The current weather has led to an increase in several water borne diseases, ranging from mild to serious. Leptospirosis commonly known as rat fever is one of them. Figures from the Epidemiology Unit (5,275) although less than the previous year, is still a matter of concern to health officials. As many of our readers who are at risk of this disease don’t understand what it means, the Sunday Observer asked to Head and Professor, Department of Microbiology, Faculty of Medicine, University of Peradeniya, Chandika D. Gamage to explain what leptospirosis is.
He said, “Rat fever or the leptospirosis is a bacterial disease. Rats and other rodent species such as squirrels, hamsters, porcupines, and their relatives harbour the bacteria which cause leptospirosis.”
Questioned as to when the disease occurs he said, “Usually we see high number of cases soon after rainy seasons and flooding episodes.”
He said those at the highest risk were agriculture and livestock farmers and their families who are involved in agricultural activities, veterinarians and animal handlers and manure labours who are exposed to sewage and other contaminated water related environments.
However, he added, “We have come across patients who are teachers, trade personnel or pudlic servants and had limited exposure to risk environments. Clean environment not infested by rodents or chronically infected animals is an important factor. ”
Prof. Gamage said, “This is a water-borne or water associated disease which means bacteria need moisture or watery media to move one host to other. Bacteria survive in animals’ kidneys and excrete to the environment via urine. Bacteria can survive a couple of months in soil, but moisture content is important. The commonest route of infection is water contaminated by either natural reservoirs i.e. rats and rodents or chronically infected livestock and pet animals.”
He said that contaminated environment caused by poor housing and waste disposal causes flooding even due to a light rain making the environment more prone to spreading of pathogenic bacteria.
He said, “Having cuts or lacerations on feet or elsewhere which can get exposed to water (contaminated) is a major risk of getting leptospirosis.”
On the adverse effects on an infected person, he said, “This varies a lot due to the person’s immune status. Mostly, we have seen acute liver failures and kidney failures due to leptospirosis. Recently, we have noticed a couple of pulmonary cases (lung involvement) from the South. On the plus side, with proper medical treatment, these conditions can be reverted. However, delay in identifying and treating the disease can lead to multi-organ complications.”
On symptoms to watch out for, he said, “Most symptoms resemble other common tropical diseases such as dengue or common viral infection. If a person feels fever or discomfort after an exposure to water or muddy environment or after gardening or clearing of drainage systems, he should look for medical advice and proper laboratory investigation. ”
He said, “According to samples we receive and diagnosis we produce, we have noticed early detection and treatment will cure almost 100 percent unless not complicated with other viral or immunological disorders.”
On easily accessible treatment for patients, he said, “The Health Ministry has advised to use Doxycyline as a prophylactic treatment for high risk occupational categories mainly for paddy farmers. The most important fact is to get diagnosed early and follow the proper medical treatment. This is not a fatal disease if diagnosis and treatment start early.”
Prof. Gamage listed Dos and Don’ts to protect people from being infected.
Do’s:
1) If you are exposed to unclean or animal infested water sources or muddy areas and feel uncomfortable (fever and body pains), immediately seek medical advice.
2) Proper garbage disposal.
3) Keep clean your house and surrounding especially drainage lines.
4) Livestock farmers should prevent access of wild animals and rodents in to their premises.
5) Get yourself educated about leptospirosis and try to educate others.
Don’ts
1) Get self medications if you suspect leptospirosis (don’t take antibiotics by yourself).
2) Keep room for nesting of rats and other rodents in your premises.
3. Don’t get into muddy or water stagnant places when you have cuts or lacerations on your feet or hands.