An outbreak investigation: the contact cases of leishmania disease among the students of the College of Vocational Education, Si Sa Ket Province, returned from apprenticeship in Israel, September 2018

Abstract

Background: Background: On 12th September 2019, Si Sa Ket Hospital was notified by the office of disease prevention and control 10 (Ubon Ratchathani) about the leishmania case admitted at Sappasitthiprasong Hospital. The case was the students of College of vocational education (CVE), Roi Et province who had just returned from apprenticeship in Israel. Among those apprentices, the students from CVE, Si Sa Ket province were also included. We were conducted the outbreak investigation to verify the diagnosis and the outbreak, to describe the distribution of the outbreak by time-place-person, to identify the cause and source of infection, and to recommend the control measures.
Methods: The descriptive study was conducted by reviewing medical records, interviewing the patients, and finding the active cases in the communities by case definitions. We performed laboratory study by collecting blood and saliva of cases/contact cases as well as blood of the animals around the CVE to send for Leishmania-PCR. The environmental study was conducted at the students’ home and the stalls located in the CVE. The entomological study was also conducted by isolating the species of various sand flies found around the CVE.
Results: We found totally 18 contact cases. Two of them were asymptomatic cases (11.11 percent). Male to female ratio was 1:1. Mean age was 20.59 years old. Nine contact cases had donated their blood at the hospital and nine recipients were recorded. Among those nine recipients, two were received blood from the asymptomatic cases. After follow up those two recipients, nobody got infected with leishmaniasis.
Recommendations: We recommend 1) Related health agencies give health education about leishmaniasis to the contact cases in order to observe themselves and to receive treatment when they become sick. 2) The hospital blood bank has screening procedure for the blood donors who have a history of traveling aboard. Blood donation should be prohibited for those who have possible risk of Leishmania transmission at least 1 year. And 3) The College informs all apprentices about the epidemic diseases of the country that they will go and has surveillance system to monitor clinical symptoms after they come back for 1 year.