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Leptospirosis - A concern after heavy rains and floods

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19 Aug, 2018

The aftermath of rains usually leaves us to battle with a host of diseases, all thanks to flooding and wading in contaminated waters. One such infection that we all need to be aware of is Leptospirosis which is seen in most urban areas where the outbreak occurs after flooding caused by heavy rainfall.

Most outbreaks of leptospirosis in India are reported from the coastal regions of the states of Gujarat, Maharashtra, West Bengal, Orissa, Kerala, Tamil Nadu, Karnataka and the Andaman Islands. Leptospirosis, the infection caused by a bacteria named leptospira and is the most prevalent zoonotic disease (which can be transmitted to humans from animals) in the world.

 

Humans can become infected with leptospira through:

  • contact with  urine of infected animals
  • Contact with water, soil, or food contaminated with the urine of infected animals.

These animals include, but are not limited to Cattle, Pigs, Horses, Dogs, Wild animals & Rodents. The first recognized carriers of leptospirosis are Rodents. Rodents can shed leptospires throughout their lifespan i.e. they can have a prolonged carrier state.

Individuals living in urban slum environments where there is inadequate sanitation and poor housing are at high risk of leptospirosis. In urban areas, domestic rats and stray dogs are known to be major sources of the pathogenic leptospira. As water-logging is a recurrent issue in Mumbai city and also due to the presence of a large number of rats and stray dogs, these factors make the city prone to leptospirosis.

 

The leptospira bacteria can enter the body through cuts or wounds on the skin or mucous membranes (eyes, nose, or mouth). Infection can also be caused by drinking contaminated water.

Veterinarians, farmers, and other individuals who work with animals and their products are at high risk, other occupations such as plumbing, sewer work, and garbage collection also involve indirect contact with infected animal products such as urine. Likewise, agricultural workers may also be exposed to contaminated soil or water. Pregnant mothers who get leptospirosis can also infect their fetus.

 Signs and Symptoms

Leptospirosis can cause a wide range of symptoms in humans which include: 

  • High fever
  • Headache
  • Chills
  • Muscle aches
  • Vomiting
  • Jaundice (yellow skin and eyes)
  • Red eyes
  • Abdominal pain
  • Diarrhea
  • Rash

Since many of these symptoms are similar to other diseases, leptospirosis can be mistaken for some other ailment. Sometimes an infected individual may have no symptoms at all. Symptoms can also take about 2 days to 4 weeks to show up after an infection.

 Leptospirosis may occur in two phases:

  • The first phase is characterized by fever, chills, muscle aches, diarrhea, vomiting, and headache. The patient may recover for some time after this first phase but can relapse.
  • If the condition relapses to the second phase, it is more severe than the first; and the person may have kidney failure or liver failure or meningitis. This second phase is also known as Weil's disease.

Leptospirosis may last from a few days to 3 weeks or longer. Recovery may take several months if not treated.

 Treatment

Mild cases of leptospirosis are mostly treated with a five to seven-day course of antibiotics. Preferred choices of antibiotics being Penicillin or doxycycline. Over the Counter painkillers (paracetamol/ibuprofen) may be advised by the doctor to help relieve symptoms such as a headache, fever, and muscle pain.

In more severe cases, Intravenous antibiotics may be required.

 Prevention

Ensuring good hygiene, covering up wounds with bandages, wearing protective footwear, and avoiding wading in flooded waters is the best prevention.