THIRUVANANTHAPURAM: Everyday routines like tending to a backyard garden or doing outdoor chores come with an unexpected risk in Kerala. Recent government death audit data, compiled from hospital records, reveal that death from leptospirosis was the highest among manual labourers, at 37% (47 deaths) in 2025. Agricultural workers accounted for 11% (14) and homemakers 10% (13) of the 390 fatalities recorded last year.
The outbreak has predominantly affected individuals between 40 and 69 years of age, though experts suspect the actual toll to be higher than reported. Amidst public focus on high-profile dengue outbreaks, Dr Althaf A, director of the Kerala Centre for Disease Control (K-CDC) and professor at Thiruvananthapuram Government Medical College Hospital, highlights a far graver threat. He points out that leptospirosis warrants urgent attention because it accounts for a staggering 52% of all deaths caused by communicable diseases in the state.
“Importantly, these deaths are preventable with the right awareness and medicines that cost just Rs 3,” he added. Despite Kerala’s robust healthcare infrastructure, leptospirosis has emerged as its most lethal infectious threat, with deaths skyrocketing over fourfold to 1,455 in 2021-2025 from 319 in 2016-20, and mortality rate climbing from 4.2% to 6%. Over the same period, case volumes surged more than threefold.
Yet, while public anxiety remains overwhelmingly consumed by dengue and localised scares of Shigella, leptospirosis continue to suffer from a critical lack of public-health prioritisation and resource allocation. This deficit has persisted in 2026, with fresh data from the Directorate of Health Services (DHS) showing the state having recorded 1,352 confirmed cases and 58 deaths as of July 29.
To combat this crisis, K-CDC has made reducing leptospirosis morbidity and mortality a top priority by partnering with the local self-government, agriculture and labour departments to improve the safety of vulnerable workers.
As part of these measures, state guidelines are being revised to promote doxycycline, an effective and recommended prophylactic antibiotic. “Earlier, it was suggested only for a specific period. Now we are recommending prolonged use, throughout the exposure period,” said Dr Althaf, who also serves on the State High-Power Committee for Epidemic Control.