Leptospirosis Outbreak during Rice Harvesting Season in Kebumen, Central Java Indonesia (The First Case Report in Kebumen) Widiastuti Dyah1,*, Puspitaningsih Dewi1,2, Wijayanti Siwi Mars Pramatama3 1Health Research and Development Unit, Banjarnegara, Indonesia, National Institute of Health Research and Development 2Postgraduate student at Master in Public Health, Gadjah Mada University, Yogyakarta, Indonesia 3Public Health Department, Faculty of Health Sciences, Jenderal Soedirman University *Corresponding Author: Dyah Widiastuti Health Research and Development Unit, Banjarnegara, Indonesia, National Institute of Health Research and Development, Jl. Selamanik No 16 A, Banjarnegara, Central java, 53415, Indonesia, Email: dyahwidi1981@gmail.com
Online published on 20 March, 2019. Abstract Leptospirosis, a public health problem in Indonesia, has never been reported in Kebumen before, but Kebumen Public Health Office reported several new leptospirosis cases in this regency during paddy harvesting season in February 2017. A descriptive cross-sectional study was conducted to investigate leptospirosis epidemiology (eg, the reservoir animals, the geographical distribution, and specific populations at risk) in Kebumen on March 2017. Thirty febrile patients were enrolled in Public Health Services and tested for leptospirosis using Leptotek. The positive cases were investigated by interview and site inspection to assess environmental risks. Rat traps were set randomly at housing areas near the positive cases's house in Kuwarasan and Buayan subdistricts. Kidneys were removed from rats and analysed using PCR assay for pathogenic Leptospira detection. Thirteen positive leptospirosis cases out of 30 febrile patients were found in 6 subdistricts consisted of Kuwarasan (30.7%), Buayan (30.7%), Karanganyar (7.7%), Gombong (7.7%), Sempor (7.7%) and Sruweng (15.4%). 92, 31% of the patients were farmers, indicating occupational exposures at paddy fields. Most of the case were in the age group of 31–40 years (53, 85%). High vulnerability among males due to activities in outdoor settings was revealed from male to female ratio (12: 1). Clinical symptoms consisted of calf muscle pain (100%), jaundice (84.6%), oliguria (38.5%) and renal failure (15.4%), with case fatality rate was 23, 08%. Rats (Bandicotta indica) with positive Leptospira were found at Kuwarasan subdistrict (6.25%). Based on the results of this study, paddy harvesting season is a critical period associated with leptospirosis transmission in Central Java. Indeed, preventive efforts should be done to avoid leptospirosis outbreak Top Keywords Leptospirosis, farmer, harvesting season, outbreak. Top |