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Know up to 233 cases! Scary red bumps that itch “Doctor Supat” wade to find the culprit, found “Itchy shell disease”
November 11, 2020, Facebook page Dr. Supat Ha Suwannakit, MD. Posted in the case of villagers with itchy red bumps on their limbs after a field trip in the Chana district area, Songkhla province, indicating that the farmer has had an itchy rash. On a mission to catch the culprit
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In the last month The incidence began to be found in many patients with skin rashes. With a terrible red itchy bump Itchy extremities It was found that the patients spread to 7 sub-districts, all patients developed rashes after the procedure. In most cases, patients begin to itch for 1-3 days after the procedure. The rash has specific characteristics. It is a rash on both legs and on the arm that predominates only with black embroidery. The other arm that was used to place the seedlings on the arm that had not touched the water did not have a rash. There are no rashes in shady areas or other areas that do not touch the water. Up to 233 patients were found who came for treatment, and some of them were not that many and did not. Each patient said with one voice that each year, I never met in this way. I have been a doctor in the hospital for over 20 years and never met them.
The question is What is the cause of this severe itchy rash? Chemical contamination in the water? Or caused by parasitic pathogens The hospital has been assisted by the Office of Occupational Diseases Source of the Ministry of Public Health. Southern Institute of Dermatology, which is located in Trang province. And Hat Yai and Songkhla Nakarin Hospital doctors Together to investigate the disease and find the cause From the medical history, physical examination, mapping the outbreak, the remaining 2 possible causes It is an itchy rash from mollusk parasites, the most suspected culprit. Wastewater from agriculture or factories probably is not. But I still have to think about it
Therefore, in order to accurately capture the culprit Therefore, the water and mollusks must be examined and 4 patients are willing to perform a skin biopsy or cut the skin tissue for examination under a microscope. And then we were able to catch the culprit. The skin biopsy test showed the larvae of cercaria in three of the four patients and in the water that was analyzed it was found. And from going to the area to explore shells in the fields Cherries, nautilus and oysters were found, and Cercaria was also found.
Then it can be concluded that This rash Diagnosed as cercarial dermatitis or swimmer’s itch or a Thai name called Shellfish disease The itch or rash is caused by the penetration of the parasite larvae into the skin of the patient. But this parasite is a blood parasite that grows only in animals (Animal Schistome) and cannot become adults in humans. When Chun Chai enters the human body, the parasite will die after a period of time around the skin. But spreading it on the skin causes a rash and itching. Which is caused by an immune response reaction in the body. It was found that most of the patients recovered their symptoms after 1-2 weeks of treatment. Using conventional topical steroid medications can help them recover faster.
Most of the questions that no one has answered are: What caused this parasitic outbreak? Or because climate change favors the growth of shellfish and parasites. Either the recirculating runoff flow that is blocked to fill the OR there are other reasons why we did not expect But surely if next year repeats the continued decline in the agricultural area of Chana is likely to be reduced significantly more.
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