malaria serious and sometimes fatal. this presentation is for employees responsible for managing...
TRANSCRIPT
Malaria Malaria Serious and Sometimes
Fatal
This presentation is for employees responsible for managing malaria – site managers, EHS workers, traveling employees
Sources:World Health Organization (WHO), www.who.intCenters for Disease Control and Prevention (CDC), www.cdc.govSchlumberger Oilfield Services, www.slb.com
Malaria Endemic Countries
Malaria Kills…
It does not only happen to others…
It could happen to you…
Malaria Kills…
June 1998
Kurt…He was a Canadian driller working in Zambia He returned to Canada for days offA few days later, he died of deadly malaria (falciparum)He left a child and a pregnant wife behind… 3 weeks after his death, his second child was born
Malaria Kills…
June 2001
Peter…He was working in Equatorial Guinea He went for days offA few days later, he died of deadly malaria (falciparum)He left a wife and 3 kids behind…
Malaria Kills…
June 2002
Carlos…He was working in Ecuador He started feeling bad in QuitoHe died 8 days later of deadly malaria
(falciparum)Carlos was a promising young field
Engineer…
Malaria Kills…
February 2006
Djibril…He was a driver in Mali He had a recurrent fever and flu like
symptomsA few days later he died of deadly
malaria (falciparum)
He left a big family behind …
Malaria Kills…May 2006
Boart Longyear employee…Working in GuineaDeveloped recurrent flu like symptoms at home in
CanadaDelayed action - thought it was flu – got very illBrother insisted that the hospital test for malaria
He was infected with deadly falciparum
Hospital had no malaria medicationHis kidneys failed
He was given 30% chance of life … He got
lucky!
He got
lucky!
Attending this training…Following these
recommendations…
Could save your life…
Malaria Deaths: Facts
• Most fatal malaria cases occur in ex-pats visiting malaria-infested countries for work or tourism
• Most fatalities occur in countries that are not malaria affected – i.e. when the worker returns home on break.
• Many fatalities occur in hospitals while the person is undergoing treatment.
• The main reasons for fatalities are a) person delays too long before seeking medical attention and b) person is treated for the wrong type of malaria by hospitals unfamiliar with malaria cases
c) person is treated with a medication to which the specific malaria parasite is partially or fully resistant
Malaria Deaths: Why?
• Low general awareness of malaria risks• “Days-off mentality”• Higher awareness on location• Incubation period delays symptoms• Symptoms easily-confused (looks like the flu)• Doctors ignorance of malaria in much of the
world• Complacency: “it won’t happen to me”• Complacency: “I’ve had malaria lots of times
and I come right in a day or two” (lucky)
Who Is Fit To Go?
• In order to work in malaria risk countries you must:– be declared medically fit on your last
physical– have the required designated vaccinations
for the country– be aware of the dangers of malaria
• Malaria risk countries are not recommended for:– pregnant women– children under 3 years of age
Recommendation: Visit your doctor and advise of your possible relocation to work in a tropical country. Get checked out.
• It is a disease transmitted by the bite of the female Anopheles mosquito (60 of 360 known Anopheles species).
• The mosquito bites at NIGHT and injects the disease into the blood.
• 300 million to 500 million infected/year.• It can be fatal. 2,000,000 deaths/year!• Symptoms start to appear between 7 and 60 days
after being bitten.• There is no vaccination, but it can be prevented
and usually effectively treated if diagnosed early.
Treatment is URGENT! MALARIA IS AN EMERGENCY!
What Is Malaria?
There are four types of Malaria parasite:
1. Plasmodium vivax2. Plasmodium falciparum3. Plasmodium malariae4. Plasmodium ovale
• Falciparum is the most serious parasite of the four.• Most malaria infections and deaths are due to
falciparum.• Oval and Vivax may remain dormant and relapse
months after the exposure if proper treatment is not provided.
• Not all anti-malaria medications protect against all four types of malaria.
• Malaria has built up resistances to some medications in different parts of the world.
Types of Malaria
Malaria Resistance
Sulfadoxine/ pyrimethamine, mefloquine resistance
Mefloquine resistance
Sulfadoxine/ pyrimethamine resistance
Sulfadoxine/ pyrimethamine, mefloquine, halofantrine, quinine resistance
Chloroquine resistance
The Malaria CycleMosquito: sucked up from the bloodstream, malaria parasites mate and move from the mosquito gut to the salivary glands. When the bugs next bite man, their saliva passes the parasites on.
Liver: the parasites make straight for the liver where they mature and reproduce. This generation then migrates to the blood.
Red Blood Cells: replicating in red blood cells, the parasites eventually burst them open. This damage leads to malaria fever and sometimes death.
Symptoms of Malaria• There are no specific symptoms.
• SYMPTOMS OF MALARIA RESEMBLE THOSE OF THE FLU OR THE COMMON COLD! – Weakness– Fever, Chills, Sweating– Aches and pains– Abdominal pain– Diarrhea, Vomiting
• Any of the above symptoms– During a stay in a malaria country– Or up to 60 days after having left a malaria country
SEE A DOCTOR !GET A BLOOD TEST FOR MALARIA!
DO NOT LOSE TIME!
Malaria Illness• The symptoms that a person feels when they have
malaria, is the result of the parasite-filled red blood cells rupturing.
• In the most severe and fatal from of malaria (falciparum), up to 80% of red blood cells can be parasitized and destroyed.
• This massive red blood cell destruction has two primary effects:
1. Severe anemia2. Clogging of the circulation to vital organs (brain and kidneys)
• The clogging occurs because the infected cells clump together causing an obstruction in blood vessels.
SEE A DOCTOR !GET A BLOOD TEST FOR MALARIA!
DO NOT LOSE TIME!
Other Insect-Borne Diseases
Don’t ASSUME you recognize your symptoms GET TESTED!!
Disease Vector Endemic Area Symptoms
Malaria Mosquitoes Global tropical and subtropical areas. Fever and Flu-like symptoms
Yellow Fever MosquitoesTropical areas of Africa and Central and South America
Fever, headache, abdominal pain and vomiting
Dengue Fever MosquitoesTropical Africa, South East Asia, South America and the Pacific.
Fever, headache, and joint and muscle aches
Japanese Encephalitis
Mosquitoes / Ticks
The Far East and South East Asia. Forested areas of Central & Eastern Europe, Scandinavia and former USSR.
Fever, headache, neck stiffness, stupor, disorientation, coma, tremors
Plague Fleas World-wide.Fever, headache, muscular aches, shaking chills, and pain in the groin and armpits
Leishmaniasis SandfliesGlobal tropical and subtropical areas including the Mediterranean.
Fever, weakness, weight loss, appetite loss, abdominal discomfort, scaly skin,
River BlindnessSmall Black Flies
Mexico, Guatemala, Ecuador, Colombia, Venezuela, Brazil, Yemen and thirty countries of Africa
Skin rash, eye lesions (which can lead to blindness), and/or subcutaneous bumps under the skin
Sleeping Sickness Tsetse Flies East, West and Central Southern Africa. Fever, boil-like swelling at the site of the bite
Ross River Fever Mosquitoes AustraliaFever, flu-like symptoms, headache, and joint and muscle aches
West Nile Fever MosquitoesAfrica, Eastern Europe, West Asia, and the Middle East
Fever, headache, mild rash, and body aches
Lyme Disease Ticks Europe (inc. UK), USA, Australia, China & Japan.Fever, headache, joint and muscle aches, red rash at the site of the bite
Malaria Management:1 - Insect Bite Prevention2 - Preventive Anti-Malaria
Medications3 - Quick and Adequate Response
1 - Insect Bite Prevention
INDOORS Keep windows and doors closed Make sure doors and windows are fitted with
screens and regularly checked for holes Where available, ensure air conditioning is
working and on cold If possible, keep air moving/circulating (fan) At night, plug in electric diffusers, particularly in
the bedrooms When out on verandas, burn coils When entering a room at night, spray
insecticides Use a chemically treated bed net. Make sure to
regularly check it for holes and use it correctly (tucked under the mattress all around the bed)
1 - Insect Bite PreventionOUTDOORS
Wear long sleeve shirts – prefer light colored clothing (bugs are attracted to dark clothing)
Wear long pants Before going outdoors, apply repellent to
uncovered parts of the body Minimize company functions organized
outdoors in the evening Stay indoors at night whenever possible Use fogging to reduce mosquito
populations
2 - Preventive Medications
In malaria risk countries, preventative medications are highly recommended.
• Take a preventive medication as prescribed by your doctor – information available from Malaria HOTLINE
• Medication needs to be taken REGULARLY during the entire stay in a malaria country and as directed.
• Risk of side effects exists with all medications but is small and reversible when medication is stopped.
The potential severity of side effects is always less than the potential severity of
malaria…. which is DEATH!
2 - Preventive Medications
Preventive treatment taken regularly greatly reduces the risk of contracting the disease.
But, even if you are taking a preventive treatment and come down with the symptoms of malaria => See a Doctor IMMEDIATELY!!
Preventive Malaria Medications
Medicine SavarineLariam
(Mefloquine) Doxycycline Malarone
Protection Level 75% 90% 90% 95%
3 - Quick and Adequate Response
See a doctor immediately. DO NOT LOSE TIME! THIS IS AN EMERGENCY
If you suspect malaria:– Perform a malaria test for confirmation of the
diagnosis. – If test is positive, seek medical attention immediately. – If test is negative but symptoms continue, repeat the
test after 6 hours.– If symptoms persist and a negative test result is
obtained after 12 hours, seek medical attention immediately
Refer to Boart Longyear’s Malaria Response Flow-Chart
Once you leave the work location
The risk of improperly managing malaria increases dramatically because you may not “think malaria first” once away from the location.– You are in a “days-off mentality” and work
seems far away.– Those around you might not suspect malaria.– Your doctor will very likely not suspect
malaria and may not have the malaria test kit or curative medicine.
– The incubation period of malaria can cause the onset of symptoms to occur weeks after leaving work.
Malaria Diagnostic Test
General Directions:
• Clean finger with Alcohol swab.
• Prick finger with lancet and squeeze to obtain a good size drop.
• Transfer blood drop to testing device.
• Add clearing fluid.• Wait for test result.
(Testing kits may vary. Ensure the directions for the type of testing kit being used are followed properly.)
Malaria HOTLINE• Your access to immediate malaria information • Staffed by doctors specialized in tropical
medicine• With up-to-date knowledge on preventive and
curative malaria medication• Toll-free number: (+1) 770 488 7788
(Mon-Fri 8am-5pm EST - USA) • After hours emergency assistance (+1) 770 488
7100 (Doctors only) • DO NOT HESITATE TO CALL!
Malaria Alert Card
HEALTH ALERT To the traveler leaving a malaria risk
country
If you or a member of your family develop malaria-like symptoms within 60 days of leaving a malaria risk country
A) go immediately to a doctor or B) self administer a malaria test & if result is
positive goimmediately to a doctor with the test device
showing result.C) if symptoms persist for 12+ hours go
immediately to a doctor
Advise your doctor of your recent travel to a malaria risk country Provide your doctor with the information printed on the reverse of
this card
Malaria may be FATALIf you have it…………Treatment is
URGENT! Keep this card in your wallet.
To the Consulting PhysicianThe person presenting you with this card, or their companion, has developed symptoms consistent with infection by malaria. This
person has been living, working or traveling in a malaria risk country in the last 60 days.
If there is any doubt as to the cause of their symptoms, please do not
hesitate to do a blood test (blood smear) for Plasmodium falciparum.
If you are uncertain as to the level of drug resistance of the malaria
specific to the country where the person contracted the disease, or of the appropriate curative medication for this type of malaria please
contact the MALARIA HOTLINE (CDC Atlanta, GA, USA)
(+1) 770 488 7788 (Mon-Fri 8am-5pm EST) After hours emergency assistance (+1) 770 488 7100 (Doctors only) Dr. DeVon C. Hale, M.D. – Boart Longyear Medical Consultant
• Make sure that you have a Malaria Kit and Malaria Alert Card
• Make sure you have informed your family of the risk and symptoms of malaria. Tell them what to do if you get sick – you may be too ill to tell them later
(Your family & friends can save your life!)
• Make sure you follow the malaria response procedure if you encounter malaria symptoms within 60 days after having left a malaria risk country.
When Leaving a Malaria Risk Country
Site/Country Manager Responsibilities
• Ensure awareness training to employees• Provide resources to reduce mosquitos at
work & accommodation sites – Maintain housekeeping – eliminate standing
water (puddles, sumps, pot plant trays etc.)– Fog sites regularly– Screens on windows & doors– Provide insect repellent, coils, mosquitos nets
etc.– Provide & maintain air conditioning– Inspect sites for mosquitos management
• Ensure constant supply of in-date malaria test kits & alert cards
• Require reporting & record all uses of malaria tests - & result
REPORT ON MONTHLY SCORECARD
Site/Country Manager Responsibilities
• Ensure visitor inductions & include malaria awareness – Check for awareness training– Carry out awareness training as
necessary– Check for in-date malaria test kits (each
visitor must have one & take it away with them)
– Provide malaria kit as necessary– Record inductions & checks– Record issue of malaria kitsMalaria is a country-specific risk.
Country managers are accountable to warn & act
Malaria is a country-specific risk. Country managers are accountable to
warn & act
Traveller Responsibilities
• Attend malaria awareness before travel• Take malaria preventive medication• Follow precautions to prevent mosquito
bites• Keep malaria test kit with you while in
malaria risk countries & for 60 days after
• Use test at first sign of flu-like symptoms or see a doctor
• Act fast to a positive test
Take malaria seriously!Take malaria seriously!
• Malaria is serious and can be FATAL!!• Not all anti-malaria medications protect against all
four types of malaria.• Malaria has built up resistances to some
medications in different parts of the world. • Symptoms of malaria resemble those of the flu or
common cold.• Take proper precautions to protect yourself from
insect bites, specifically mosquito bites.• Boart Longyear recommends that you take
preventive medications. Proper preventive medications drastically reduce the chance of contracting malaria.
• If you suspect you have malaria, follow the malaria response procedure.
MALARIA
= EMERGENCY!
Malaria in Conclusion