There is a scare about this “new” disease; the media is carrying all sorts of frightening information about this disease. It is reported in northern districts of Kerala, including our neighbouring district of Kasargod. Sporadic cases of this disease could be seen occasionally in all hospitals, if doctors kept vigil. The name is frightening enough, as most Greek names are! It simply means a disease caused a family of bacteria, which are both thin and coiled. ( leptos=thin, peeled,insignificant; speira=coil.).



These germs are present in the excreta of many rodents, especially black rats ( rattus rattus) and the large bandicoots in our hilly areas; occasionally some other mammals like dogs could carry another germ of the same family. The urine of these animals contains the germ, leptospira icterohaemorrhagiae, under some special circumstances. During the rainy season, when this urine gets mixed with stagnant water near the rat holes, human beings might get the germ entering them through the skin or mucus membrane. Walking barefoot or drinking this contaminated water without boiling could help the germ enter our body to produce the disease.



Please remember that germs are not there to kill man. In fact, no germ is eager to get into man, if it could help it. In every man-germ war, it is one hundred percent death for the germ and, only a small chance for the man to die. Most, if not all, germs would want to live in symbiosis with man. Even the most intimate life force of man, the organelle inside every human cell, belongs to a kind of germ. If the disease-producing germ succeeds in killing man (rarely) the germ gets buried or burnt along with the dead body. If man is able to get over the infection, man’s immune system kills the germ. Please do not get worried that germs are out to kill you. This is a scare (myth) spread by the soap, antiseptics, and the antibiotic industry.



That said, I must hasten to give some truths to the public to allay their anxiety, and some others to the health authorities, to lessen the general public’s panic. There is, however, an ever-present risk in our villages, where one finds lots of rat holes around the mud- walled houses. Curiously, one of India’s leading medical college hostels had an outbreak of leptospirosis some time ago resulting in lot of trouble. The source was the dried up underground water sump, that became home for hundreds of rodents of all sizes and families. Periodically, when water filled the tank partially, the rodent excreta used to get into the water supply used for drinking, bathing and, for ablution. Thank God! many lives were not lost, as the authorities acted pretty fast. This shows how vulnerable some of our modern amenities could be!



For the Public:



* THIS NEED NOT BE A FATAL DISEASE, IF DIAGNOSED EARLY.

* IF ANY ONE GETS JAUNDICE WITH FEVER, BURNING MICTURITION, BAD HEADACHE, SKIN RASHES, AND RED EYES, PLEASE SEE YOUR DOCTOR IMMEDIATELY.

* DO NOT BELIEVE THE MYTH THAT JAUNDICE HAS NO TREATMENT IN MODERN MEDICINE AND ONE SHOULD GO TO THE FOLK MEDICINE MAN FOR TREATMENT.

* LEPTOSPIROSIS IS EMINENTLY TREATABLE, IF DIAGNOSED EARLY.



* DURING THE SCARE PERIOD IT MAY BE WISE TO SEE THE DOCTOR, WHEN IN DOUBT.

* REQUEST YOUR DOCTOR TO CHECK YOUR WHITE BLOOD CELL COUNT (which is raised very much in this kind of jaundice) AND YOUR URINE FOR RED BLOOD CELLS. WHEN PRESENT, REQUEST HIM/HER TO SEND YOUR URINE FOR DARK GROUND ILLUMINATION STUDY FOR THIS BUG.

* THIS GERM GETS KILLED VERY EASILY WITH PENCILLIN.

* NOTHING TO WORRY AT ALL EVEN IF YOU GET THE DISEASE.

* GOOD FOOD IS A MUST DURING THE DISEASE. THE MYTH THAT ONLY RICE-CONJEE AND COCOANUT WATER SHOULD BE TAKEN DURING JAUNDICE IS BAD FOR HEALTH.

* THIS DISEASE DOES NOT SPREAD BY AIR OR FROM PERSON TO PERSON.

* WE NEED NOT RUN AWAY FROM KASARGOD-OR AVOID GOING THERE.

* SEE THAT YOU DO NOT HAVE MANY RODENTS AS YOUR HOUSEGUESTS. CLOSE ALL RODENT HOLES. DO NOT LET CHILDREN PLAY IN DIRTY WATER OR WALK BAREFOOT.

* DRINKING WATER MAY BE BOILED, IF IT IS NOT FROM THE CORPORATION WATER SUPPLY.

* FEAR KILLS! FEAR DECREASES THE BODY’S CAPACITY TO FIGHT DISEASES.

* THE SCARE SPREAD BY RUMOURS KILLS MORE PEOPLE IN AN EPIDEMIC THAN THE POOR GERM.

* WHEN YOU LAUGH, YOUR IMMUNE CELLS ALSO LAUGH. WHEN YOU WEEP THEY ALSO WEEP AT THEIR LACK OF POWER TO PROTECT YOU. BE HAPPY AND LAUGH YOUR WAY TO GOOD HEALTH.



For the Health Authorities:



* TRY GETTING RID OF RATS IF POSSIBLE.

* COUNTER RUMOURS WITH TRUTH THROUGH THE MEDIA.

* INFORM PEOPLE TO SEEK MEDICAL ATTENTION EARLY-FIRST WEEK TREATMENT IS 100% EFFECTIVE. LATER ON IT MAY BE EVEN FATAL.

* KEEP DOCTORS UPDATED ON THE LATEST METHODS OF DIAGNOSIS AND TREATMENT.

* SUPPLY ALL PRIMARY HEALTH CENTRES AND HOSPITALS THE CORRECT PROTOCOL FOR INVESTIGATIONS AND TREATMENT OF ALL SUSPECTED CASES.

* INFORM THE MEDICAL PERSONNEL TO BE ON THE ALERT; HIGH DEGREE OF SUSPICION IS THE BEST POLICY DURING ANY EPIDEMIC.

* ACT AS IF EVERY JAUNDICE IS LEPTOSPIROSIS UNLESS PROVED OTHERWISE, DURING AN EPIDEMIC.

* STOCK ENOUGH PENICILLIN AND OTHER ANTIBIOTICS FOR USE IN ALL THESE CENTRES.

* IF DOCTORS SUSPECT MENINGEAL OR KIDNEY INVOLVEMENT LET THEM QUICKLY REFER THE PATIENT TO CENTRES OF EXCELLENCE FOR MANAGEMENT.

* LET DOCTORS COUNTER ALL RUMOURS WITH THE TRUTH, TO THE EXTENT POSSIBLE.

* HEALTH EDUCATION HAS THE BEST COMPLIANCE WHEN THE ADVICE COMES FROM A DOCTOR WHOM PEOPLE RESPECT.

* DO NOT GIVE ALL DETAILS OF THE DISEASE TO THE PUBLIC TO SCARE THEM.

* REMEMBER ANY SCARE IS KNOWN TO DEPRESS THE IMMUNE SYSTEM.

* ABBOTAIR WORKERS, FARM WORKERS, AND WATER SPORTS ENTHUSIASTS SHOULD BE WARNED OF THE RISK.



[This DISEASE is not Rat bite fever, as is reported in some papers. That is a totally different germ, the latter is contacted by the bite of a rat or scratch by the cat (Rat Bite Fever or Cat Scratch Disease)]