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India battles outbreak of rat fever in wake of floods
More than 60 people in the Indian state of Kerala are thought to have died from "rat fever", a disease which has been spreading in the stagnant water left behind after the worst floods in a century.
Rat fever - also known as leptospirosis or Weil’s Disease - is spread in water contaminated by the urine of animals, particularly rats, infected with the bacteria.
The state’s health ministry has confirmed that 13 people have died from the disease, but the total death toll is more than 60 - pending examinations, it said. The ministry has declared an emergency protocol in the Kozhikode district and issued a high alert in several regions of the state.
Reports say the state is facing a shortage of medicine to combat the spread of the disease, with demand surging for the antibiotic doxycycline, which is used as a prophylaxis.
The Kozhikode area needs around three million tablets over the next two months, but currently only has about 500,000 in stock, Dr RS Gopakumar, a state medical officer, said.
“We have got supplies, but the stocks have been depleting fast,” Dr Gopakumar told Reuter.
The antibiotic needs to be taken weekly for at least four weeks.
“Supply shortages are being replenished. Of course the demand has shot up, but we are monitoring daily,” said Saritha RL, the state’s director of health services. The health ministry has appealed for help from the nearby states of Maharashtra, Tamil Nadu and Karnataka.
Rat fever's symptoms include muscle pain and fever. It also affects the kidneys and liver and is often accompanied by jaundice.
“Leptospirosis could lead to death if it isn’t diagnosed and treated correctly," Dr Sachin Melinkeri, an infection specialist at KEM Hospital, Pune, told reporters. “The trouble is that it often gets misdiagnosed as a viral infection like dengue [fever], due to similarities in early symptoms."
“Leptospirosis usually shows symptoms in a matter of two to five days from the time someone is infected. It is unlikely for an infected person to be asymptomatic for longer than 10 days at the most. Poor sanitation is the biggest reason for spread of the infection," he added.
But the lack of communication as storms pounded the state last month and the priority given to search and rescue rather than the aftermath, meant many people did not take any preventive medicine against Weil’s disease.
A district medical officer from Kozhikode, Dr Jayashree, said: “Many people who are presenting with symptoms of the fever are giving us a history of not having taken doxycycline tablet as a preventive measure, as we had advised to all following the floods. This could be the reason we are seeing such a high number of cases.
“The doxycycline is given to us by the Kerala Medical Service Corporation. As of now, they have enough stock to manage, but we have reached out to those who can possibly provide us with more so that there does not end up being a lack of medicines.”
Last month Kerala faced the threat of water-borne illnesses, with health experts warning of possible outbreaks of cholera, typhoid and hepatitis; but immunisations and medicines appear to have brought these under control.
Since the floods started the Kerala health ministry has also recorded 846 cases of dengue fever, 518 cases of malaria, and 34 cases of chikungunya - diseases all carried by mosquitoes attracted by the standing water.
Health officials have also asked people working in certain sectors, such as sanitation workers and dairy farmers, to take extra care as they are more likely to be exposed to the infection.
Dr Melinkeri also urged people to avoid walking in flood water that could have been contaminated by animals.
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