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Wednesday, July 12, 2017

Experts explain how leptospirosis could lead to tahfiz student's death

A Facebook page dedicated to providing a layman explanation on various scientific inquiries have sought to explain circumstances which could have led to the death of tahfiz student, Mohamad Thaqif Amin Mohd Gaddafi, which an official autopsy report had identified as being due to a leptospirosis bacterial infection.
Thaqif, aged 11, died after both his legs and his right arm were amputated, at the time reported as following suspected abuse at his school - Madrasah Tahfiz al-Jauhar in Kampung Lukut, Kota Tinggi, Johor.
Thaqif’s mother has rejected the outcome of the autopsy conducted by a special investigation committee that was formed to probe the death and released on Monday.
Further questions were also raised by netizens who responded to the news reports which had gone viral, among others, on how the bacterial infection could have led to the multiple amputations and death.
In response to the questions, administrators behind the Root of Science Facebook page - who are listed by their full names and professional qualifications but does not sign off on any postings - have clarified the possible circumstances through an article which was later endorsed by Health Ministry director-general Noor Hisham Abdullah (photo).
Among others, they quoted findings from the autopsy report which explained that Thaqif could have suffered from Disseminated Intravascular Coagulopathy (DIVC) - a rare condition when a severe bacterial infection, in this case leptospirosis, could prevent his blood cells from clotting and lead to continuous internal bleeding.
“It is very rare for a person who contracted leptospirosis to (also) suffer from gangrene in the legs. But it can happen from DIVC because the condition can cause severe blockage in the blood vessels which then prevents blood from flowing to the legs.
“This then kill the cells in the leg and causes gangrene. Dead cells are perfect for breeding bacteria. It could be due to that the doctors treating him decided to amputate the gangrenous leg infected by (leptospirosis) bacteria to (try and) save the patient’s life,” explained the writer.
In the post, it was noted that symptoms of the condition are in line with signs showed by Thaqif, as previously mentioned by his relatives.
These include the pain he felt in his legs around two weeks after he was allegedly hit by an assistant warden, and the subsequent discovery of blood clots after he was warded at the Sultan Ismail Hospital in Johor Baru.
Two or three months to analyse sample
To questions on reasons behind the perceived delay in completing the autopsy report, it was explained that two or three months is the average time needed for the Health Ministry’s Histopathology Department to complete its study on skin cell samples taken from Thaqif.
“And at this time, it is not an ‘urgent’ sample like for example samples to detect cancer. So for the sample to be analysed for two or three months is a normal situation…,” it said.
Within the comment section, the page administrators also responded to netizens who questioned whether Thaqif could have contracted leptospirosis via existing injuries due to the alleged beatings.
“In this case, the ‘caning’ is most probably a separate and unrelated issue, but unfortunately it happened before or during the time of infection,” it said, adding that the bacteria will also not be “triggered” by any alleged beatings.
“Open wounds which increase risk of bacterial infection is a possibility. But the bacteria will not ‘re-incarnate’ due to caning,” it further explained.
The question was asked in the context of an open wound or skin abrasion being one way that the leptospirosis bacteria could infect a person.
It also alluded to the beatings which Thaqif had allegedly suffered from and whether its impact could have triggered the bacteria in his system.
When contacted, Noor Hisham told Malaysiakini that outcome of the autopsy did not identify possible causes of the leptospirosis infection, including whether it was through existing injuries.
“The post-mortem only showed the cause of death due to multi-organ failure, as reported,” he said.

Noor Hisham added that public health surveillance measuresare ongoing to identify the possible source of infection.
Thaqif’s school principal Mohammad Afdhaluddin Ismail had said that Thaqif showed no signs of illness while boarding at the dormitory and insisted there was no chance the boy had contracted leptospirosis while under its care.
Police had initially arrested and investigated the school’s assistant warden for alleged murder but deputy inspector-general Noor Rashid Ibrahim yesterday said that it may now seek a lower charge following the latest developments.- Mkini

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