January 24, 2014

The Situation
More Flooding Likley in Jakarta, Indonesia with Heavy Rainfall Forecast
Comments

Heavy flooding is likely to continue in Jakarta through at least early February, when the rainy season is predicted to peak. Flood waters began to recede in many affected parts of Jakarta, though large portions of South Jakarta and East Jakarta remained inundated. However, heavy rainfall in Bogor and Depok, West Java are likely to cause river water levels to rise, contributing to flood conditions as water flows downstream. The situation will probably be worst during periods when heavy rainfall occurs as rising waters reaches the city. Additional flooding is likely in the capital through at least Jan. 26.

Floods have disrupted road traffic and public transport in and around the capital. Weather-related traffic congestion is likely to be worst during periods of heavy rainfall due to the threat of flash flooding. While there has been no direct impact on flight operations at Soekarno-Hatta International Airport (CGK) in Tangerang, delays are possible if airline crews have difficulty reaching the facility from hotels in Jakarta. Flooding has occurred along a stretch of the Sedyatmo toll road, the main route for those headed to CGK. Widespread power outages are also possible: state electricity company Perusahaan Listrik Negara shut down 433 substations Jan. 19 to prevent electrocution in flood-hit areas.

The latest round of flooding has affected Daan Mogot and Grogol areas in West Jakarta; Gunung Sahari and Rubber Tengsin in Central Jakarta; Jatinegara and Kampung Melayu in East Jakarta; Cawang, Kalibata and Tebet in South Jakarta, and Kelapa Gading, Pluit and Penjaringan in North Jakarta. All areas are susceptible to flooding during periods of heavy rainfall, with portions of East Jakarta most at risk for severe flooding. At least 12 people have been killed and more than 64,000 others displaced during the floods.

Waterborne Diseases
Dengue fever, also known as breakbone fever, is an infectious tropical disease caused by the dengue virus. The virus is transmitted by several species of mosquito and has five different types; infection with one type usually gives lifelong immunity to that type, but only short-term immunity to the others. Subsequent infection with a different type increases the risk of severe complications.

Symptoms, which usually begin four to six days after infection and last for up to 10 days, may include:

  •     Sudden, high fever
  •     Severe headaches
  •     Pain behind the eyes
  •     Severe joint and muscle pain
  •     Nausea
  •     Vomiting
  •     Skin rash, which appears three to four days after the onset of fever
  •     Mild bleeding (such a nose bleed, bleeding gums, or easy bruising)

Sometimes symptoms are mild and can be mistaken for those of the flu or another viral infection. Younger children and people who have never had the infection before tend to have milder cases than older children and adults, however, serious problems can develop. These include dengue hemorrhagic fever, a rare complication characterized by high fever, damage to lymph and blood vessels, bleeding from the nose and gums, enlargement of the liver, and failure of the circulatory system. The symptoms may progress to massive bleeding, shock, and death. This is called dengue shock syndrome (DSS). People with weakened immune systems as well as those with a second or subsequent dengue infection are believed to be at greater risk for developing dengue hemorrhagic fever.

Doctors can diagnose dengue infection with a blood test to check for the virus or antibodies to it. If you become sick after traveling to an area where dengue is prevalent, let your doctor know. This will allow your doctor to evaluate the possibility that your symptoms were caused by a dengue infection.

There is no commercially available vaccine for dengue fever. If you think you may have dengue fever, you should use pain relievers with acetaminophen and avoid medicines with aspirin, which could worsen bleeding. You should also rest, drink plenty of fluids, and see your doctor. If you start to feel worse in the first 24 hours after your fever goes down, you should get to a hospital immediately to be checked for complications. Treatment of acute dengue is supportive, using either oral or intravenous rehydration for mild or moderate disease, and intravenous fluids and blood transfusion for more severe cases.

Leptospirosis is a bacterial disease that affects humans and animals. It is caused by bacteria of the genus Leptospira. In humans, it can cause a wide range of symptoms, some of which may be mistaken for other diseases. Some infected persons, however, may have no symptoms at all. Without treatment, Leptospirosis can lead to kidney damage, meningitis (inflammation of the membrane around the brain and spinal cord), liver failure, respiratory distress, and even death.

The bacteria that cause leptospirosis are spread through the urine of infected animals, which can get into water or soil and can survive there for weeks to months. Many different kinds of wild and domestic animals carry the bacterium.

These can include, but are not limited to:

  •     Cattle
  •     Pigs
  •     Horses
  •     Dogs
  •     Rodents
  •     Wild animals

When these animals are infected, they may have no symptoms of the disease.

Infected animals may continue to excrete the bacteria into the environment continuously or every once in a while for a few months up to several years.

Humans can become infected through:

  •     contact with urine (or other body fluids, except saliva) from infected animals
  •     contact with water, soil, or food contaminated with the urine of infected animals.

The bacteria can enter the body through skin or mucous membranes (eyes, nose, or mouth), especially if the skin is broken from a cut or scratch. Drinking contaminated water can also cause infection. Outbreaks of leptospirosis are usually caused by exposure to contaminated water, such as floodwaters. Person to person transmission is rare.

In humans, Leptospirosis can cause a wide range of symptoms, including:

  •     High fever
  •     Headache
  •     Chills
  •     Muscle aches
  •     Vomiting
  •     Jaundice (yellow skin and eyes)
  •     Red eyes
  •     Abdominal Pain
  •     Diarrhea
  •     Rash

Many of these symptoms can be mistaken for other diseases. In addition, some infected persons may have no symptoms at all.

The time between a person's exposure to a contaminated source and becoming sick is 2 days to 4 weeks. Illness usually begins abruptly with fever and other symptoms. Leptospirosis may occur in two phases:

      1. After the first phase (with fever, chills, headache, muscle aches, vomiting, or diarrhea) the patient may recover for a time but become ill again.

      2. If a second phase occurs, it is more severe; the person may have kidney or liver failure or meningitis. This phase is also called Weil's disease.

The illness lasts from a few days to 3 weeks or longer. Without treatment, recovery may take several months.

Leptospirosis is treated with antibiotics, such as doxycycline or penicillin, which should be given early in the course of the disease.

Intravenous antibiotics may be required for persons with more severe symptoms. Persons with symptoms suggestive of leptospirosis should contact a health care provider.

Advice
Seek updated information on road conditions before driving in the capital. Avoid flooded areas to the extent possible. Use caution around rivers and streams after heavy rains in the metropolitan region or interior areas of the Bogor regency in West Java Province. Allow considerable extra time if driving to or from Soekarno-Hatta International Airport. Observe strict food and water precautions.  If you experience any of the symptoms related to the illnesses discussed above during or after your travels, seek medical treatment immediately.

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The content of this edition of AssistAlert is for informational purposes only and is not intended to replace further investigation or personal observations. If you are planning travel, or are traveling in or proximate to the locations identified in this newsletter, you are encouraged to contact SecurAssist for additional information.

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