PENYAKIT

HAWAR
PENYAKIT ZOONOSIS

RODENSIA vs FLEA

Kejadian
Kawasan Barat USA, Amerika
Selatan, Utara,Timur dan Selatan
Afrika, Indonesia, Asia Tengah
Endemik:
Indonesia, Myanmar, Vietnam

6th century 100 million death in

North Africa
Black Death 25 million in
Europe

In Peninsular Malaysia, no human plague had occurred since 1928

With influx of Vietnemese Illegal Immigrants ( V.I.I ) the situation
become receptive and valnurable to and outbreak of plague.

June, 1979 rumour of plague outbreak of and island Pulau Tengah

off Mersing, Johore and visit of WHO Consultant guideline
concerning plague control & prevention were than produced

3 Jenis :
a. BUBONIC PLAGUE berlaku komplikasi
pada sistem linfatika di noda limfa akibat
kebocoran pada tempat gigitan fles
b. SEPTISEMIK PLAGUE Lanjutan dari bubonic
plague bakteria masuk ke saluran darah
mengakibatkan septisemik plague
c. PNEUMONIC PLAGUE berlaku jangkitan pada
paru-paru merebak melalui titisan udara
boleh menyebabkan wabak

BUBONIC PLAGUE
Bacteria invade lymph nodes, which swell and call
Buboes
Blood vessel break, causing internal bleeding
Dried Blood under the skin turn black, hence the
name Black Death
Spread is slow from person to person
Mortality is very high (up to 75%) in untreated
cases
Early treatment with antibiotics is very effective

PNEUMONIC PLAGUE
Bacteria invade victims lungs
Lung fill with fluid bloody liquid
Spread is common from person to person

PLAGUE LYMPH GLAND

DEFINITION
An infection caused by
the organisma Yersinia
pestis which occurred in
wild rodents and
transmitted to human

CAUSES & RISKS

Plague is transmitted among
rodents and to humans by flea
bite Xenopsylla cheopis or by
ingestion of feces of fleas
It can also be transmitted
human to human when plague
victim develops pneumonia
spread infected droplet by
coughing ----An epidemic may
be started this way

Kutu (Flea) - X-cheopis

Bakteria : Yersinia @ Pasturella
pestis
Infeksi bakteria ke haiwan dan manusia

TAKUNGAN

TANDA DAN GEJALA

Lymphadenitis lumph
nodes (berhampiran tempat
gigitan
Lymph nodes bengkak,
inflamasi, kesakitan,
bernanah
Demam,septisemia,
meningitis, Pneumonia

Kutu kekal infektif hingga beberapa

bulan

DIAGNOSIS

Micro-Bipolar-Stainning
Aspirasi dari buboes, kahak
ELIZA
Culture aspirasi :buboes dan kahak
Passive Haemagglutination Test - serologi

Penyimpanan
Makanan
Basmi kutu
pada anjing
dan kucing

Pendidikan
Kesihatan

Elak berkhemah di
kawasan tikus yang
banyak

Elak gigitan kutu

tikus-repelen

KAJIAN POPULASI TIKUS

BERKALA
Kebersihan asas alam
sekitar
Pengurangan populasi
tikus racun serangga
Flea Index

Rodent
proofing

Fumigasi
gudang

Fumigasi
Kapal

Indek
kutu

IMUNISASI AKTIF
( Bakteria yang dilemahkan & dibunuh)
Diberi kepada High Risk Group
Perlindungan beberapa bulan
Pelalian tambahan adalah perlu

LANGKAH KAWALAN

NOTIFIKASI: Pihak Berkuasa

PENGASINGAN:
- Pastikan pesakit, pakaiannya, barang-barangnya
bebas dari Flea
- Perhatikan sekreasi Bubonic Plague
- Perhatian perlu pneumonic plague sebar
melalui udara
- rawatan antibiotik perhatikan selama 3 hari
selepas rawatan

LANGKAH KAWALAN

KONKAREN DISENFEKSI: kakah,

discharge, barang-barang
KUARANTIN:
Semua kontak seisi rumah dengan pesakit
pneumonic plague rawatan
chemopropilaktik pengawasan selama 7 hari
Tetracycline : 15 30mg/kg
Sulfonamides : 40mg/kg

LANGKAH KAWALAN

RAWATAN SPESIFIK: streptomysin,

tetracycline dan choramphinecal

LAW OF MALAYSIA
Act 342
Prevention And Control Of
Infedtious Disease Act 1988
Sec 1 Interpretation
PART III: Prevention Of Importation Of
Infevtious Disease Sec 6 (1)(2)(3): Declaration Of Infected Area
Sec 7 (1)(2)(3): Entry into and examination of
Vehicles and the measure thereafter
Sec 8(1)(2): Time Foe Examination

LAW OF MALAYSIA
Act 342
Prevention And Control Of
Infedtious Disease Act 1988
PART III: Prevention Of Importation Of
Infevtious Disease Sec 9 (1)(2)(3): Importation or exportation of
human remains and phathogenic organism or
substance

LAW OF MALAYSIA
Act 342
Prevention And Control Of
Infedtious Disease Act 1988
PART IV: Control Of The Spread Of
Infectious Disease
Sec 10 (1) to (6) : Requirement to notify
infectious disease

INTERNATIONAL HEALTH
REGULATIONS, 1969
PART I Definitions
PART II Notification & Epidemiological
Information Article 3,5,7a (1)(2)
PART III- Health Organisation Article 14 17
PART IV Health Measures & Procedure
Chapter I- General Provision Article 25

INTERNATIONAL HEALTH
REGULATIONS, 1969
PART V Special Provisions Relating to Each
Of The Disease Subject To The RegulationsChapter 1 PLAGUE

Article 50 to 60