A short supply of doxycycline and public negligence have been identified to be the main causes over the spike in leptospirosis cases reported this year, according to Ministry of Health Chief Epidemiologist Dr. Sudath Samaraweera.
“Leptospirosis is prevalent in areas where there are a lot of paddy fields/marshlands in which people engage in various economic activities. While there is not a significant spike in incidents when considering the month-by-month average, the Department of Epidemiology from time to time does conduct awareness programmes to educate the farmers and the people from the areas,” Dr. Samaraweera told The Sunday Morning.
He also reiterated that despite the awareness that is created, there are times when the regional hospitals and Medical Officers of Health (MOHs) have a short supply of the antibiotic doxycycline. Moreover, the negligence of farmers or area residents also contributes to the increasing number of leptospirosis cases.
Sri Lanka is projected to record the highest number of leptospirosis cases in a decade with the caseload reflecting 6,784 cases for the period from 1 January to 30 October.
This year, the Regional Director of Health Services Ratnapura recorded the highest number of leptospirosis cases at a total of 1,401.
Leptospirosis continues to be a disease of public health importance in Sri Lanka with approximately 3,000-5,000 suspected cases reported each year and a Case Fatality Rate (CFR) of 1-2% in the recent past.
Being a zoonotic disease which occurs worldwide, it is more common in tropical countries such as Sri Lanka. In Sri Lanka, leptospirosis is reported throughout the year, with two peaks generally observed which coincide with paddy cultivation. High humidity and heavy rainfall may cause outbreaks because of widespread exposure to flood water.
Transmission to humans may be direct by inoculation with infected animal tissue or body fluids or indirect with the organisms entering via mucosal surfaces or damaged skin from infected urine or contaminated environments such as moist soil in agricultural lands, lakes, streams, and rivers. Several studies have shown the survival of pathogenic leptospires in the environment ranging from three to 14 days.
Leptospirosis can have a markedly varied clinical course. The incubation period is usually five to 14 days, with a range of two to 30 days. Most infections will be asymptomatic or mimic a mild flu and may pass without being brought to medical attention. However, a small number of cases can develop into a severe form of illness with multi organ failure and a CFR of over 40%.
In the initial bacteraemic phase, there is an acute onset of fever with chills and rigours, headache, myalgia, nausea, and vomiting. Conjunctival suffusion usually appears in the third day of illness and is characteristic but non-specific. Myalgia is characteristic in the calf but may also be prominent in the back and neck.
In the immune phase, fever and other constitutional symptoms may persist in some patients. The onset of organ involvement will be apparent in severe disease with the development of oliguria, jaundice, meningism, haemorrhage, shock, pulmonary involvement, and myocarditis.
The most common organ involved is the kidney with interstitial nephritis and acute tubular necrosis leading to acute kidney injury.
He also reiterated that despite the awareness that is created, there are times when the regional hospitals and Medical Officers of Health (MOHs) have a short supply of the antibiotic doxycycline. Moreover, the negligence of farmers or area residents also contributes to the increasing number of leptospirosis cases.
Sri Lanka is projected to record the highest number of leptospirosis cases in a decade with the caseload reflecting 6,784 cases for the period from 1 January to 30 October.
This year, the Regional Director of Health Services Ratnapura recorded the highest number of leptospirosis cases at a total of 1,401.
Leptospirosis continues to be a disease of public health importance in Sri Lanka with approximately 3,000-5,000 suspected cases reported each year and a Case Fatality Rate (CFR) of 1-2% in the recent past.
Being a zoonotic disease which occurs worldwide, it is more common in tropical countries such as Sri Lanka. In Sri Lanka, leptospirosis is reported throughout the year, with two peaks generally observed which coincide with paddy cultivation. High humidity and heavy rainfall may cause outbreaks because of widespread exposure to flood water.
Transmission to humans may be direct by inoculation with infected animal tissue or body fluids or indirect with the organisms entering via mucosal surfaces or damaged skin from infected urine or contaminated environments such as moist soil in agricultural lands, lakes, streams, and rivers. Several studies have shown the survival of pathogenic leptospires in the environment ranging from three to 14 days.
Leptospirosis can have a markedly varied clinical course. The incubation period is usually five to 14 days, with a range of two to 30 days. Most infections will be asymptomatic or mimic a mild flu and may pass without being brought to medical attention. However, a small number of cases can develop into a severe form of illness with multi organ failure and a CFR of over 40%.
In the initial bacteraemic phase, there is an acute onset of fever with chills and rigours, headache, myalgia, nausea, and vomiting. Conjunctival suffusion usually appears in the third day of illness and is characteristic but non-specific. Myalgia is characteristic in the calf but may also be prominent in the back and neck.
In the immune phase, fever and other constitutional symptoms may persist in some patients. The onset of organ involvement will be apparent in severe disease with the development of oliguria, jaundice, meningism, haemorrhage, shock, pulmonary involvement, and myocarditis.
The most common organ involved is the kidney with interstitial nephritis and acute tubular necrosis leading to acute kidney injury.