As the district administration continues to grapple with leptospirosis, questions have been raised about the diagnosis of the disease and the difficulty doctors face in identifying the infection which has symptoms similar to dengue and malaria.
The case in point was that of Praveen (17), who is among the four persons who have died because of leptospirosis so far. Praveen and his father Seetharam Poojary were subjected to tests at KMC Hospital in Attavar on August 18 following the death of Praveen’s elder brother Deepak Poojary. While Mr. Seetaram was tested positive, Praveen tested negative for the disease. But he got readmitted to the KMC hospital at Jyothi Circle the same night and he died of the disease on August 20.
Physician B. Srinivas Kakkilaya said identifying the disease clinically has challenges. Malaria, dengue, chikungunya and leptospirosis shared common manifestations and it is difficult to differentiate.
The doctors will have to spend more time with patients for a more accurate diagnosis. The ache behind the eyes could suggest both dengue and leptospirosis. Frequency of fever, body ache, white blood cell (WBC) count, urine analysis should all be evaluated. Low WBC count could indicate dengue, high WBC and urine abnormality would indicate possibility of leptospirosis. Indications of jaundice would be added factor. Thereafter lab tests could be used for further confirmation.
An official from the KMC said Praveen underwent a microbiological test specific to leptospirosis on August 18, which showed negative. The second test of the blood sample of Praveen taken on August 20 has shown him to be positive for the infection but this report was received only on Tuesday. Mr. Seetaram was undergoing treatment for the infection in the hospital, he added.
A senior district official from the Department of Health and Family Welfare said the procedure adopted by the hospital on Saturday cannot be faulted. The official said the test done on Praveen was the one that was also done on his father on the same day and his father was found positive for leptospirosis.
The official said personnel working in Urban and Primary Health Centres have been trained in detecting malaria, dengue and leptospirosis which are common infections found in the district. The official said malaria is ruled out first when patients with fever are admitted. This will be followed by a test for dengue using the rapid diagnostic kits provided by the Central Government. Lastly the patients are subjected to leptospirosis tests, the official said.
Dasacharya from Father Muller Hosptial said a doctor has to physically examine a patient and also look at the history of the patient’s exposure to leptospirosis. Laboratory tests specific for the infection are carried out for confirmation. It was necessary for the patients to visit nearby hospital during the early days of fever.