Leptospirosis is an infectious disease caused by the Leptospira bacterium that develops in stagnant water after floods or heavy rains and which in milder cases causes flu-like symptoms, from fever to abdominal pain, according to the World Health Organization (WHO).
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A person searches for bodies in the Torrent swamp (Valencia) after the damage. EFE/Jorge Zapata
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A person searches for bodies in the Torrent swamp (Valencia) after the damage. EFE/Jorge Zapata
THE Department of Health of the Valencian Community reported this Friday two probable cases of leptospirosis, in the absence of confirmation by the results of the corresponding analyzes, in two people who voluntarily carried out cleaning or debris removal activities in two municipalities affected by dana in the province of Valencia.
Both people present a good clinical course and one of them is hospitalized, according to the Generalitat, which explains that leptospirosis can be contracted through contact with floodwaters, moist soil or mud contaminated with urine or tissues of infected animals, being the rats are the most frequent causes.
The accumulation of waste, debris and food remains favors the increase in rodent populations, reservoirs of the disease, thus increasing the probability of transmission, which is low in the short term but moderate to medium in those who have infection solutions on their skin continuity that facilitate infection, according to a document from Ministry of Health.
Leptospirosis is a disease endemic in Valencia due to floods, lagoons and irrigation canals; According to another document released by Spanish Society of Emergency Medicine (SEMES).
From 2019 to 2022, 137 cases were reported in Spain in ten communities, 50 of them in the last available year.
In 90% of cases it manifests itself in a mild or self-limited manner, which can go unnoticed; the mortality rate, according to data from Carlos III Health Institutevaries greatly between different regions of the world, averaging between less than 5% and 30%.
Symptoms of leptospirosis
The milder clinical manifestations of leptospirosis are similar to those of influenza, but if it becomes complicated it can cause jaundice, renal failure, hemorrhage and myocarditis with arrhythmias; meningitis and pulmonary hemorrhage with respiratory failure, according to the WHO.
Some of the symptoms cited by the Valencia Department are:
- High and persistent fever.
- Severe diarrhea or vomiting.
- Intense abdominal pain.
- Yellowing of the skin and/or eyes.
- Dark urine.
- Persistent cough or difficulty breathing.
- Red or purple rashes that may indicate bleeding under the skin.
- Confusion, disorientation, or agitation.
Likewise, special attention should be paid to open wounds or lesions, especially if they show signs of infection (redness, swelling, discharge or pain).
The transmission
It can be transmitted through contact with contaminated water, food, and soil that contain urine contaminated with bacteria from infected animals (such as rodents).
Floods – underlines the SEMES document – facilitate the proliferation of rodents and the spread of the Leptospira bacterium in a human community.
According to the WHO, the incubation period is between 5 and 14 days.
The treatment
There are antibiotic treatments for infection caused by bacteria.
Guidelines for preventing Leptospira infection
The Department of Health of the Valencian Community has provided a series of recommendations aimed at people working in the rescue and cleaning tasks of the areas affected by dana, both emergency professionals and volunteers and affected people:
- Wash your hands very well manos with soap and water.
- Usage maskgloves, eye protection and appropriate long-sleeved clothing.
- Do not consume food in contact with flooded land.
- In homes, open windows and doors ventilateremove all wet objects, standing water, mud and mud, clean walls and floors and disinfect with bleach.
Leptospirosis in the world
This disease is widespread throughout the world but is endemic especially in countries with humid subtropical and tropical climates. According to the WHO, there are more than 500,000 cases worldwide every year.
“Leptospirosis is a human and veterinary public health problem. The numerous strains of Leptospira can establish infections in a variety of animal hosts that include rodents, livestock, and other domestic animals, with humans serving as accidental hosts. WHO.
Interview with Dr. Elena Martinez, Infectious Disease Specialist
Time.news Editor (TNE): Welcome, Dr. Martinez. Thank you for taking the time to discuss the rising cases of leptospirosis in the wake of recent flooding in Valencia. Can you start by explaining what leptospirosis is and how it typically spreads?
Dr. Elena Martinez (EM): Thank you for having me. Leptospirosis is an infectious disease caused by the Leptospira bacterium, often found in stagnant water, especially in flood-affected areas. The transmission occurs primarily through contact with contaminated water, soil, or food that contains the urine of infected animals, particularly rodents. After heavy rains and flooding, the risk of exposure increases significantly due to the proliferation of these rodents and the bacteria in affected environments.
TNE: It sounds quite concerning, especially given the recent reports from the Valencian Community about probable cases among those involved in cleanup efforts. What symptoms should people be aware of?
EM: You’re right; awareness is key. In mild cases, symptoms of leptospirosis can resemble flu-like conditions, including high fever, severe diarrhea or vomiting, and abdominal pain. However, complications can lead to severe outcomes such as jaundice, renal failure, or even pulmonary hemorrhages, among others. It’s crucial for anyone involved in cleanup to monitor for these symptoms, especially if they come into contact with potentially contaminated materials.
TNE: Given the environment that floods create, how does this impact the prevalence of leptospirosis, particularly in regions like Valencia?
EM: Flooding creates a perfect storm for leptospirosis outbreaks. Stagnant water facilitates the spread of the Leptospira bacterium and increases rodent populations, which are significant reservoirs of the disease. In Valencia, this endemicity is further exacerbated by the region’s geography, including irrigation canals and lagoons. According to available data, from 2019 to 2022, there were 137 reported cases across Spain, highlighting that outbreaks can emerge in the aftermath of heavy rains and floods.
TNE: What preventive measures can be implemented to reduce the risk of infection during such clean-up operations?
EM: The Department of Health in Valencia has issued several recommendations for those involved in rescue and cleanup efforts. These include wearing protective clothing like gloves and boots, ensuring that open wounds are covered, and avoiding contact with contaminated water wherever possible. Community education on the importance of sanitation and rodent control can also help minimize outbreaks.
TNE: What treatment options exist for those who contract leptospirosis, and how effective are they?
EM: Fortunately, leptospirosis can be treated with antibiotics, which are most effective when administered early in the course of the disease. Many cases are mild or self-limiting, but prompt treatment is essential to prevent more severe complications. The mortality rate varies globally, which is why early detection and intervention play crucial roles in managing the disease effectively.
TNE: Dr. Martinez, it’s alarming to think about the implications of a disease like leptospirosis after floods. What can individuals do to protect themselves and their communities during these times?
EM: Staying informed is the first step. Individuals should educate themselves on the symptoms of leptospirosis and practice preventive measures. Working together with local health departments to clean and sanitize areas after flooding is essential, as is watching out for any symptoms and seeking medical attention promptly. Lastly, community initiatives to manage waste and rodent populations can greatly reduce the prospects of disease transmission.
TNE: Thank you, Dr. Martinez, for sharing your insights on this important topic. Your expertise is invaluable in keeping the public informed, especially in light of recent events.
EM: Thank you for raising awareness about leptospirosis and its impact on communities. With awareness and proactive measures, we can help reduce its incidence and protect public health.