Emergence of Leptospirosis in Rajasthan: First Patient Detected in Bhilwara

Bhilwara- In a concerning development, the first case of leptospirosis (Rat Fever) has been reported in Bhilwara, marking it as the first patient in the entire state to be diagnosed with this potentially dangerous disease. Leptospirosis, primarily transmitted through rat-borne sources, poses a particular risk to children. The affected individual, a young girl, is currently undergoing treatment at a private hospital in Bhilwara.

As per a report in Rajasthan Patrika, a resident of Makadia in Mandalgarh, Bhilwara district, shared that her four-and-a-half-year-old daughter, recently experienced a high fever, accompanied by the appearance of blisters on her body. Initially treated at home with basic remedies, the child was later taken to Mandalgarh Hospital, where she was subsequently referred to Bhilwara for further examination and treatment.

Upon consultation with specialists at a private hospital in Bhilwara, the girl was admitted for a thorough evaluation. Despite several tests initially failing to identify the ailment, a subsequent test for leptospirosis returned a positive result. Treatment has since been administered based on this diagnosis. Dr. Atul Heda, a pediatrician involved in the patient's care, believes that this is likely the first reported case not only in Bhilwara district but also in the entire state of Rajasthan.

Leptospirosis is a common infection during monsoon, especially in areas prone to flooding and waterlogging; it is caused by a bacteria called spirochete. The bacteria usually enter the host body through cuts and abrasions in the skin, sometimes they enter the body through the ingestion of floodwater through the mouth or nose. It is known to spread to children through contact with rat urine, presenting symptoms similar to dengue, including fever and widespread body effects. Typically, the onset of normal fever precedes noticeable symptoms by five to six days. Without proper and timely treatment, the fever may persist for 10 to 15 days.

Leptospirosis Crisis in India

In India, leptospirosis often spread after heavy rain or post flooding. It was declared as a public health problem in India from 1980 onwards, and isolated cases have been reported prior to this date . Several outbreaks of Leptospirosis have been reported from Tamil Nadu, Gujarat, and Karnataka. Other states of India have reported the incidence of sporadic leptospirosis cases. Rat fever has long been a major threat to the State of Kerala with more than 1,000 cases is being reported annually. Nationally, it causes the highest number of deaths among all communicable diseases in Kerala. 

In a research paper titled "Modeling the Dynamics of Leptospirosis in India," published in Scientific Reports on November 13, 2023, authors Antima and Sandip Banerjee, based on their study, advocate for decisive preventive actions to control and combat leptospirosis in India.

The report says, India is a hotspot for leptospirosis, a bacterial infection that causes significant illness and death. However, the true impact is often underestimated due to a lack of awareness and limited diagnostic facilities in many regions. The primary modes of exposure to leptospirosis in India are through activities such as paddy farming, livestock farming, and working in underground sewers. Despite being recognized for decades, public awareness about the disease remains low.

In the late 1980s, a mysterious febrile illness started appearing in seasonal outbreaks in India, particularly in the Andaman region. A notable and alarming symptom was severe bleeding from the lungs (haemoptysis) in most cases. This condition, known as Andaman Haemorrhagic Fever (AHF), raised concerns due to its epidemic potential and high case fatality rates ranging from [specific rates not provided]. For five years, the cause of AHF remained unknown.

In 1995, a breakthrough occurred during an outbreak in Diglipur in North Andaman, revealing compelling evidence of a leptospiral origin for AHF. This discovery marked a significant turning point, identifying severe pulmonary hemorrhage as a complication of leptospirosis in India. Since then, various outbreaks and isolated cases of this ailment have been reported from different parts of the country, including Surat, Cochin, Orissa, Mumbai, and Chennai.

Leptospirosis symptoms

Initially, fever, muscle pain and headache. Later, jaundice, low urine output, bleeding tendency, respiratory distress, cardiac failure, convulsions and coma

Clinical findings- Fever, muscle tenderness especially calf and thigh, lower backache, congestion of eyes, later may have a subconjunctival haemorrhage, jaundice and evidence of hepatic, pulmonary and renal involvement

Preventive measures

• Spreading of awareness regarding the disease

• Maintain personal hygiene

• Use personal protective equipment

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