Malaysia is a country rich in natural forest. Our forests are very rich in flora and fauna species that do not only contribute to environmental well-being but also an eco-tourism attractions.

Hutan lipur, national parks or recreation areas are frequently visited by local and oversea tourists. Those who visits the forest area may be exposed to infectious diseases if preventive measures are not taken. The risk also includes those who participate in outdoor activities, hunters, military personnel operating in remote areas, those who work in the forest, logging areas and others.

Diseases that may be infected while visiting forest include:

• Leptospirosis
• Melioidosis
• Malaria

Leptospirosis

• Leptospirosis is an infectious disease caused by pathogenic spirochete bacteria of the genus leptospira that are transmitted directly or indirectly from animals to human (i.e., a zoonotic disease).
• Infection is acquired from contact with skin, mucosa/conjunctiva with water, soil or food contaminated with the urine of rodents, carrier or diseased animals in the environment.
• A variety of wild and domestic animals can be host to Leptospira bacteria. Among them is are rats, cats, dogs, cows, pigs, rabbits, horses and others
• Leptospirosis is endemic in tropical countries including Malaysia.
• For more information please visit https://myhealth23.primuscore.com/v2/index.php/my / leptospirosis (In Malaysia Language)

Malaria

• Malaria is a vector-borne disease spread by Anopheles mosquito
• For more information, please visit https://myhealth23.primuscore.com/dewasa-malaria/ (In Bahasa Malaysia Language)

Melioidosis

• This disease is caused by the gram-negative bacillus, Burkholderia pseudo mallei that are found in soil.
• Humans can be infected with this disease through exposure to soil and water contaminated with the bacteria.
• People with chronic diseases such as diabetes, lung disease, renal failure, liver disease and other conditions that cause immune suppression are at a higher risk to contract melioidosis.

Signs and Symptoms

Leptospirosis

• The incubation period is between 2 to 30 days (average 10 days)
• Fever
• Chills
• Body/Muscle pain
• Headaches
• Cough
• Nausea, vomiting, diarrhea
• Conjunctivitis 
• Skin rash

Malaria

• The incubation period is between 7 to -30 days
• Chills 
• Recurring fever
• Sweating
• Headaches
• Nausea and vomiting
• Body pain
• Weakness and fatigue

Melioidosis

• The incubation period is between 2 to 7 days
• Skin lesion that always leads to ulceration or abscesses
• Fever
• Cough
• Chest pain
• Headache
• Lost appetite
• Body pain

Preventions and Precaution Steps

• Take precautions to minimize insect bites by wearing long pants and long sleeves shirts and used insect repellant
• Wear proper shoe and clothing.
• Avoid swim or bathe in the river if there are wounds or cuts on the skin. Cover cuts with waterproof plaster.
• Avoid drinking untreated water (River water).
• Avoid contact with rodent feces and urine. If contact happens, wash hands thoroughly with soap and water
• If camping in the forest:
  • Use mosquito nets to prevent mosquito bites while sleeping
  • Avoid sleeping on bare ground
  • Avoid sleeping in places that are currently, or have recently been, infested with animals especially rodents.
  • Keep food in containers and do not drink untreated water.
• Malaria prophylaxis is a preventive treatment of malaria. Prophylaxis for malaria can be given to:
  • visitors from other countries who want to visit the remote area in Malaysia,
  • Soldiers working in remote areas, especially at the border of Malaysia –Thailand
  • local residents who work in the forest, logging, and others
  • *medical advice should be obtained before taking prophylaxis
• Currently, no vaccine is available for leptospirosis, malaria, and melioidosis
• Consult a physician immediately if you are showing symptoms of illness after visiting these places. Inform your doctor that you have visited these places!

References

1. Ministry of Health. (2011). Guidelines for the Diagnosis, Management, Prevention and Control of Leptospirosis (1st ed.). Disease Control Division, Department of Public Health, Putrajaya.
2. Ministry of Health. (2007). Management Guidelines of Malaria in Malaysia. Disease Control Division, Department of Public Health, Putrajaya.
3. Jabatan Kesihatan Negeri Pahang. (2012). Guidelines For Clinical And Public Health Management Of Melioidosis In Pahang (1st ed).Communicable Disease Control Unit, Jabatan Kesihatan Negeri Pahang, Kuantan.
4. Kementerian Kesihatan Malaysia. (2010). Nota Makluman: Meliodosis [Press Release]. Diambil dari http://www.moh.gov.my/index.php/database_stores/store_view_page/20/39
5. Kementerian Kesihatan Malaysia. (2010). Nota Makluman: Leptospirosis [Press Release]. Diambil dari http://www.moh.gov.my/index.php/database_stores/store_view_page/20/40