ALERT over increase in rat fever cases in Kerala

Just as we closed the CIJ Newsletter of September with the lead news on warnings of impending outbreak following floods in Kerala, the doctors began raising concerns over alerts received over the sudden increase of Leptospirosis cases from Thrissur, Pallakad, Kozhikode, Malapuram and Kannur districts. All the cases being reported had indirect contact with flood water. The Additional Director of the Directorate of Health Services issued a notice to all clinics to treat any fever with myalgia to be taken as Leptospirosis and to be treated accordingly until further orders.

While the cases of Leptospirosis or ‘rat fever’ is common during monsoons, the increase in incidence in the last few days in Kerala has raised an alarm. Leptospirosis is a zoonotic infection which is caused by the bacteria leptospira.

Dr Raghavendra Kulkarni, MD, Professor & Head, Department of Microbiology, SDM Medical College, Dharwad, who had brought the topic for discussion in the whats app group of microbiologist, told Clean India Journal that “early diagnosis of Leptospirosis is difficult.”

Sharing his expertise to the doctors on detecting infected cases, Dr Kulkarni said that “DRDO Gwalior had developed a fantastic antigen detection kit. Unfortunately, it is not available. In the present situation PCR needs to be promoted especially during the early phase of the disease. IgM ELISA helps but other immunochromatographic tests are not reliable. High index of suspension and history of contact with flood or murky water is important. As far as possible clinicians should use Crystaline Penicillin. Chemoprophylaxis with Doxycycline 200mg could be given orally, weekly as long as there is exposure.”

Leptospirosis is diagnosed by blood and urine tests. Those found to have contracted the infection are already being treated with doxycycline and supportive measures as deemed necessary. The symptoms of Leptospirosis include fever, malaise, body ache, retrobulbar pain and injected eyes. Reports say that it is not contagious, however, with increased exposure more people are likely to get infected.

In the wake of such a spread, Dr Kulkarni has advised to avoid self-medication. “Fortunately, the organism is sensitive to most routinely used antibiotics. If logically treated it is not dangerous.”

He further added to avoid milk, milk products and antacids with doxycycline. Drink safe drinking water which has permissible quality of chlorine, as chlorine kills Leptospires. Above all, maintaining personal hygiene is of prime importance during these trying times.

Read more on what Dr Dhruv Mamtora, Consultant Microbiologist, S.L. Raheja Hospital, Mumbai, has to say on preventive and precautionary measures for Kerala, in the CIJ Newsletter, September 2018 issue. Look for the CIJ Newsletter after 6pm in this link https://cleanindiajournal.com/final/newsletter/