It took my colleague eight long hours to reach our current location. As she shared her journey from the north to attend a conference, I couldn’t help but dwell on the bigger issues at hand. Climate change, diseases, poverty, and the struggles of those forced to navigate through flooded areas all came to mind.
Unfortunately, the statistics from the Department of Health paint a grim picture. Leptospirosis cases have seen a regrettable increase compared to the previous year. Leptospirosis is a zoonotic disease that can be contracted from exposure to infected animal urine. While various animals can serve as reservoirs, rats are the most notorious carriers, contaminating the environment with the bacteria.
During flooding, a dangerous combination of sewage, infected soil, and water is inevitable. While this is the most common mode of transmission, occupational exposure, recreational activities like kayaking and swimming, and even drinking contaminated water can put individuals at risk.
The disease can present in different ways, ranging from mild to severe, and in some cases, fatal. Symptoms such as fever, headache, nausea, cough, diarrhea, body pain, conjunctival suffusion, and jaundice may appear. We categorize leptospirosis into anicteric and icteric, the latter being more severe and commonly known as Weil’s disease, causing fever, jaundice, and renal failure. Complications can affect multiple systems, including the lungs, heart, and liver.
Given the local epidemiology and the presence of exposure history and symptoms, physicians need to prioritize leptospirosis as a possible diagnosis. Management primarily depends on supportive care and the progression of the patient’s condition. This may involve renal and respiratory support, blood transfusions, and antimicrobial therapy.
Prevention should be the focus, as no human vaccines for leptospirosis exist. It’s crucial to avoid potential sources of infection and keep the surroundings clean, as rats can invade spaces and contaminate food and water. If one must wade through potentially contaminated water, appropriate clothing and footwear should be worn. Animal owners and caretakers should ensure their pets are vaccinated.
Chemoprophylaxis may be considered in certain scenarios, but it’s important to consult a physician for guidance. It’s essential to understand that antibiotics do not guarantee 100% protection against leptospirosis, and monitoring for symptoms is still necessary.
While we can’t live in a bubble, we must acknowledge that everyone is at risk, with vulnerable populations being even more susceptible. Complete eradication of leptospirosis is impossible, but control measures can be implemented. Pest control for rodents is available to mitigate the risk.
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