$#%;(.
RE'ERENCE+
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