Leptospirosis epidemic worries Kerala after floods

After the removal of water from most flooded areas of Kerala, the state was threatened by the epidemic of leptospirosis (rat fever), a zoonotic infection caused by the bacteria. Theeptospira. According to the Kerala Health Services Directorate (DHS), 54 people died of leptospirosis, of which 19 deaths were confirmed by 3 September.

In August, 559 cases of leptospirosis were suspected, including 229 confirmed cases. From September 1 to 3, 283 cases were reported, including 143 confirmed cases of rat fever, DHS reported.

On August 28, DHS alerted about the outbreak of rat fever. "There is a sudden increase in leptospirosis in the districts of Thrissur, Palakkad, Kozhikode, Malappuram and Kannur. All had indirect contact with flood waters. You can take this situation very seriously and alert the entire clinical team in your district. Any fever with myalgia should be taken as leptospirosis and treated accordingly until further notice, "said the public health official.

The highest number of cases were reported in Kozhikode district, Kerala, where the flood was very severe. From September 1st to 3rd, more than 70 cases were reported in the district, 6 of which died.

"During the monsoon, Kerala has always been subject to this fever and this time it has become more vulnerable because of the flood," said K.J. Reena, additional director for public health. "Human contact with water contaminated with urine from rats, dogs, infected cattle, etc." causes the spread of fever in rats. We were therefore expecting an increase in cases after a flood. When we take the history of the deceased, they did not take the vaccine to prevent this disease. The department is ready to face the situation. "

Prevention is the best medicine

The health department has strongly warned all those involved in post-flood clean-up missions to take preventive medications.

"We did not have a major outbreak of diseases after a flood, but cases of rat fever have been reported in different parts of Kerala. The state is threatened by this disease, so anyone who has had a chance to come into contact with water during floods should take preventive medication. The health department is very active after the floods. We have set up many temporary health care centers in each district. The health department was well prepared and prepared to deal with this situation. We have a special treatment protocol for patients with rat fever, "K.K. Shailaja, Kerala's Minister of Health, said.

The minister also pointed out that people's reluctance to take the drug is a concern for the health department.

AP Sugunan, Senior Researcher at the Indian Medical Research Council's Regional Research Center, Andaman and Nicobar, who visited Kerala to review the current situation, told reporters in Thiruvananthapuram that "hundreds of thousands of people reported cases are low. The current health services will therefore be sufficient to cope with the situation. Of the 15 deaths except one, none had taken Doxycycline (a preventative). Anyone exposed to floodwater should take this medicine.

Although health officials have informed that the situation was not alarming in Kerala, they fear that the health status of patients worsens within three or four days following the "accident". infection, sometimes even before diagnosis. Thus, DHS informed the public that even a mild fever should be considered leptospirosis and approach the hospital immediately.

The previous Kerala government had repeatedly warned against the outbreak of communicable diseases after the floods. That's why the health department immediately set up a 30-day health plan shortly after the flood to prevent disease. In August and September, more than 70 people died in Kerala due to communicable diseases, including leptospirosis, fever and dengue fever.

Leptospirosis was still a major concern for Kerala

In 2015, 43 people died of rat fever in Kerala. In 2016 and 2017, the number of deaths was respectively 35 and 80. In 2018, from January to July 31 (before the flood), 28 people died of leptospirosis. More than 1000 cases are reported each year. Of the communicable diseases in the state, rat fever is at the origin of the largest number of deaths. Before 2010, every year, at least 100 people had died from this disease. The state being vulnerable to this particular fever, this flood had caused a huge panic, but according to health officials, there was no major epidemic as expected.

Dr. C.K. Jagadeeshan, Deputy Director of Public Health, said the ecological and environmental scenario of Kerala was favorable for this disease. "In India, leptospirosis is predominant in South India. The strong monsoon seasons, intermittent rains and waterlogging create an environment conducive to the spread of this disease in Kerala. The rodent population can easily contaminate stagnant water sources with their urine. Non-rodent hosts, including cattle, rabbits and other various domestic animals, also carry this disease. Preventive measures and early treatment are the best solution. Kerala has an effective strategy for prevention, early diagnosis, early treatment and awareness, "he added.

Kerala has experienced its worst floods in the last 100 years in August of this year, when 370 lives were lost. Although since August of last week the water has started to retreat, thousands of people still live in relief camps. A clean-up campaign is still ongoing in flood-affected districts, where health officials have set up temporary health centers to prevent communicable diseases.

However, the health department and officials say the situation is under control and the epidemic has not been as severe as they had anticipated.