Health risks increase in Guyana with leptospirosis

Feb 8 2005

Leptospirosis has become a health concern in Guyana, as the number of cases continues to rise and 43 people were being treated for suspected cases of the bacterial disease, which is usually caused by exposure to water contaminated with the urine of infected animals.

The people of Guyana refer to it as 'the Flood Disease.' Two deaths have been confirmed as related to leptospirosis, and another nine suspected cases are being investigated, according to the Pan American Health Organization (PAHO). The rapid increase in suspected cases of leptospirosis has led to an overburden of the Georgetown Public Hospital, which is the only public hospital for Georgetown and the East Coast. All day people were lined up to get doxycyline as prophylactic treatment.

Dr. Bernadette Theodore-Gandi, PAHO/WHO representative in Guyana, warned that health workers should not to focus solely on leptospirosis.

"Leptospirosis has a wide range of symptoms that can mimic other diseases. We should be careful not to overlook the other diseases that may be a result of the flood, such as tuberculosis or pneumonia," she said. "In the coming weeks we should also be very alert to cases of vector-borne and water and food-borne diseases. The floods created an enormous breeding capacity for mosquitoes. We have to take into account that this may also lead to outbreaks of dengue."

PAHO is actively monitoring new cases of leptospirosis and collaborating closely with the Ministry of Health in Guyana to prevent a further increase in cases. Prophylaxis is being distributed on a large scale in the flooded areas, with 120,000 persons already receiving a weekly preventive dose of 200 mg. of doxycycline. People coming from the flooded areas to mobile clinics who show symptoms of leptospirosis receive treatment.

Samples were sent to the Caribbean Epidemiology Center (CAREC) in Trinidad for final confirmation. The total number of casualties directly or indirectly related to the floods, has now risen to 19. Other deaths were caused by drowning and acute dehydration and delays in accessing treatment due to flood waters.

Blood samples are taken to the hospitals for further testing. If they are tested negative, blood is tested for other possible diseases such as dengue or malaria. All mobile health units now use a special form developed by PAHO to monitor the health situation, indicating the most common symptoms and syndromes.

PAHO is also distributing health promotion and disease prevention messages through the newspapers, radio and posters.

According to Dr. Cummings, Chief Medical Officer of the Ministry of Health in Guyana this monitoring of diseases is highly appreciated. "I believe it is very important and it has been very useful in our reply to the flood."

The emergency unit at Georgetown Public Hospital was overwhelmed by people complaining of nausea, headaches and fevers. A number of these patients have been admitted to hospital with suspected Leptospirosis. Dr. Hedwig Goede, Health Systems Advisor at PAHO Guyana, says she is worried about the capacity of the hospital to deal with this overflow of patients. "The hospital is in need of more beds. Even now, people are doubling up in beds. Furthermore there is an urgent need for personal assistance from health workers and nurses."

Guyana is already mobilizing retired nurses to return to the hospital. PAHO offered financial support to facilitate the recruitment and employment of retired nurses. PAHO also relieves the immediate need for additional space by facilitating 200 renovated cots and the purchase of extra mattresses. Georgetown Public Hospital has relocated the psychiatric clinic from the hospital in order to create room for the extra patients with flood-related diseases.

Symptoms of leptospirosis include high fever, severe headache, chills, muscle aches, and vomiting, and may include jaundice (yellow skin and eyes), red eyes, abdominal pain, diarrhea, or a rash. If the disease is not treated, according to the U.S. Centers for Disease Control and Prevention (CDC), the patient could develop kidney damage, meningitis (inflammation of the membrane around the brain and spinal cord), liver failure, or respiratory distress. In rare cases death occurs.

The Pan American Health Organization, founded in 1902, works with all the countries of the Americas to improve the health and raise the living standards of their peoples. It also serves as the Regional Office for the Americas of the World Health Organization.