Leptospirosis Impacting Fiji
Leptospirosis is an infection in many kinds of wild or domesticated species, as well as rodents [1]. “The infection in man is contracted through skin abrasions and the mucosa of the nose, mouth and eyes [1]. “Exposure through water contaminated by urine from infected animals is the most common route of infection" [1]. The bacteria can get into water or soil and can survive there for weeks, even months [2]. Fortunately, human transmission is rare. Leptospirosis cases may peak during the rainy season [1]. In Fiji, the summer season also increases the risk of Leptospirosis due to higher rainfall [2]. Hence, Leptospirosis is most common in temperate or tropical climates such as Fiji [2].
Many different kinds of wild and domestic animals carry the bacterium [2]. Prevention strategies of human leptospirosis include wearing protective clothing for people at occupational risk and avoidance of swimming in water that may be contaminated [1].
Without treatment,"Leptospirosis can lead to kidney damage, meningitis (inflammation of the membrane around the brain and spinal cord), liver failure, respiratory distress, and even death" [2].
Infected animals may continue to excrete the bacteria into the environment continuously or every once in a while for a few months up to several years [2].
Humans can become infected through:
Contact with urine from infected animals
Contact with water, soil, or food contaminated with the urine of infected animals.
The bacteria can enter the body through skin or mucous membranes (eyes, nose, or mouth), especially if the skin is broken from a cut or scratch.
It is important to remember that drinking contaminated water can also cause infection [2]. Outbreaks of leptospirosis are usually caused by exposure to contaminated water, such as floodwaters [2]. In addition, Leptospirosis is an occupational hazard for many people who work outdoors or with animals such as farmers , mine workers, crop farmers, slaughterhouse workers, fish workers, dairy farmers and military personnel [2].
In humans, Leptospirosis can cause a wide range of symptoms [2], including:
High fever
Headache
Chills
Muscle aches
Vomiting
Jaundice (yellow skin and eyes)
Red eyes
Abdominal Pain
Diarrhoea
Rash
Unfortunately, many of these symptoms can be mistaken for other diseases [2]. "The time between a person’s exposure to a contaminated source and becoming sick is 2 days – 4 weeks [2].
Leptospirosis may occur in two phases [2]:
After the first phase (with fever, chills, headache, muscle aches, vomiting, or diarrhoea) the patient may recover for a time but become ill again [2].
If a second phase occurs, it is more severe; the person may have kidney or liver failure or meningitis. This phase is also called Weil’s disease [2].
The illness lasts from a few days to 3 weeks or longer. Without proper treatment, recovery may take several months" [2].
To avoid becoming infected;
Store food safely away from animals
Always wear protective clothing and protective footwear around animals and agricultural areas
Never swim in contaminated waters
In 2020, Fiji had declared an outbreak of leptospirosis diseases in the country amid the Covid-19 pandemic [3][4]. During the time of that report, the health ministry announced 4 people had died from dengue while 10 others died from leptospirosis this year [3]. According to the Minister of Health Dr Ifereimi Waqainabete, January and July, 3300 dengue cases and 1000 cases of leptospirosis were recorded [3].
In February of 2021 alone, the Ministry recorded 160 Leptospirosis cases nationally and 5 confirmed deaths while 335 confirmed Dengue Fever and 1 confirmed death [4][5][6]. Similarly, there was 53 Typhoid cases nationwide and 1 confirmed death.
Furthermore, the ministry stated, "clinical teams of specialists including public health workers have been deployed to Sigatoka. Rakiraki, Navosa, Nadarivatu, Nabouwalu and Savusavu to combat the spread of these diseases [4]. The teams will facilitate community awareness and public health measures to reduce the risk of the spread of Leptospirosis, Typhoid, and Dengue (LTD’s) and will further ensure that community screening remains the priority for early diagnosis and treatment of LTD’s and any other undiagnosed medical problems" [5].
WHO. Leptospirosis. Available at : https://www.who.int/zoonoses/diseases/leptospirosis/en/. 2021
Ministry of Health and Health Sciences. Leptospirosis. Available at: http://www.health.gov.fj/what-is-it-3/. Updated 2021
RNZ. Fiji declares dengue and leptospirosis outbreak. Available at: https://www.rnz.co.nz/international/pacific-news/423925/fiji-declares-dengue-and-leptospirosis-outbreak. 2020
Fiji Times. Wanshika Kumar Leptospirosis outbreak: Five dead. 2021
Outbreak News Today. Leptospirosis cases up in Fiji with 5 deaths recorded. Available at: http://outbreaknewstoday.com/leptospirosis-cases-up-in-fiji-with-5-deaths-recorded-45216/. 2021
Fiji Sun. 3 Leptospirosis Deaths, 300 Cases Of Dengue Fever. 2021