UPM student Life part 8~ About Dengue Fever and Fogging in Community Posting

So currently Im in Kuala Pilah, a place that is so hulu, yet popular of Dengue Fever just like Serdang do. Kuala Pilah is one of the dengue fever hotspot of Negeri Sembilan, and since it is remote enough =..=, and UPM think that we enjoy too much of easy life in the city, so they decided to throw us to Kuala Pilah for a 6 week posting

and thanks GOD I survive for 3 weeks and 3 more weeks to go before I go into the freezer muahaha

This posting is an easy one, not much study to do, just blank and blur everyday ( guess Im the only one doing this?). It is a posting under Public Health posting, and if you read my previous post, I HATE this posting so much, especially when we need to conduct a research project here in 6 weeks time. Ya 6 months become 6 weeks, luckily we work in a team. 

OK enough of the grandma story. Will talk about my research project after this, now let's talk about something interesting about dengue fever. Do you ever know how dengue fever is transmitted? 

basically it is vector-borne, which means they need a live media to be the bridge to spread the disease. So we know that dengue fever  is transmitted by mosquitoes, to be more accurate, Aedes mosquitoes, which loves stagnant, clear and shady water area so much. 

this is the life cycle of Aedes mosquitoes. This little tiny creature will breed eggs on the surface of stagnant water, well this bloody eggs can survive for 6 months without water as long as it is not exposed to sunlight. Then, it will develop into larva, which is more famous to be named as " jejentik" in our society, then become Pupa. Pupa can transform into an adult mosquitoes in 12 hours time. Sounds scary isnt it? 

this is how the closer look of Larva is

But, not every larva belongs to Aedes mosquitoes. The normal mosquitoes species- Culex got larva too. hwo to differentiate them? 

they can be differentiated from Pupa. this is how pupa looks like, with bigger head

Basically, pupae of Aedes moves faster in the water as compared to Culex. 

once pupa or larva of any kind of mosquitoes is detected in the house, the authority person in charge will collect some sample and the owner need to eradicate all the pooled water immediately, and clean out all the possible breeding site

and this is how the adult mosquitoes look like. it is black colour with white spots, while Culex mosquitoes is brown in colour. However, not all aedes mosquitoes will bring Dengue fever, but who knows if they were not infected? 

So, maybe you will be curious? why is Dengue fever so important in Malaysia?

FYI, Dengue fever is one of the most common communicable disease in Malaysia, and brings a number of fatality rate. In Kuala Pilah, there were 2 fatal case so far until mid of May. The most significant symptoms that one will experience is high grade fever, then accompanied by chill and rigors, muscle ache, retroorbital pain, occasionally rashes that we named as "white island in the sea of red" ; or small and multiple dots especially over the trunk and limbs area, which we named as "petechiae", a sign of low platelet count that may lead to bleeding easily. 

forgot to mention, the most common cause of death for Dengue Fever is bleeding from internal organs, lead to shock and died. So now, do you see how scary a dengue fever is? 

In the morning time, we followed person in charge from Jabatan Kesihatan Daerah for the elimination of breeding sites project in a housing area. Funny fact was, as the previous policy is " caught and fined", many residents dare not to open up the door for the officer to check their house. The new policy dont really aimed to fine anyone, but provide larvaciding to eradicate the pupae, eggs and larvae before they transform into adult mosquitoes, and cleared up all the possible breeding sites especially flower pots. We were surprised that mosquitoes can even breed in the small area at the margin of the flower pot. 

Then in the late evening, we went to another residential area for fogging activities, and we were asked to bring mask on our own. Fogging activity usually done at early morning 4am, or late evening after 6pm. Fogging is aimed to kill the adult Aedes mosquitoes. The health authorities will perform fogging in area with Dengue cases reported ( dengue fever is a notifiable disease) 

The officer demonstrate to us on how to carry a fogging machine. the fogging criteria is as below: 

• 1 case - household fogging radius 200m
• more than 1 case - wabak. household fogging and ultra-low volume cold fogging ( which is the machine that we used on the day) 
• more than 15 cases- declare as a hotspot area, fogging will be performed in the residential area. 

okay, so why radius of 200m? the range of flight for Aedes mosquitoes is about 200m. Besides Dengue Fever, Aedes mosquitoes can also cause Yellow fever and Chikungunya, however, rare in Malaysia. If there is presence of any of these diseases can be considered as an outbreak in Malaysia. 

Before the fogging started, health authorities will make a public announcement so the residents will get out from their house during the fogging session. And anyone with allergies or asthma should leave the area as far as possible to prevent from any exacerbation. 

Neh, no more hiding and closing up the windows during fogging session. 

The respirator during fogging session. As it is somekind of pesticide poison, it is important to make sure tat we do not get poisoned like the adult mosquitoes too. 

However, we don get the chance to wear it. Erm, I don think I would like to wear it a well, it is fulled of bad breath smell from someone else

the ear muff

This is important to protect our ears as the fogging machine will produce a very loud sound when operated. It was quite unbearable, we can hardly hear conversation with our frens when the fogging was going on. 

these are the personal protective equipment for fogging session and too bad we don even get any of this. What we had is just a small piece of 50 cents mask lol

other PPE that required are goggles, vest reflector, gloves and safety boot

And, here the fogging session begin!!

we were split into a group of 3 each, and we followed the person in charge to learn on how to fogging. Well, don ask me do Doctors need to perform fogging or not in future. who knows? But according to my doctor in charge of public health, she never involved in any fogging activities before

looks at the smoke. Well it actually is poison to adult mosquitoes instead of normal smoke. Looks like it is easy to carry the machine right? It is actually damn heavy, I really had a hard time to carry it and perform my task of the day

Oh ya forgot to mention, fogging activities will be cancelled if heavy rain. Luckily, we just met with drizzle rain that day, so the activity was still carry on ( it seems like we are having fun more than learning process LOL) 

what are the target area of fogging?

basically is the possible breeding sites of Aedes mosquitoes, which are : shady and protected stagnant water. gardens, pots, garbage site, Longkang especially, these are the sites that should not be missed out. After the fogging session, they will have larvaciding session on the next morning to eradicate the mosquitoes, before the next waves of Dengue fever comes. 

im in the middle of mist !, shut up, im just in the middle of the fogging. Thought that fogging is safe? not when you overdose ( like me on the next day) 

those who got allergies to fogging will present with asthma, red watery eyes, shortness of breath and rashes. How about overdose? well I inhale too much of fogging smoke, and I presented with horrible and terrible diarrhoea the next day ( no vomiting or fever). And usually it just present for a day duration, and recovered on the next day. Pity WL had the same condition as me also LOL

Then, it is our showtime! we were directed to perform fogging on a certain area under supervision of the health authority person in charge. So exciting huh hehe

My fren, as if she was holding a machine gun instead of fogging machine.

we were told to be cautious all the time as this machine might get into fire when overheated X..x 

it weight about 5kg after filled up with diesel and pesticides. 

Then it is my time to have the fogging show!! 

The person in charge instruct me the proper way to hold the fogging machine and how to start it. Okay im too clumsy to perform the task haha. 

I was instructed to carry the fogging process in the backlane of the houses hehe

He told me that he fogged about 3 houses on his own. Okay he is much better than me

I will kill you Aedes mosquitoes! Leave me aside!

after I complete my fogging task. 

it was quite exhausting, as the machine was quite heavy, and i had some difficulty in breathing LOL

the fogging machine

the whole machine is imported from German. Clean weight of 3.5kg, add in diesel and poison for the fogging, then it may weight up to 5kg. The machine could heat up to 3000 degree celcius when operate. Hence, a layer of insulator is covered up to prevent us from heat injury

Last but not least, our selfie together ^^ 

After fogging, we were directed to wash our own clothes as poison will stick on it. 

Here is my experience on fogging, hope you enjoy it! more to go