By ANNE MARXZE D. UMIL
MANILA – Leptospirosis is among the common yet potentially fatal diseases prevalent during rainy season. The recent monsoon rains that flooded many areas in the country have increased the number of cases of people infected with Leptospirosis. News reports said there are 2,213 reported cases of Leptospirosis as of July 28, 87 percent higher than the cases recorded during the same period last year.
Gerard Cortes, registered nurse and clinical administrator of the Center for Health and Development (CHD) said that people are not fully aware of how to prevent the disease. “In communities where we conduct health seminars, most of the people are not very well aware of common diseases and how to prevent it. Some would even say that they don’t know anything about it.”
The CHD together with the Samahang Operasyon Sagip (SOS) regularly conducts health seminars in communities in Metro Manila. They discuss not only about Leptospirosis but other diseases that are commonly acquired by the people in depressed communities where people are most vulnerable to communicable diseases.
Leptospirosis also known as Weil’s disease, is a disease caused by Leptospira bacteria, which is common to rats. Leptospirosis can be acquired by wading in floodwaters contaminated with the urine of rats or other animals such as pigs, cows, dogs, horse or any wild animals infected by Leptospira bacteria. People who have wounds and waded in floods easily acquire the disease that is why it is highly recommended that they use the necessary protective gears before wading in flood waters.
“People who have open wounds or lesions and waded through floods are highly at risk of being infected by Leptospirosis. So it is highly recommended to wear boots if it cannot be avoided to walk in areas that are flooded,” Cortes said. The disease is not transmitted from person to person.
The bacteria can also penetrate through the mouth, nose or the eyes. Leptospirosis can also be acquired in foods and drinks that are contaminated by the urine of animals with Leptospira bacteria. Leptospirosis is common in warm or tropical climates, especially in developing countries like the Philippines.
Leptospirosis have seven to 19 days incubation period so it is important to monitor the symptoms if a person was exposed to floodwaters. The symptoms to watch out for are:
-High fever with chills (39 to 40 degrees Celsius)
-Body ache particularly in the legs
-Severe headache (usually frontal headache)
-Stomach ache, diarrhea
In severe cases, persons infected with Leptospirosis have Jaundice (yellowish skin and eyes), Hepatomegaly or enlargement of the liver or renal failure. These complications may lead the patient’s death if not immediately treated.
“It is important to take confirmatory tests to check if a person is infected by Leptospirosis so that necessary medication will be prescribed by the doctor,” Cortes said. The microscopic agglutination test is a laboratory test that will confirm if a person is infected by the disease. “However, this is quite costly for poor patients. This is why most of the cases are already severe because the poor, who have limited or no resources at all, cannot go to the hospital immediately and take the necessary tests and be cured,” said Grace Cuasay of CHD’s health education training and services.
If a person waded or would wade in floodwaters, it is recommended that he or she takes doxycycline antibiotics. But Cortes stressed that this is merely a first aid measure and taking doxycycline does not guarantee that a patient is 100 percent protected from the disease.
According to Cortes, low risk patients, meaning those who were exposed to floodwaters but have no open wounds can take two capsules of 100mg doxycycline, single dose after 24 to 72 hours of exposure. Moderate patients or those who were exposed to floodwaters and have wounds or accidentally ingests water contaminated with Leptospira bacteria can take two capsules of 100mg doxycycline a day for three to five days after exposure. High risk patients or patients who are continuously exposed to floodwaters like residents in flooded communities or rescuers with or without wounds can take two capsules of 100mg doxycycline weekly until the end of the exposure.
However, it should be noted that pregnant women, nursing mothers and children below eight years old cannot take doxycyline. “There are other alternative medicines that the doctor can prescribe,” Cortes said.
“Please note that patients should still be closely monitored because it is not guaranteed that after taking doxycyline they are already protected from the disease. Symptoms should still be noted and the patient should immediately see a doctor if any of the symptoms manifest,” Cortes added.
Cortes also reminded that people who waded or swam in floodwaters should immediately wash and clean body parts that are exposed to floodwaters.
‘Prevention is better than cure’
Prevention is always better than cure. If one has left with no choice than to walk through floodwaters, he or she should be wearing protective gears like rain boots. Eliminating rodents will also prevent the disease; however, affected patients are mostly living in the depressed areas where they are most vulnerable to disasters and diseases. “It still falls to the government’s responsibility to provide social services like housing,” Cuasay added.
Other preventive measures to avoid Leptospirosis are; make sure to clean the surroundings; boil drinking water; do not walk into the flood without wearing boots; and have a massive campaign and education in the community about the disease and how to prevent it.
“Education is very important especially for those who live in far flung areas and are rarely reached by health care services,” Cuasay said.
Cuasay said that the increase in cases of Leptospirosis should serve as a challenge to the Department of Health (DOH) to be more proactive not only during times of disaster where illnesses like Leptospirosis are widespread.
“If the DOH is sincere in serving the people, it should make sure that its services reach the people in grassroots communities. Recently they said that they will provide free doxycycline to depressed communities but, according to a lot of communities that we have visited, they did not receive any supply of the medicine,” Cuasay said in an interview with Bulatlat.com.
The DOH recently announced that they will provide free doxycycline to flooded areas. In a statement, the DOH said it allocated 11 boxes of doxycycline to each of the 17 local government units in Metro Manila. Meanwhile, people in the communities of Pasig, Fairview and Isla Puting Bato in Tondo, Manila have not received doxycyline, Cuasay said.
The health department also announced that patients can also reimburse their medical expenses up to P11,000 ($255) through Philhealth and non-members will be automatically enrolled. But Cuasay said these are all reactive steps and are not effective in controlling the outbreak. Cuasay pointed out the importance of information dissemination not only through television advertisements but also through community visits.