Catastrophic and destructive, floods can come without a warning in most parts of the world. This natural disaster has a higher incidence in tropical areas where heavy rainfall is common – Malaysia is one of them.
Apart from the obvious damage to property and life that a flood can cause, the aftereffects that floodwater has on our health are often underestimated. In countries where floods have become a norm, playing in the floodwater is pretty common, especially amongst children.
What parents and children do not realise is that this innocent act of playing in floodwater can have serious adverse effects on their health. Infections that are water-borne (spread through water) are the biggest health hazards and these infections can be the direct cause of a high mortality rate in flood-stricken areas.
Floodwater Infections: Rat Urine Infection
You may have heard the term rat urine disease/fever if you live in the tropics. This potentially deadly infection, medically known as Leptospirosis, is the cause of around 60,000 deaths annually with over 1 million cases diagnosed every year.
The bacteria that causes Leptospirosis, Leptospira, are corkscrew-shaped microorganisms that can infect animals and humans. In particular, rats and rodents act as the main reservoir of infection. Exposure to these infected animals ultimately passes on the disease to humans.
Leptospirosis is more commonly seen in the tropics and subtropics with outbreaks observed around the time of rainfall or floods. Poor drainage of floodwater due to overcrowded housing and poor sanitation are major contributors to the spread of the disease.
Leptospirosis in Malaysia
The climate of Malaysia is dominated by heavy rainfalls, humidity and an increased likelihood of floods. These, along with the ever-growing population of the country, are risk factors for rat urine infection.
It might be hard to believe, but it is estimated that there are at least 8 rats per person in Malaysia! This makes the outbreak of leptospirosis common in the country and it poses as a national health epidemic during flooding periods.
How Does Rat Fever Spread?
Rats, rodents and other animals act as reservoirs or hosts of the infection. The bacterium that causes leptospirosis can live for many months in the urine of these animals and this urine can contaminate water and soil surfaces during heavy rainfall.
Humans are infected by rat urine infection by directly being exposed to this contaminated water. Although not contagious through droplet infection or direct human contact, there is evidence that leptospirosis can be spread through intercourse or breast milk.
How Does Leptospirosis Present?
The initial symptoms of the infection are pretty vague and most cases remain without symptoms. The illness usually takes form after about 5 to 14 days of the exposure.
Although the mild form of the infection is more common, sometimes this can be superseded by a severe illness.
Leptospirosis can cause headaches, bloody diarrhoea, fever, body aches, nausea, vomiting and pain in the abdomen. Sometimes the patient might suffer from jaundice or develop skin or eye problems.
When a pregnant woman is infected by leptospirosis, there could be an imminent threat to the foetus. Spontaneous miscarriages and intrauterine death of the foetus are common.
How is Leptospirosis Diagnosed?
The investigation of choice that confirms the diagnosis of leptospirosis is a PCR test to detect bacterial DNA. This, however, is an expensive test, so other initial tests could be considered. Other tests include:
- Detection of antibodies to the bacteria in the blood, Leptospira Ig M
- Microscopic agglutination test (MAT)
Currently, many clinics offer a complete leptospirosis diagnostic screen. If you experience symptoms of the disease, it is a good idea to get tested as soon as you can at BioMark’s participating clinics in Malaysia.
How Can Leptospirosis be Prevented?
Prevention is the most important step in managing the outbreaks of leptospirosis. You should be extra cautious after heavy rainfall and avoid playing, bathing and swimming in the floodwater.
During the rainy seasons, food could also be contaminated so it is wise to exercise caution when you are eating out during this period.
If you must be exposed to the floodwater for certain reasons, make sure that you are fully geared and protected. This means that you should be wearing waterproof clothing and protective equipment.
Pest control is also another important aspect in the prevention of leptospirosis. Keeping your vicinity clean and free of rodents will decrease the incidence of this disease.
How is Leptospirosis Treated?
When the infection is mild, a course of oral antibiotics would suffice. However, if you have severe symptoms, you might need to be admitted to the hospital where you would be rehydrated and given intravenous antibiotics.
Early treatment is crucial to avoid complications of the infection. If the treatment is delayed, leptospirosis can cause kidney, liver, lung and brain damage – and even death.
Floodwater and rain might seem alluring to play and bathe in, but they bring with them a collection of hazardous bacteria including the one that causes deadly rat fever. Make your health your priority and avoid any activity in floodwater.
If you experience symptoms of leptospirosis, get tested immediately. Early treatment can be lifesaving!