Leptospirosis Philippines Outbreak - Death Toll at 89

The Department Of Health have declared an outbreak of leptospirosis in three barangays in Marikina as the death toll hit 89 cases. The three barangays are Tumana, Concepcion and Malanday. Secretary of Health, Francisco Duque III said the number of leptospirosis cases in public hospitals rose tremendously from 140 to 1027 between October 12 to 15.

The death toll from leptospirosis reached 89 as cases of the flood-borne disease in Metro Manila and flooded provinces rose tenfold in the past three days, the Department of Health (DOH) reported yesterday.

“Cases of leptospirosis have really shot up these past few days. In fact, the Metro Manila figure even exceeded the 812 nationwide admissions in government hospitals for the whole of last year,” Duque further added.

“As we start to see in the National Capital Region (NCR), we also expect a lot of cases in the communities in Rizal, which make up the biggest number of barangays still under water at this time,” Duque noted.

“Although fewer than five cases were recorded in each barangay, we declared an outbreak because those areas had zero incidence of the infection last year,” Duque said.

According to Secretary Duque, at least 1.7 million people are at risk of acquiring leptospirosis since many areas in Metro Manila and CALABARZON are still submerged. He further believed that at least 3000 cases will be infected by the disease.

“We expect 3,800 people to get the infection and of this number, 3,040 will suffer uncomplicated symptoms while the rest will manifest complicated symptoms that would require them to undergo dialysis or face eventual death,” Duque said.

In response of the DOH to prevent the increase of leptospirosis, the department is giving 100 mg prophylaxis capsule to people at risk. “For the next three weeks, we will be giving 100 mg. prophylaxis capsule once a week to those at risk of acquiring the infection,”.

Medical experts clarified that the prophylaxis would only protect the people for a week, thus they are encouraged to avoid wading in floodwaters, especially if they have an open wound.

Increase in Leptospirosis Disease in Flood Stricken Area

The Department of Health told the press that there is a total of almost 400 cases of leptospirosis in Metro Manila after two weeks that Ondoy has devasted the country

As of October 12, the Department of Health has recorded 383 cases in nine hospitals in Metro Manila.

These are the East Avenue Medical Center (69 cases), Jose Reyes Memorial Medical Center (1), Manila Doctor’s Hospital (10), The Medical City (70), National Kidney and Transplant Institute (28), Quirino Memorial Medical Center (18), Philippine General Hospital (17), Rizal Medical Center (13) and San Lazaro Hospital (157).

“We strongly advise anyone who has a history of wading in the recent floods and who has the symptoms of the disease to consult at once at the nearest doctor or health facility for treatment,” Health Secretary Francisco Duque III said in an interview.

“This is a cause for concern since this surge in the number of cases reported by only nine Metro Manila hospitals already represents about half of last year’s annual figures,” the Secretary further added.

For the information of the general public here are some facts about leptospirosis from DHPE.org

Leptospirosis [lep-to-spy-RO-sis] is a potentially serious bacterial illness that is most common in the tropics. Leptospirosis can affect many parts of the body.
Infected wild and domestic animals pass leptospirosis-causing bacteria in their urine.

People get leptospirosis by contact with fresh water, wet soil, or vegetation that has been contaminated by the urine of infected animals.
Leptospirosis is treatable with antibiotics.
To prevent leptospirosis, minimize contact with fresh water and mud that might be contaminated with the urine of infected animals.

What is leptospirosis?

Leptospirosis is a potentially serious illness that can affect many parts of the body.

What is the infectious agent that causes leptospirosis?

Leptospirosis is caused by Leptospira interrogans, a corkscrew-shaped bacterium (spirochete).

Where is leptospirosis found?

Leptospirosis-causing bacteria are common worldwide, especially in tropical countries with heavy rainfall. Infected rodents and other wild and domestic animals pass the bacteria in their urine. The bacteria can live for a long time in fresh water, damp soil, vegetation, and mud. Flooding after heavy rainfall helps spread the bacteria in the environment.

How is leptospirosis spread?

People get leptospirosis by contact with fresh water, damp soil, or vegetation contaminated by the urine of infected animals. People who canoe, raft, wade, or swim in contaminated lakes, rivers, and streams can get leptospirosis. Leptospirosis is also a problem for people who work in contaminated flood plains or wet agricultural settings.

Leptospirosis bacteria can enter the body through broken skin and mucous membranes. The bacteria can also enter the body when a person swallows contaminated food or water, including water swallowed during water sports. Once in the bloodstream, the bacteria can reach all parts of the body and cause signs and symptoms of illness.

What are the signs and symptoms of leptospirosis?

Most infected persons have a mild to moderate illness that is like many other tropical diseases. Symptoms include fever, headache, chills, nausea and vomiting, eye inflammation, and muscle aches. In more severe cases, the illness can result in liver damage and jaundice (yellowing of the skin and whites of the eyes), kidney failure, and internal bleeding. People who are seriously ill with leptospirosis often need to be hospitalized.

How soon after exposure do symptoms appear?

Symptoms usually begin about 10 days after infection.

How is leptospirosis diagnosed?

Leptospirosis is diagnosed by a special blood test that is available through state health departments.

Who is at risk for leptospirosis?
People who take part in freshwater recreational activities in areas where leptospirosis is common, especially during the rainy season or in times of flooding
Farmers, workers in rice fields, sewer workers, and others whose jobs involve contact with water or mud that is contaminated by animal urine, especially the urine of rodents Veterinarians and others in contact with leptospirosis-affected animals

What complications can result from leptospirosis?

Severe or untreated leptospirosis can lead to organ system damage and, in rare cases, death.

What is the treatment for leptospirosis?

Leptospirosis is treatable with antibiotics. Treatment should be started as soon as possible. Severely ill persons might need intravenous antibiotic treatment and other supportive care.

How common is leptospirosis?

Mild leptospirosis is common in tropical countries where people have regular contact with fresh water and animals. The disease is under-diagnosed in the United States. The 50 to 150 cases reported each year are probably only a fraction of the total number of infections.

Is leptospirosis an emerging infectious disease?

Yes. Increased awareness of the disease has led to increased recognition. In 1995, after widespread flooding in Nicaragua, a leptospirosis epidemic killed at least 13 persons and made more than 2,000 others sick. In 1997, nine whitewater rafters from the United States were infected during a river trip in Costa Rica. Leptospirosis is also a problem in deteriorating inner cities that are infested with rats.

How can leptospirosis be prevented?

Minimize contact with fresh water, mud, and vegetation that might be contaminated with the urine of infected animals, especially rodents.
Wear protective clothing, such as waterproof boots or waders, when participating in recreational or work activities that might result in contact with contaminated water.

source: http://www.dhpe.org/infect/Lepto.html