In the past month and a half, relentless rains in this monsoon season have caused severe flooding in many parts of the country, with churning waters drowning entire towns and provinces. Silted with garbage and waste, the floods have become a breeding ground for leptospirosis, an infection caused by the bacteria Leptospira. The bacteria is transmitted to humans via contact with the urine of infected animals like rats, livestock, dogs, cats, and even some marine mammals, through open wounds and the mucous membranes of the eyes, nose, or mouth.
The potentially fatal infection has recently been declared an epidemic in Manila and Quezon City, as the spike in cases has surpassed the ‘epidemiological threshold.’ Over 100 cases and 22 deaths have been recorded at the San Lazaro Hospital in Manila as of Sept. 7, while 738 cases and 47 deaths have been noted in Quezon City.
As of Aug. 29, the Department of Health (DOH) has logged 6,253 leptospirosis cases and 378 deaths nationwide from Jan. 4 to Aug. 29, Health Undersecretary Dr. Gloria Balboa said.
Incubation period
Leptospirosis poses a major health problem in the country, especially during the monsoon season, as the bacteria can survive in contaminated water or soil for weeks to months. About 10 to 15 percent of patients die from it since its flu-like symptoms have lulled patients into delaying medical consultation. In its early stages, leptospirosis symptoms include fever, headache, chills, body or muscle aches, rashes, stomach pain, diarrhea, vomiting or nausea, and yellowed skin and eyes.
In serious cases, patients may experience jaundice, dark-colored urine, low urine output, and severe headache, which may later involve kidney or liver failure, or inflammation of the membrane surrounding the brain and spinal cord (meningitis). The illness can last from a few days to several weeks, but without treatment, it can lead to life-threatening complications and even death.
While the disease has an incubation period of five to 15 days, the DOH has urged the public to immediately visit a health center if they were exposed to floods or mud so they can get the appropriate treatment, in most cases the antibiotic doxycycline.
Information-education campaign
The DOH has also cautioned the public to wear boots and protective clothing when wading into floods, but that may be prohibitive to people most at risk: DOH data itself noted that 55 percent of leptospirosis patients are jobless. In a Special Health Forum organized by the Philippine College of Physicians on Sept. 8, infectious disease expert Dr. Rontgene Solante said 1,084 of those infected have no regular jobs, 190 are students, while the rest are drivers, riders, construction workers, market vendors, laborers, or factory workers.
Which makes the distribution of doxycycline to affected barangays by the DOH and the Manila local government commendable. Just as noteworthy is the National Kidney and Transplant Institute’s decision to convert its gymnasium into extra leptospirosis wards following its full bed capacity amid the surge in cases. Balboa meanwhile reminded patients referred to private hospitals that their treatment is covered by the Philippine Health Insurance Corp.
Much more can be done, starting with an extensive information-education campaign on the hazards of swimming or wading in floodwaters, without necessarily banning such acts as suggested by some. Because really, how else are most people going to get anywhere these days without getting their feet wet?
Full accountability
A good start would be informative and weather-proof posters on symptoms to watch out for and how to avoid the disease, tacked in accessible areas, including barangay halls, bus stops, buses, and MRT/LRT stations and carriages. Being stuck in traffic for hours then becomes a productive exercise in health awareness.
To enable commuters to negotiate flood-prone areas, local government units (LGUs) can field shuttle vehicles, including bancas in their barangays, while the national government can take care of army trucks and other transport on highways and major roads. LGUs, too, can construct makeshift walkways to allow pedestrians to negotiate floodwaters from their homes. Companies can meanwhile provide workers with boots and protective clothing as productivity depends a lot on these workers’ health.
Just as helpful are regular cleanups of clogged creeks and waterways, and the drainage or siphoning of floods using water pumps. Solid waste management too-in coordination with the Metropolitan Manila Development Authority-must be improved as carriers of the bacteria thrive in uncollected garbage. Individual responsibility must not be overlooked either as households must maintain cleanliness to keep rodents out.