Filth and human neglect

As if ruin and devastation following torrential rains, floods, and mudslides were not grievous enough postscripts to a disaster, in this country the aftermath is made even worse by the onset of diseases among the population.

These may range from common colds, flu, diarrhea, and a slew of other communicable diseases resulting from overcrowding and unsanitary conditions in evacuation centers, to more deadly and “exotic” illnesses such as leptospirosis. Of course, still looming over this scenario in these days of dread is COVID-19, the coronavirus that causes it unaware (and uncaring) that it is aggravating an already bad health situation.

A topic on many people’s minds and in the headlines lately is leptospirosis, “a bacterial, water-borne disease that can lead to kidney damage, meningitis, liver failure, respiratory distress and even death when not treated properly,” as reported in this paper this week. Most commonly afflicted are people exposed to “floodwater, mud or food contaminated by the urine of infected animals, such as rats, pigs, dogs, cattle, and goats.” The most common mode of entry are open wounds or sores on the feet or skin of people who wade in (or jump into) floodwaters without adequate protection.

“Lepto” cases have swamped the National Kidney and Transplant Institute (NKTI), which had to convert its gym into a ward for patients suffering from this ailment. A total of 89 patients have been admitted since Nov. 12, said NKTI executive director Rose Marie

Liquete. This is the day Typhoon “Ulysses” cut a swathe through much of Luzon, including Metro Manila, Bicol, and Northern Luzon.

The aftereffects of these successive typhoons go beyond the damaged homes, muddied streets, flooded fields, and ruined crops that the country beheld soon after the winds died down and the floodwaters receded. Two years ago, Health Secretary Francisco Duque III sounded the alarm about the onslaught of “lepto,” warning that after a series of typhoons, the number of cases had risen by 41 percent from the previous year. The number of cases, at the time numbering over a thousand, was already considered an outbreak, “because they have already breached the epidemic threshold, which means that the cases reported now in these cities and barangays have already gone past the average number for the last five years,” said Duque.

Indeed, leptospirosis is likely to add more to the count of the injured and debilitated as well as the death toll. It is far more than just a disease caused by the urine of infected animals in the mud and floods left behind by weather disturbances. It is, in essence, a disease caused by environmental negligence and human indifference.

There are things we can still do to stem the tide of “lepto” infestations. Duque had called on local government units, specifically their mayors, to fight the disease by improving garbage collection, saying “adequate and efficient garbage collection systems, a mandate of the local governments,” should ensure that no garbage is left on the streets. It is garbage, after all, that attracts “lepto”-infested rodents and other creatures.

Human victims (or potential victims) can also do many things to protect themselves. Since the disease spreads through people wading unprotected in filthy floodwater, the first step is to avoid puddles and flooded streets, and filthy water from sewers and garbage areas. If unavoidable, people should wear protective footwear like boots and waterproof clothing before plunging in, as well as check for open wounds and covering these up as well.

After contact with floodwater, say medical experts, people should immediately wash their feet and legs with clean water and soap and, if possible, disinfect afterwards. “The DOH emphasizes that early and immediate treatment can prevent the disease from getting worse,” reminded a 2018 editorial in this paper.

How can one tell if one has contracted leptospirosis? For starters, check for flu-like symptoms like body pains (particularly the calf muscle), weakness, and headache. But even before the symptoms appear, one can already be infected as far back as three weeks before, said the NKTI’s Dr. Liquete. She thus advises patients to seek prophylactic treatment or preventive care within 24 to 72 hours after exposure. The longer the exposure, the longer the treatment. Medicines should be available for free in health centers, she noted.

But Dr. Liquete cannot emphasize this enough: “The most important factor in preventing the disease is keeping a clean environment.” We may keep our homes and surroundings pristine, but when rains and floods hit, and everywhere around us is filth, we are all—rich or poor—potential leptospirosis victims.