On 24th April 2009 the World Health Organisation (WHO) announced Pandemic Influenza A (H1N1) alert phase 4 which was later raised to phase 6 on 11th June 2009. By 11th October 2009, 199 countries were affected with 399,232 laboratory confirmed cases resulting in 4735 death. In Pahang, the state and district operation rooms were activated on the 28th April and 5th May 2009 respectively to monitor surveillance, control and preventives measures carried out. This study was done to describe the situation of Pandemic Influenza A (H1N1) in Pahang from 28th April 2009 till 10th October 2009 in terms of laboratory confirmed cases and clusters reported, Influenza-Like Illness (ILI) surveillance, Severe Acute Respiratory Infection (sARI) surveillance and health education activities. During the period, 490 laboratory confirmed Influenza A (H1N1) cases were registered with 5 deaths. The age ranges from less than 1 year to 76 years with median of 16 years old. 207 ILI clusters were recorded, 139 (67.5%) were Influenza A (H1N1) clusters. For surveillance activity, 11,570 (2.2%) of outpatient attendances were ILI cases while 966 (2.0 %) of total admissions were sARI cases. There were 14,927 health education activities carried out during the period. The number of people affected by Pandemic Influenza A (H1N1) in Pahang reached its peak in mid August 2009 and later showed a downward trend. ILI surveillance was a useful tool to detect Influenza A (H1N1) activity in Pahang.
Study site: Klinik kesihatan, outpatient clinics, hospitals, Pahang, Malaysia
Water filters are being increasingly promoted and used in the home. There are many types of commercial water jilters available for domestic use but almost all of them employ a physical filter media and an activated substance. The study showed that water filters effectively removed suspended solids and residual chlorine. However, as far as removing colhform bacteria is concerned, in ZZ .5% of the cases, bacteria were in fact introduced into the water. And in 20% ofthe cases, the amount of bacteria introduced was “too numerous to count (TNTC)". Furthermore, water hlters can lose their ability to filter bacteria without losing their ability to filter suspended solids and residual chlorine. This highlights the necessity of some authorized body looking into the claims made by these water filter manufacturers and impose certain standards to ensure that at the very least, the water quality ofthe hltered water is not worse than the unfiltered water.
A retrospective study was conducted to investigate 183 serologically-confirmed cases of dengue fever (DF) admitted from October 2004 to March 2005 in a large hospital in Pahang. Clinical and laboratory features, progress and outcome of these patients were analysed in order to identify risk factors associated with development of dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS). Individually, we found that older patients, secondary dengue infection, high baseline haematocrit levels, low platelet levels and prolonged activated partial thromboplastin time (APTT) ratio were significant associations with bleeding tendencies. Of these risk factors, haematocrit and APTT ratio were two independent significant risk factors on multivariate analysis. Older patients with primary infection and younger patients with secondary infection had significant bleeding tendencies. We also verified the validity of the haematocrit levels suggested as cut-off levels for plasma leakage for the Malaysian population by Malaysian Clinical Practice Guidelines for Dengue Infection in Adults (2003).