Investigation of Crew Member Deaths aboard KM Sri Mariana Indonesia: A Case Study Differentiating Leptospirosis and Beriberi

The death of six crew members aboard the KM Sri Mariana during a prolonged voyage in the Sunda Strait in August 2024 raised concerns of a potential outbreak caused by infectious diseases, particularly leptospirosis. Objective This article aims to analyze the causes of death and illness among the crew members of KM Sri Mariana based on epidemiologial, clinical, and laboratory data, with emphasis on the differential diagnosis between leptospirosis and beriberi. Methods A descriptive case-based study was conducted using data from epidemiological investigations, laboratory examinations of human and environmental specimens (PCR, serology, and vitamin B1 status assessment), and a review of relevant literature on infectious and nutritional deficiency diseases among maritime workers. Results is Laboratory investigations did not provide strong evidence supporting leptospirosis as the primary cause of the event. In contrast, vitamin B1 deficiency was identified in the majority of examined crew members. These findings were consistent with clinical manifestations, including peripheral edema, muscle pain and weakness, and respiratory distress. The pattern of illness demonstrated a close association between prolonged sea voyages, heavy physical workload, limited nutritional intake, and the development of beriberi. Beriberi due to vitamin B1 deficiency is the most likely etiology underlying the deaths and illnesses among the crew members of KM Sri Mariana.