Mediscene

Beware of the Rat

Don’t ignore flu-like symptoms, they maybe signs of the deadly leptospirosis or Rat Fever. Kumudini Hettiarachchi reports

Severe body aches and pains, frontal headaches and red eyes. If you have been working outdoors where there is stagnant water even in highly residential areas, don't ignore it as the flu, but seek medical help immediately.

For these are the early symptoms of rat fever or Mee Una (leptospirosis), warns Chief Epidemiologist Dr. Paba Palihawadana.

Around 60% of those who contract rat fever have been engaged in some kind of agriculture work, according to data available at the Epidemiology Unit, says Dr. Palihawadana, explaining that others who are vulnerable are those who work in marshy areas, garbage collectors, those cleaning canals and drains, fresh-water fishermen, brick manufacturers, gem miners and also sand miners.

Even those doing home gardening should be careful, MediScene understands.

The Epidemiology Unit has been working not only with health personnel but also with officials from the agriculture and agrarian sector, environment sector and provincial administration on the prevention and management of leptospirosis. A National Committee has been formed and District Committees are being set up, it is learnt, to ascertain strategies to deal with this disease which is found in the districts of Colombo, Gampaha, Kalutara, Ratnapura, Kegalle, Kandy, Matale, Galle, Matara and Kurunegala. "We identified certain vulnerable groups and gave them antibiotics as a prophylactic treatment, which brought down the number of deaths last year," she said.

Some people are not keeping to the traditional methods of paddy cultivation such as clearing the fields of dirt and also leftover dried sheaves of paddy first, said Dr. Palihawadana, adding that labourers get into the fields, not only those worked round the year but also neglected lands, which maybe highly infested with rats. "There should be an effort to get rid of the rats before cultivations begin."

The Epidemiology Unit is also hoping to work with the Education Ministry and make schoolchildren aware on the importance of keeping the environment free of garbage and stagnant water, she added.

What is leptospirosis?

This is an infectious disease caused by bacteria called leptospires found in the kidneys of animals such as rodents, livestock (cattle and buffalo), canines and also wild mammals.

It could be transmitted directly or indirectly from animals that are "natural hosts" to humans, when they excrete the bacteria through their urine and humans are exposed to contaminated water, soil or food. Humans may then become "incidental" or "accidental" hosts.

The bacteria may enter humans through wounds or lesions in the skin or nasal, oral or eye mucous membranes, and with prolonged exposure even through the skin, says Dr. Palihawadana, explaining that another way that a human can get infected is by drinking contaminated water. The bacteria would then get into the blood and invade tissues and organs.

The symptoms of leptospirosis appear within 5-14 days of exposure to the germ and may range from mild flu-like illness to serious and sometimes fatal disease. The symptoms include fever, chills, conjunctival suffusion (reddening of the eyes), headache, muscle tenderness (particularly calf and lumbar areas) and jaundice (yellowing of the skin and eyes). Leptospirosis could also mimic many other diseases such as dengue, influenza, meningitis and hepatitis.

If neglected, there could be renal failure, heart failure and haemorrhage, causing death. Re-infection from the same sub-strain of bacteria does not occur once a person is cured but a different sub-strain can affect the same person, she says, stressing that though rat fever is a potentially serious disease it is treatable.

Urging clinicians not to await laboratory test reports but to begin treatment with antibiotics, as serological tests do not become positive until about a week after the onset of illness, Dr. Palihawadana says particular attention should be paid to fluid and electrolyte balance which is vital. If renal failure occurs, the patient needs to be dialysed.

How to prevent leptospirosis

  • Remove garbage and keep areas around human habitation clean to prevent infestation by rodents. Rid fields of rats by not keeping straw piled up.
  • Try to clean up stagnant pools of water
  • Keep animals away from gardens, playgrounds and places where children play.
  • Where possible use protective clothing, knee-high boots, gloves and keep wounds covered with waterproof dressings.
  • Use boiled water as virulent organisms can withstand chlorination and filtering.
  • Don't wade through flood waters.
 
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