1,097 suspected cases, 48 suspected deaths so far this year
The panic over dengue fever and the focussed attention on just source reduction and vector control activities has somehow eclipsed the fact that the incidence of leptospirosis has been on the rise in all districts after the rain began.
Cleaning workers, manual labourers and farm workers are vulnerable to this disease but public health experts point out that it is not just rural folk who are susceptible to this infection. If rodent control is not effective, the rotting garbage in urban areas and the flooding of roads after rain will mean that anyone who wades through these contaminated waters are at the risk of contracting leptospirosis.
“Our strategy to counter leptospirosis has always been to target cleaning workers and manual labours and put them on Doxycycline prophylactic treatment. This medicine has been our only weapon and it has been very effective also. But a possibility of leptospirosis should be considered when anyone from the rural area or urban slums report to the hospital with fever because during a dengue epidemic, most fevers tend to get classified as dengue,” a senior Health official said.
Till date this year, 1,097 suspected cases of leptospirosis and 48 suspected deaths due to the disease have been reported in the State. (Official figures show that only 348 cases of leptospirosis and eight deaths due to the infection have been confirmed).
Last year, the State reported 736 confirmed cases of leptospirosis and 18 deaths. Public health experts have pointed out that the suspected leptospirosis deaths this year so far has been more than double the number of deaths reported last year and that preventing mortality due to leptospirosis required a more focussed attention.
Dengue fever usually presents as a self-limiting illness and only in the case of a very small percentage has complications such as haemorrhage or shock syndrome been reported. However, leptospirosis has always been considered as a disease more dangerous and difficult to manage than dengue because of its higher mortality rate and a higher rate of serious complications. Renal failure and liver impairment results in many when there is a delay in diagnosis and treatment.
The problem of leptospirosis is invariably linked to the problem of accumulated garbage and pollution of water sources, which aggravates when the rain begins. The cases begin to spike just two weeks after the rain commences. In Thiruvananthapuram, where 294 suspected cases, 153 confirmed cases and 12 suspected deaths due to leptospirosis have been reported so far this year, cases suddenly shot up in April with the confirmation of 56 cases. In May and June, 218 and 53 suspected leptospirosis cases have been reported in the district.
Leptospirosis is contracted usually by people who come into contact with water contaminated by rat excreta. The leptospira bacteria enter the human body through minor cuts and abrasions on the skin.
Job scheme workers
After a series of leptospirosis outbreaks, including deaths, were reported from among the workers engaged for cleaning canals under the MNREG scheme, health officials have been issuing directives to panchayats that such workers be regularly given Doxycycline as a prophylaxis before they start work. The area where cleaning is to be done should be sprayed with bleaching powder 24 hours before workers are allowed to work; gloves and gum boots have to be worn compulsorily and that all workers have to undergo medical examination before they start cleaning operations.
“We have issued directives to all local bodies and primary health centres to give 200mg Doxycycline to cleaning workers on the first work day and to continue the weekly dose for 7 to 13 weeks, depending on how long the person is engaged. Clinical symptoms of this disease is no different from any viral fever and hence all doctors in the periphery have been given special instructions to ask about the patient’s job/occupation before starting treatment,” one of the Health officials said.
The mortality rate of leptospirosis is much higher than that of dengue, at seven per 100. Leptospirosis is spread not only by rodents, but also by infected cattle, pig, dogs, horses and wild animals. The disease has been known to trigger abortions in cattle and hence the Animal Husbandry department has a big role to play in issuing an early warning to the community on the presence of the infection in the community, it is pointed out.
Delayed diagnosis can lead to renal failure, liver impairment Mortality rate higher than that of dengue
Delayed diagnosis can lead to renal failure, liver impairment
Mortality rate higher than that of dengue