KOCHI: As the southwest monsoon sweeps India, zoonotic pathogens are spreading terror across the country. Numerous seasonal and zoonotic diseases are putting the health systems in the southern states, especially Kerala and Karnataka, in overdrive. Kerala has witnessed a spike in the number of dengue and leptospirosis cases since May this year – 8,726 dengue cases and 22 deaths, 1,211 leptospirosis cases and 64 deaths – while Karnataka reported 7,165 dengue cases and seven deaths, and 787 chikungunya cases.
One of the major factors influencing illnesses during the monsoon is the sudden change in weather from hot to cold, according to Dr Suchismitha Rajamanya, head of internal medicine at Aster Whitefield Hospital, Bengaluru. “During this period water stagnates, and serves as a breeding ground for mosquitoes which spread diseases such as dengue, malaria, and chikungunya. During the monsoon, it’s the warm, wet, and humid conditions that allow organisms like bacteria, viruses, and fungi to multiply at a high rate which causes most infections such as cold, flu, fungal infection, and respiratory diseases,” she said.
Right treatment
Diagnosis is important in providing the correct treatment to patients. “Once we test and detect the presence of virus or bacteria, we can provide the patient with the right treatment. For leptospirosis, we give antibiotics, and antivirals to treat viral infections. In the case of dengue, supportive care is provided. The doctors can decide whether hospital admission is required or not according to the condition of the patient,” said Dr Dipu T S, professor, infectious disease division, department of internal medicine, Amrita Hospital, Kochi.
Consulting a doctor at the right time can help in stopping the spread. “Every disease is presented by fever. Thus consultation is a must to test and diagnose the presence of a disease. If a person shows symptoms, he should consult a doctor. Also, medicines and antibiotics are available to treat the disease. Unlike before, we have preventive medicines and vaccines available. Every condition has different treatment strategies, which we can use according to the disease and the condition of the patient,” said Dr Althaf A, professor, department of community medicine, Government Medical College Thiruvananthapuram.
Meanwhile, Dr Purushothaman Kuzhikkathukandiyil, professor (paediatrics), MES Medical College, Malappuram, highlighted the challenges in diagnosing leptospirosis as delayed diagnosis often occurs when people self-medicate with paracetamol, and physicians face difficulty in distinguishing leptospirosis from influenza, which comprises 90% of cases, and usually requires minimal treatment. Early detection of leptospirosis is crucial due to its potential fatality if left untreated. This bacterial infection affects vital organs such as the liver, kidneys, brain, and heart. “Missing leptospirosis is perilous, as most deaths result from delayed treatment. Earlier the disease used to be found in rural areas. But recently more cases are being reported from the urban areas. It should be noted that the disease is caused not just by rats, but also by cattle, and dogs,” he said
Monsoon-related infections can be combated with strong immunity created through a balanced diet rich in vitamins, and minerals. “The consumption of fresh fruits and vegetables rich in vitamins overcomes oxidation stress as it prevents body dehydration involving pure water usage only,” said Dr Suchismitha, adding that getting appropriate vaccination against influenza, hepatitis-A, and typhoid can help.
The spread also indicates improper vector control, and unhygienic conditions. “To prevent spread, we need to take vector control measures, ensure proper waste management, and ensure safe and clean drinking water. We must ensure that the conditions are not favourable for the vector to breed. Pre-monsoon cleaning activities, proper drainage system etc can help,” said Dr Rajeev Jayadevan, chairman of IMA research cell, Kerala.
Dr Althaf added that the healthcare system should be equipped to tackle the situation. “The number of cases – be it dengue, leptospirosis, chikungunya, and H1N1 cases reported – is increasing worldwide. Thus, the rising numbers should alert hospitals – both government and private – to be prepared and efficient to tackle the situation. Better treatment and diagnosis facilities can help prevent the spread, as well as treat the affected patients,” he said, adding that setting up fever clinics can be beneficial.
“Setting up fever clinics has several advantages. It can reduce the waiting time for patients and helps avoid mixing up of patients and thereby prevent transmission of the disease,” he added.
One health approach
According to WHO, ‘One Health’ is an integrated, unifying approach to balance and optimise the health of people, animals, and environment. It is particularly important to prevent, predict, detect, and respond to global health threats such as Covid-19, which involves the public health, veterinary, and environmental sectors. At the national level, India launched the National One Health Programme for Prevention and Control of Zoonoses (NOHP-PCZ) under the National Centre for Disease Control to protect communities and minimise socio economic losses due to emerging zoonotic threats.
Outbreaks in Kerala
This year, there have been 1,211 confirmed cases of leptospirosis, resulting in 64 deaths. Leptospirosis is caused by the bacterium leptospira, typically found in contaminated water or soil. Transmission occurs through contact with the urine of infected animals, either directly or indirectly via contaminated environments. The infection is not restricted to people who enter the muddy waters.
Unexpectedly, a homemaker in Pathanamthitta contracted the disease while gardening, acquiring it through a wound on her palm, which tragically proved fatal, two years ago. Kerala also witnessed the worst hepatitis outbreak this year as over 1,000 cases were reported in Malappuram, and 292 cases in Vengoor, Ernakulam. In both cases, the cause was improper chlorination of the water sources.
(With inputs from Rishitha Khanna @Bengaluru, Unnikrishnan T @ T’puram)