People cross flood waters brought by localized thunderstorms along Araneta Avenue in Quezon City on June 6, 2023. Maria Tan, ABS-CBN News/File
MANILA — Leptospirosis cases continue to increase following weeks of heavy rainfall and flooding in some parts of the country, according to the Department of Health (DOH).
Data from the agency’s Epidemiology Bureau showed that leptospirosis cases have risen by 32 percent in the recent 3 to 4 weeks compared to prior weeks.
The cases are so far higher compared to the past five years.
As of September 2, leptospirosis cases have climbed to a total 3,728 with a case fatality rate of 11 percent.
NCR logged the highest growth rate at 91 percent, Caraga at 66.67 percent, and BARMM at 50 percent.
Region 1, Region 4A and Region 3 trail behind with 45.65 percent, 36.84 percent, and 25.30 percent growth rates, respectively.
At the National Kidney and Transplant Institute (NKTI), a facility commonly flocked by patients needing dialysis following a leptospirosis infection, cases have risen to 14.
NKTI Executive-Director Dr. Rosemarie Liquete said while the facility caters to leptospirosis patients, not all are in need of dialysis.
“Kahit naman saang ospital pwede silang pumunta. Kaya lang nasa isip kasi ng pasyente, may dialysis dito. Hindi naman lahat ng may leptospirosis ay nauuwi sa dialysis. Iba diyan conservative management, hydration. Hindi naman komo may dialysis sa NKTI, pwede silang pumunta sa ibang ospital,” she said.
Liquete explained that renal failure is among the complications of leptospirosis resulting in the need for dialysis.
In some cases, the illness progresses to pulmonary hemorrhage where a patient would need the more delicate procedure of extracorporeal membrage oxygenation (ECMO) to allow artificial oxygenation of blood and the removal of carbon dioxide.
In the last four weeks, majority of leptospirosis cases were acquired through floodwater exposure.
The DOH has categorized leptospirosis cases into three, namely suspect, probable, confirmed.
Suspect cases are those who develop acute febrile illness with headache, myalgia and protration or extreme physical weakness.
A person who develops jaundice, eye redness, bleeding, skin rashes and reduced urination are also considered suspect cases.
A probable patient is said to be a suspected case in an ongoing epidemic or epidemiology-linked to a confirmed case or one who tests positive using a rapid test kit.
A patient is considered a confirmed case if specimens are confirmed by a laboratory to be infected by leptospira, a potentially fatal infection caused by the leptospira bacteria.
In a Department Memorandum issued last August, the DOH said that communities should focus on prevention and control of leptospirosis by targeting specifically the source of infection, route of transmission between the source and human host, and the prompt treatment of infection.
Epidemiology Bureau Director Dr. Alethea De Guzman stressed that while all measures are important to control infection spread, prevention should be given utmost priority by the public.
Good personal hygiene including cleaning wounds on the legs and feet as well as avoiding wading in filthy flood water or potentially contaminated bodies of water are among key measures.
And while some may not be able to avoid exposure, wearing protective footwear like boots have been proven to be effective at preventing infection.
While the spread of the leptospira bacteria is aggravated by heavy rain and flooding, De Guzman said leptospirosis is an endemic disease.
“Hindi nawawala o tuloy-tuloy ang ating mga nare-report na kaso dahil most of the exposure are related to their jobs or occupations. Dahil endemic disease ito, napakahalaga na pag-practice ng preventive measures gaya ng pagsuot ng bota ay talagang tamang paggamit ng pre and post exposure prophylaxis,” she said.
PREVENTION AND CONTROL
Awareness on leptospirosis is seen as the most effective way to curb the cases that are considered on the rise.
DOH Diseases Prevention and Control Bureau, Adult Health Division Medical Officer IV Dr. Ma. Regina De Jesus Valdez said the disease is preventable if only people will adhere to self preventive measures.
More importantly, maintaining a clean environment is also an important factor in terms of fully controlling its spread.
These include monitoring vermin activity and destroying rat habitats.
Because exposure is inevitable especially among the working population, prophylaxis helps especially if taken before and after exposure.
While pre-exposure prophylaxis is not routinely recommended, it can still be given to individuals with short-term exposures in highly endemic areas.
The intake and dosage of doxycycline, according to the DOH can also be categorized according to exposure. Individuals with mild exposure may take 200 milligrams of the antibiotic immediately within 24 to 72 hours from exposure.
Those with moderate exposure may take 200 milligrams for 3 to 5 days within 24 to 72 hours after exposure, while those considered high risk may take it once weekly, until the end of exposure.
The disease is more commonly found in tropical or temperate climates such as sub-Saharan Africa, parts of Latin America, the Carribean, South and Southeast Asia and Oceania.
Throughout the world, less than one million cases are recorded with 59,000 dying from the infection.