Leptospirosis cases and deaths have spiralled up in all districts in the aftermath of heavy rain and flooding. Even though the Health Department has launched an awareness drive on the efficacy of doxycycline prophylaxis, the health advisories seem to be falling on deaf ears.
In a health system preoccupied with COVID-19, the increasing number of deaths due to communicable diseases are not getting adequate attention, many health officials say.
“Patients and even doctors seem to be discounting the possibility that a patient presenting with fever and myalgia these days could be having a disease other than COVID such as dengue and leptospirosis. People go back home relieved that they tested negative for COVID, but in less than a week, their condition worsens,” says an official.
Leptospirosis has high mortality but is easily prevented by the prophylactic administration of doxycycline . However, failure to recognise the anicteric form of leptospirosis, when the disease presents as a mild, febrile illness with body pain, seems to be the current issue.
“Anicteric form of leptospirosis is mild and flu-like but an early diagnosis and treatment is crucial so that the patient does not go into later complications. It is the clinician’s skill in suspecting lepto, which makes the difference between a patient living or dying,” he says.
Leptospirosis cases are reported throughout the year in Kerala, with occasional spurts during monsoon months. The disease-causing organism is transmitted through contact of the skin and mucous membranes with water or mud contaminated with rodent and other animal urine. During heavy flooding, the infectious organism is spread to larger and distant areas and, hence, everyone who come into contact with overflowing waters are at risk of contracting the infection.
“Usually, we suspect leptospirosis in people living in rural areas, those engaged in agrarian activity or canal/cleaning work. But the altered rainfall pattern in the State in recent times and continuous episodes of flooding and rainwater stagnation, even in urban areas, have changed the seasonality of the disease and even the profile/ social strata of those affected,” says a senior clinician.
In 2018, 2,079 confirmed cases and 99 deaths were reported in the State, two-thirds of which were reported in September, two weeks after the major floods in August. In 2019, 1,211 confirmed cases and 57 deaths were reported.
A significant number of suspected leptospirosis cases/deaths too are reported every year because laboratory diagnosis even in the acute phase continues to be a challenge.
However, this year, already as on November 19, 1,333 confirmed cases of leptospirosis and 46 deaths (2,053 suspected cases and 180 suspected deaths) have been reported.