Wednesday, October 14, 2009

LEPTOSPIROSIS: There’s Something Lurking in The Flood

It’s not about any monster, nor even any species of flesh-eating reptiles. It’s smaller than the tip of your hair, only about 5 to 15 micrometers, but it is very dangerous and can kill.
Every year, during times of rain and flood, acute respiratory infections such as bronchitis, pneumonia and colds become widespread, as well as dengue fever, influenza, cholera, typhoid fever, malaria, hepatitis-A and red-tide poisoning. For the past few years, the Department of Health (DOH) had also released another warning, against leptospirosis, a bacterial infection that also breaks out during the rainy season, especially when there are floods and stagnant waters.
Leptospirosis, sometimes called Weil’s Disease (named after the German physician, AdolfWeil, who first described it in1886), Infectious Jaundice or Swineherd’s Disease, is a contagious disease of animals, which is also transmissible to humans, caused by a pathogenic spirochete (spiral-shaped bacteria) of the genus Leptospira.
According to the DOH’s Communicable Disease Control Service, anyone who is exposed to water, moist soil or vegetation that is contaminated with the urine of infected animals, most particularly rats and other rodents, is subject to infection.
The number of attended cases of leptospirosis in Metro Manila alone has more than doubled in the last five years. Records dating back to 1995 showed that most victims were children seven to 12 years old, constituting nearly 55 percent of the reported cases. This is most likely because children love to play, wade and swim in floodwaters unknowingly exposing themselves to the microorganisms.
“The bacteria usually enters the body through a wound. But the skin, even if it is not broken, also has pores where the leptospira bacteria can enter,” said DOH medical specialist Nerissa Domingo.
The reservoir of leptospires includes rodents and certain domestic animals like cats, dogs, pigs and cattle. These animals excrete live, fully virulent organisms in their urine and contaminate the environment. Outside the animal’s body, leptospires can live for several weeks in fresh water. Thus infection takes place by direct contact with the urine of infected animals or by indirect contact with contaminated food or water.
Leptospires can readily penetrate mucous membranes and may gain entrance to the body through the pores on prolong exposure. A scratch, abrasion or wound, as well as the nasal mucosa and eye, are excellent portals of entry; thus the origin of many infections can be traced to contact with water containing virulent leptospires, most particularly to stagnant flood water.
While it has been known to cause many losses among stock animals, the incidence in humans depends upon the opportunity for exposure in wading and swimming in contaminated waters, the harvesting of rice in paddies where the organisms are present, and contact with infected animals.
Clinical evidence of the disease in humans varies depending upon the severity of infection. The first sign of the disease, usually after an incubation period of five to 12 days, is manifested by fever, followed by pain in the legs and thighs, then influenza-like symptoms such as headache, back and muscular pains. Nausea, vomiting, abdominal pain and diarrhea are usually experienced midway. One characteristic symptom is congestion of the conjunctival blood vessels around the corneas of the eyes, as such, reddish eyes are evident. Jaundice, the condition in which the eyeballs, the skin, and the urine become abnormally yellowish, may occur after the first week of illness. And if the disease is not diagnosed and treated immediately, liver and kidney infections developed, and bleeding also occurs in the urinary tract.
Death usually occurs after severe hemorrhage and systemic infection or the breakdown of the body functions such as renal failure because the infection has spread to almost all the vital organs. The death rate is approximately 30 percent of the severely ill and jaundiced patients.
To prevent contracting leptospirosis, experts advised the public to avoid wading or swimming in potentially contaminated areas such as stagnant mudholes and floodwaters. If this cannot be avoided, proper skin protection like boots and gloves should be used.
Since the bacteria comes from the excretion of animals such as rodents and even cats and dogs, the DOH said households must control rats by using rat traps or poison, and maintain healthy pet management, cleanliness in the house and surrounding environment. Areas where waters become stagnant after heavy rainfalls must be drained regularly and thoroughly.
The DOH said it is important for residents of both urban and rural areas who experience frequent flooding to know about the disease. Patients exhibiting the aforementioned symptoms should be taken to the hospital immediately. The department’s health advisory also reminded the public about properly cooking food, boiling water from doubtful sources for at least twenty minutes, and properly handling and disposing garbage.

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