Investigation on injuries and death from lightning in Umphang district, Tak province, May 2017

Abstract

Background: On 24 May 2017, the Bureau of Epidemiology was notified from the Office of Disease Prevention & Control, Region 2 about 35 injury cases with one death from lightning in one border patrol police school in Umphang district, Tak province. All cases received treatment in Umphang hospital. This report presented the investigation results aiming to describe the epidemiologic characteristics of these injuries, identify risk factors and recommend preventive measures.
Methods: The investigation was conducted by reviewing medical records of the lightning injury cases from Umphang hospital and interviewing all the victims in this event. A retrospective cohort study was carried out to identify risk factors associated with the injury. An environmental investigation was also performed in the area.
Results: Of the 49 exposed persons in the event, 39 (79.6%) were injured and one was dead, giving a case-fatality rate of 2.6%. The male to female ratio was 1:1.05. They were 10-39 years old with a median of 11 years. Of the 39 cases, 7 (17.9%) were admitted to the hospital and 32 (82.1%) were out-patients. The most common clinical feature was tinnitus (48.7%), followed by leg pain (35.9%) and leg numbness (30.8%). The dead case was a 12- year-old boy who did not have any metal thing on his body and stood one meter from the lightning. He had no wounds but unconscious after the lightning. He received cardio-pulmonary resuscitation (CPR) and was referred to the hospital and was eventually dead. A retrospective cohort study did not find any risk factors significantly associated with the injury. An environmental investigation revealed that the lightning might be ground current pattern which could injure nearby persons. The dead case was the nearest to the lightning. There was no lightning rod protection system in the school.
Conclusion: This event occurred in the very remote school where the travel was somewhat difficult. It is important to educate teachers and students about the lightning and how to prevent lightning injury. The teachers should be trained for first aid management and basic CPR. The school should have lightning protection system.