Leptospirosis in the Davao region of the Philippines

In the Philippines, at least 4 deaths out of 25 cases of leptospirosis were reported in the Davao region from January 1 to April 2, 2022, according to the Department of Health (DOH). Two of the 4 deaths were in Davao del Norte, 1 in Davao City and 1 in Davao Occidental.
The 25 cases of leptospirosis were also found to be the highest in Davao City: 18 cases, 4 cases in Davao del Norte, 2 cases in Davao de Oro and 1 case in Davao Occidental. In these regions, there are areas of flooding due to the situation in the area of ​​low pressure and bad weather.

Leptospirosis Reminders:

Leptospirosis is a bacterial disease that is common throughout the world. Leptospirosis is caused by the bacterium Leptospira interrogans. It is rather easily preserved in the external environment (fresh water, muddy soils), which contributes to infection. The seasonality of the disease is very pronounced, with summer-autumn outbreaks associated with heat and precipitation.

leptospira bacteria capable of infecting a large number of wild mammals (rodents and insectivores: rats, tenge, shrews, etc.) and domestic ones (cattle, sheep, goats, pigs, dogs), which serve as reservoirs and excrete them with urine. The bacteria can survive for several months in a humid and warm environment. There are over 250 serovars of Leptospira species, with several serovars endemic to this geographical area.

Certain professions (farmers, livestock keepers, sewer workers, garbage collectors, etc.) and people involved in water sports (swimming, canoeing, kayaking, fishing, hunting, canyoning, etc.) are particularly susceptible risk. In humans, the bacterium penetrates mainly through damaged skin or mucous membranes.

The disease is often mild, but complications are possible, including kidney failure, which can be fatal in 5–20% of cases. Incubation of the disease lasts from 4 to 14 days.

  • In the moderate form, the disease begins with a high fever with chills, headache, muscle and diffuse pain in the joints. In 20% of cases it is complicated by hemorrhagic syndrome.
  • Severe forms (icterohemorrhagic or Weil’s disease) combine acute renal failure, neurological disorders (convulsions, coma) and more or less severe bleeding (pulmonary, digestive).

Initial non-specific clinical signs (headaches, fever, myalgia) may delay diagnosis and treatment due to confusion with differential diagnoses such as influenza, chikungunya, or dengue fever.

Prevention and measures of individual protection against leptospirosis:

  • Avoid swimming in fresh water, especially if you have wounds and also when the water is cloudy or cloudy;
  • Avoid contact with water, nose, mouth and eyes;
  • avoid walking barefoot or in open sandals on muddy ground, puddles, stagnant water, ravines (especially in overseas departments);
  • Protect wounds from contact with water with waterproof dressings;
  • Wear protective gear when:
  • high-risk occupations (breeding, sewer workers, garbage collectors, farmers, earthworks, etc.) including boots, gloves, waders, protective clothing, even goggles in case of risk of splashing;
  • water sports activities such as canyoning, kayaking, including a protective suit, boots and gloves.
  • Control of rodents, which are a reservoir of the disease;

After risk exposure:

  • Rinse with drinking water and disinfect wounds;
  • Seek immediate medical attention if symptoms develop, informing him/her of the risky activities carried out in the previous two weeks.

These measures should be strengthened during the rainy season.
There is a vaccine against leptospirosis. Since its effectiveness is limited to certain strains of Leptospira, it is rarely used in practice, mainly by specialists.

Source: ProMED.

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