With rains come plethora of diseases including leptospirosis, DR TRUPTI GILADA tells SHALINI SAKSENA
Even though the monsoon brings with it the much-needed relief from the scorching heat, it does have a down side as well. Dengue and malaria are some of the diseases that are common during this season. Then there are diseases that come due to flooding and water-logging of low-lying areas. One such disease is leptospirosis.
What is it
It is mainly a monsoon associated infection associated with exposure to water, soil or mud contaminated with the urine from infected animals. It is caused by a bacteria called Leptospira. It is carried by many animals. It lives in their kidneys and is found in the urine and faeces.
Who is at risk?
Anyone who wades through flooded water is at risk. When there is water-logging, the water gets contaminated by bacteria because of the mixing of the stool or urine. The bacteria then enters the body through skin cuts or abrasions when a person wades through this contaminated water, and occasionally through the lining of the mouth, nose and eyes. Farmers are also at high risk as they may get exposed to the urine and excreta of field rats while working.
Symptoms
Symptoms usually develop after five to 14 days following exposure. The most common initial symptoms of this disease include either few or all of these symptoms: Fever, severe headache, sore muscles, chills, vomiting, and red eyes. Since these mimic other monsoon-related illnesses like malaria and dengue, clinical diagnosis can sometimes be difficult.
Few people with leptospirosis can develop severe disease and may need hospitalisation.
This can include kidney failure, jaundice, liver failure, bleeding and respiratory complications. Lesser common complications include meningitis where the lining of the brain and spinal cord gets involved and causes altered sensorium.
Treatment
This disease is commonly treated with antibiotics. Treatment is thought to be most effective when detected early. The testing can take some time and the disease may be severe in some patients. A doctor may therefore sometimes choose to start antibiotics prior to confirming the diagnosis with tests. However, some people recover spontaneously without antibiotics.
Long-term effects
Most individuals recover from leptospirosis without further sequelae. But in some individuals who went undiagnosed and untreated in the early and or acute illness, there can be long-term effects. People can have a chronic-fatigue-like illness that lasts for months. Others can have persistent headaches, depression or other neurologic complaints. Occasionally the bacteria can persist in the eyes and cause chronic eye complaints.
Prevention
As far as possible, avoid wading through puddles and water-logged areas. Wear well covered footwear in monsoon. Cover any cuts and abrasions with waterproof dressings. Wash hands and legs with soap, as leptospira bacteria are quickly killed by soap, disinfectants, and drying. Rodent control is of paramount importance and requires efforts both at individual and government level. Prompt cleaning up of garbage dumps and removing food sources that are close to housing is essential. Appropriate personal protective gear for those who work with animals or on the farms (like waterproof boots)
Those who may have been exposed to the bacteria because they waded through floods must contact their doctor immediately. The doctor may prescribe certain antibiotics (like Doxycycline) that can be taken to prevent the disease.
Dr Trupti Gilada, Consultant Physician in Infectious Disease, Masina Hospital, Mumbai