leptospirosis betul2

8/9/2019 leptospirosis betul2

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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%'#.

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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%+)# ((#*.

4. P$#8%$#+#(( %+ $%8i $#(8&+(# & &',$#%;( & i+#)i&'( i(#%(#( %+ 8$#v#+iv#

*#%('$#(

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)(.

• Ev%'%# "# ##)iv#+#(( & "# %)ivii#( & 8$#v#+i&+ %+ )&+$& & i+#)i&'(

i(#%(#( %+ & $#)&**#+ )&$$#)iv# *#%('$#( %+ i*8$&v#*#+(

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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+#.

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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+#.

• C&+$& *i)# i+ &'$ 8$#(#+)# , #+('$i+ &8i*'* "i#+#. R#*&v# % #,$i( %+

$i* && %(#/ i+ &$#$ & %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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20/26

• 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 "# %/ # #$# "# % *##i+ i" "# )&**i## vi%# & #B8$#((

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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+

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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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