Rats and bandicoot
plague could cause death:
Leptospirosis epidemic on the rise-don’t delay to seek medical care
and adhere to preventive measures...
By Rosanne Koelmeyer Anderson
[email protected]
A plague of death due to Leptospirosis, a high risk zoonotic disease
which mimics symptoms of serious viral fever similar to Dengue and
Chickungunya has been reported from around the country causing 41 deaths
up to April 11, Dr Navaratnasingam Janakan, Consultant Epideiologist,
Epidemiology Unit of the Ministry of Healthcare and Nutrition told the
Sunday Observer.
 Death due to the epidemic is on the increase because of
delay in care seeking and failure to adhere to preventive measures.
There is no vaccine to prevent Leptospirosis.
In 2007, the total number of Leptospirosis cases notified were 2195
with 34 deaths reported but this year up to April 11 the total number of
cases notified has been 1147 and 41 deaths; an alarming increase causing
much concern to health authorities. The highest number of reported cases
have been from the Matale, Colombo, Kalutara, Matara, Gampaha and Galle
districts.
A good number of cases were also reported in the Ratnapura,
Hambantota, Moneragala and Anuradhapura areas as well, Dr Janakan said.
‘Leptospirosis is an infectious disease caused by bacteria leptospires
and is more common in tropical countries.
Leptospires are naturally seen in the kidneys of rodents, certain
mammals and livestock, canines and wild mammals in particular; a disease
transmitted from animals to humans which was earlier identified as an
occupational hazard affecting farmers especially during the paddy
harvesting season, gem miners, sewage workers and those who engage in
work in marshy land in particular.
However, the change in weather patterns, high humidity and periodic
heavy rainfall has intensified outbreaks of Leptospirosis in the recent
past. Usually, the peaks of incidence are the two monsoon periods’, Dr
Janakan explained.
‘The bacteria leptospires is very virulent in rodents especially rats
and bandicoots when they are displaced from their burrows and drains are
contaminated due to floods.
These animals are said to continuously excrete leptospires with their
urine although they do not suffer from the disease and exposure to
leptospire contaminated environment which enters the body through
abraded or traumatized skin, nasal, oral or eye mucous membranes leads
to infection and causes Leptospirosis’, Dr Janakan further explained.
Leptospirosis may present a wide variety of clinical manifestations
and mimic diseases such as dengue fever, influenza, meningitis and
Jaundice posing a high risk as the incubation period is between 1-2
weeks.
The common symptoms are that the patient begins to develop high
fever, redness of eyes and very severe muscular tenderness in the calf
muscles notably in the lumbar region and some times due to incorrect
diagnosis and the delay in proper care seeking could lead to death.
Death in such instances is often a result of complications which
occur as a result of seeking proper care which in turn results in renal
failure, miocarditis and bleeding in some organs especially the brain
and the lungs.
‘Diagnosis of Leptospirosis should be considered in any patient
presenting an abrupt onset of fever, chills, conjunctival suffusion,
headache or muscle tenderness. If any doctor suspects that a patient
could be having Leptospirosis he/she should refer the patient to the
districts Epidemiology Unit as confirmatory diagnosis tests are not
freely available.
Confirmatory diagnosis tests are available at the MRI, the Medical
Faculty and some of the Private sector hospitals and these tests become
positive only after the second week.
Even simple urine full report (albumin+) and white blood cells/
differential count (Polymorpholeucocytosis) would help the clinicians to
make a probable diagnosis and decide if hospitalization is necessary.
Patients especially in high risk areas should give the doctor the
history of the environment they are exposed to when seeking treatment.
Leptospirosis is a potentially serious but treatable disease and it
has to be administered with the most effective antibiotics at the
earliest. Doxycycline can be administered to people who are at very high
risk’, Dr Janakan went on to explain.
How can you prevent Leptospirosis ?
Preventive measures must be based on knowledge of the high risk
groups and the local epidemiological factors.
Raising awareness about the disease is a very important factor.
Health care providers can play an important role by educating the public
on how to recognize and treat the disease at the earliest. If you are or
know of anyone involved in occupations such as farming, mining, cleaning
drains and canals Dr Jankan’s advise is to inform the area MOH or PHI .
The following specific measures can help prevent Leptospirosis:
* Removal of rubbish and keeping areas around human habitation clean
to control rodents.
* Keep animals away from gardens, playgrounds, sandboxes and other
places where children play.
* Wear appropriate protective clothing, knee-high boots and gloves
and cover all wounds with waterproof dressing *Use boiled water
(chlorination is seldom useful as virulent organisms withstand up to 4
ppm; filtered water is also not safe)
* Avoid walking in flooded water
* Doxycycline has been reported to give some protection against
infection and disease.
Highest number of cases of Leptospirosis reported from January
-April 11, 2008
Matale 173
Colombo 137
Kalutara 135
Matara 123
Gampaha 106
Galle 115 |
