Outbreaks of dengue fever and foot-and-mouth syndrome

Leptospirosis in the Eastern Visayas region …

Aux Philippinesthe Ministry of Health (DOH) of the Eastern Visayas reported 53 cases of leptospirosis from January 1 to May 29, 2022. Of these 53 individuals, 8 died. Of the 53 cases [dans la région des Visayas orientales]22 came from Leyte ; 10 de Samar ; 7 de Leyte du Sud ; 7 de Samar oriental ; 5 de Northern Samar ; and 2 of Biliran.

Deaths have been reported in Tacloban (3 cases), the provincial capital of Leyte, Abuyog and Hilongos; 2 deaths in Padre Burgos and Hinunangan cities in South Leyte province; 2 in Basey and Catbalogan City in Samar; and 1 in the town of Maydolong in the east of Samar.

Reminders on the leptospirosis.

The leptospirosis is a worldwide bacterial disease. Leptospirosis is caused by bacteria Leptospira interrogans. This is maintained quite easily in the outdoor environment (fresh water, muddy soils), which promotes contamination. The seasonality of the disease is very marked, with a summer-autumn increase related to heat and precipitation.

Bacteria of the genus Leptospira are likely to infect a large number of wild mammals (rodents and insectivores: rats, tangs, shrews, etc.) and domestic mammals (cattle, sheep, goats, pigs, dogs), which serve as reservoirs and excrete them in their urine. Bacteria can survive for months in a humid, hot environment. There are more than 250 serovars of Leptospira species, with several serovars endemic to a given geographic area.

Some occupations (farmers, ranchers, sewers, scavengers…) and people who practice water recreation (swimming, canoeing, kayaking, fishing, hunting, canyoning …) are particularly at risk. In humans, the bacterium penetrates mainly through damaged skin or mucous membranes.

  • The disease is often benign but complications are possible, including kidney failure which can lead to death in 5 to 20% of cases. The incubation of the disease lasts from 4 to 14 days.
  • In moderate form, the disease begins with a high fever with chills, headaches, muscle aches, and diffuse joint pain. In 20% of cases, it is complicated by hemorrhagic syndrome.
  • Severe forms (jaundice or Weil’s disease) are associated with acute renal failure, neurological impairment (convulsions, coma) and more or less severe bleeding (pulmonary, digestive).

Unspecified initial clinical signs (headache, fever, myalgias) may lead to diagnostic and therapeutic delay due to confusion with differential diagnoses such as influenza, chikungunya, or dengue.

Measures to prevent and protect against leptospirosis:

  • Avoid bathing in fresh water, especially when carrying wounds, and when the water is cloudy or muddy;
  • Avoid contact with water, nose, mouth and eyes;
  • Avoid walking barefoot or in open sandals on muddy ground, in puddles, stagnant water, ravines (especially in the overseas departments);
  • Protect wounds from water contact with waterproof bandages;
  • Wear protective equipment when:
  • occupational activities at risk (livestock, sewers, garbage collectors, farmer, earthwork, etc.) including boots, gloves, thigh-highs, protective clothing, and even goggles in case of risk of splashing;
  • white water sports such as canyoning, kayaking, including a protective suit, boots and gloves;
  • Fight rodents, which are the reservoir of disease.

After a risk exposure:

  • Wash with drinking water and disinfect wounds;
  • Consult a physician immediately if symptoms occur by reporting the risk activity in the previous two weeks.

These measures need to be strengthened during the rainy season.

There is a leptospirosis vaccination. Because its effectiveness is limited to certain strains of leptospire, it is rarely performed in practice, primarily for professionals.

Source: ProMED.

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