Rotavirus outbreak in Kedah now up to 86 cases

20170220080000, Vi-Jean Khoo
The contamination is believed to be a result of lack of personal hygiene amongst visitors
The Health Ministry has confirmed a total of 86 incidences of rotavirus infection associated with visits to the Ulu Lengong Hotspring in Baling, Kedah.

“However, since 11 February, there have been no new cases reported, and the final two patients have been discharged,” announced Health director-general Datuk Seri Dr Noor Hisham Abdullah, adding that there were no reported incidences of extreme dehydration or deaths associated with the infection.

The ministry will continue to monitor the cases of acute gastroenteritis until 16 February before declaring that the outbreak has ceased, Hisham said.

Faecal contamination in ponds the likely cause of outbreak

Authorities ordered for the temporary closure of the Ulu Legong hotspring two weeks ago, following the emergence of new cases of rotavirus infections in visitors of the recreational park.

"The recreational centre has been closed to allow investigations by the Kedah Health Department, Baling Health Office and the National Public Health Laboratory in Sungai Buloh,” said state director Datuk Dr Norhizan Ismail at the time.

Last week, Dr Zaki Zainudin, a water quality and modelling specialist, posited that the rotavirus outbreak could have been linked with faecal contamination.

“It maybe that there was faecal contamination because someone did something nasty there or there was a sewage overflow within the vicinity, or a nearby toilet. I am speculating but these are the potential possibilities,” Zaki said, explaining that certain strains of microbes can survive longer in environments outside the body, especially in uncontrolled environments, such as the hot springs.

“But in a controlled environment like a swimming pool, where it is chlorinated, the chlorine essentially kills all the bacteria and viruses and it is very hard for something like this to happen,” he also said, adding that it was time to review the Environmental Quality (Sewage) Regulations 2009.

“Sewage treatment plants (STPs) have to treat sewage before discharging it but as the assumption is that bacteria and viruses die when they enter into the environment, hence it is not regulated. The implication of this is that some STPs may or may not disinfect the effluent prior to being discharged,” he said.

Investigations revealed no leakage of wastewater

According to Noor Hisham, investigations at the recreational park revealed no leakage of its wastewater management system, adding that the level of cleanliness was satisfactory.

“It is believed that the contamination may have happened on 29 and 30 January, based on the centre’s cleaning schedule,” he explained.

“We believe the contamination was due to lack of awareness of personal hygiene among (visitors),” he also said, adding that the ponds were cleaned on 31 January and operations at the hot spring resumed on 6 February.

Following the outbreak, the Baling District Council has taken steps to periodically clean the ponds as per schedule, approximately once every two days, and taking measures to ensure that no interruption or obstruction of hot water into the ponds.

Noor Hisham has also advised the public to adhere to rules at the hot spring to maintain sanitary levels. Individuals with symptoms of acute gastroenteritis and young children wearing disposable diapers should not enter the pool. MIMS

Read more:
Rising incidences of rotavirus in Kedah linked with hot spring visit
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Sources:
http://www.nst.com.my/news/2017/02/212940/after-86-infections-kedah-rotavirus-outbreak-nears-end
http://www.thestar.com.my/news/nation/2017/02/10/expert-someone-must-have-defecated-in-hot-springs/
https://kpkesihatan.com/2017/02/16/kenyataan-akbar-kpk-16-februari-2017-perkembangan-kluster-jangkitan-rotavirus-di-pusat-rekreasi-air-panas-ulu-legong-baling-kedah/
http://www.thesundaily.my/news/2165147