Acute Gastroenteritis Outbreak in a Rural Area in Perak, Malaysia, 2022

Abstract

An outbreak of acute gastroenteritis was identified in a rural village in Perak, Malaysia, on 22 Jun 2022, following the detection of 20 cases. The Larut, Matang, and Selama District Health Office implemented public health measures to control the outbreak. We detected 25 cases during 22–24 Jun 2022, among private boarding school students and residents. Half (52%) of the cases were aged between 11 and 15 years, 68% were male, and 44% were students. Common symptoms included vomiting (88%), abdominal pain (76%), and diarrhoea (72%). No food was suspected based on food diaries, as there was no common food eaten by all cases. The epidemic curve showed a point-source pattern. Mapping of cases demonstrated that all cases used water for drinking, cooking, and other domestic usages that were supplied by the same gravity feed system. Several empty containers of carbofuran-containing insecticide and nematicide, used for agriculture, were found near the gravity feed system route at an altitude higher than its inlet. No known pathogen was isolated from the rectal swabs of cases. This acute gastroenteritis outbreak was suspected to have occurred from drinking water contaminated with chemicals such as carbofuran. After excluding other possible causes, health education to the villagers, particularly on the appropriate use of insecticides nearby the source of water supply with good cooperation from the local communities had helped successfully controlling the outbreak.