Leptospirosis cases in Metro Manila reach over 700

MANILA, Philippines–More than 700 cases of leptospirosis have been reported in four government hospitals with more people suspected of having contracted the potentially fatal disease coming in every day.

Of the total number of cases, there were 39 fatalities.

As of Wednesday, there were 134 suspected cases at San Lazaro Hospital (SLH) in Manila with 20 deaths recorded while East Avenue Medical Center (EAMC) in Quezon City reported 96 cases with 19 deaths.

Another government hospital in Quezon City, Quirino Memorial Medical Center (QMMC), recorded more than 400 cases while 70 patients were confined at Philippine General Hospital (PGH) after they showed symptoms of the disease.

Most of the patients in the four hospitals came from parts of Metro Manila and Rizal province which were submerged in floods at the height of Tropical Storm “Ondoy” on Sept. 26.

Dr. Rontgene Solante, a consultant at SLH and vice president of the Philippine Society of Microbiology and Infectious Diseases, said a lot of the patients they were treating for the the disease have been confined at the hospital since Oct. 1.

“We’re now observing cases of individuals who were exposed two or three weeks ago to floods caused by Ondoy. We did not expect the surge in the number of cases. But we’re not turning away anyone,” he said at a forum organized by the Philippine College of Physicians on Wednesday.

Solante said the hospital had run out of beds and testing kits although its supply of medicines, particularly antibiotics, was still sufficient.

“Our supply of penicillin is adequate but we lack enough beds. In San Lazaro, all the wards and the hallways are being utilized,” he said.

“It’s the first time we have an outbreak of leptospirosis. We have much more patients than we expected,” Solante added.

He said most of the patients were from Marikina, Pasay, Pasig, Mandaluyong and San Mateo in Rizal province—areas which were heavily-flooded when Ondoy struck.

Dr. Emmanuel Bueno, EAMC spokesperson, said more than 20 cases were admitted to the hospital on Wednesday, on top of the 76 patients whom they have been treating since Oct. 7.

Of the total number of cases, there have been 19 deaths, mostly due to kidney failure.

Bueno, meanwhile, expressed concern over the fact that most of the people who sought treatment were already showing signs of being in the advanced stage of the disease.

“There are those who have not urinated for two days because their kidneys have shut down. This is what will kill them. That explains the high mortality,” he said.

“We have observed that many come to us too late because of their desperate situation. They have lost their homes or their homes were damaged. So they try to tolerate their condition as far as they can and by the time they go to the hospital, it’s too late,” Bueno added.

Solante also stressed the need for early treatment.

He said in the early stage of the disease, it was “very difficult” to distinguish the flu-like symptoms of fever and myalgia (muscle pain) from ordinary flu and other ailments.

According to Bueno, due to the rise in cases, they were talking to private hospitals about “resource-sharing,” especially in the use of life-saving dialysis machines.

“We have to help each other,” he said.

Leptospirosis is a bacterial infection caused by exposure to the urine of rats and other animals in floodwaters.

The incubation period before the appearance of symptoms has been observed to be as early as two days within exposure or as late as 21 days after.

Doctors advised those who waded through floodwaters who experience flu-like symptoms such as fever and muscle pain to immediately seek medical attention.

Other common symptoms include redness of the eyes, vomiting, headache, jaundice and difficulty in urinating. Severe cases of the disease can result in kidney failure and liver and brain involvement that may lead to death.

Treatment involves antibiotics which should be prescribed by a physician. To avoid complications, the disease should be diagnosed early and treated immediately.

In Pasig, the city government has poured several drums of chlorine into stagnant, dirty floodwaters in low-lying barangays to prevent the spread of diseases, including leptospirosis, which has downed a few dozen residents since Ondoy.

The chlorine treatment is not meant to clean the floodwaters, but only to make it less murky and to reduce the concentration of disease-causing bacteria, Mayor Robert Eusebio said.

“Last Sunday, we emptied 10 drums of chlorine into the floodwaters. It’s not meant to cleanse the water. We just want to lower the levels of bacteria in the water,” he said.

Eusebio added that health officials had not yet declared an outbreak of leptospirosis in Pasig, although several cases had already been recorded in the city.

“At Medical City alone, we already have 40 people with leptospirosis, but we’re still verifying where they live,” he said.

The Department of Health recorded another 13 cases in the Rizal Medical Center as of Oct. 12.

Eusebio said other precautionary measures the city has taken against leptospirosis include putting up signs warning residents against swimming in floodwater and building footbridges in flooded areas.

It has also started distributing antibiotics and other medicine.

“We gave all residents of barangays that remain flooded medicine packs containing paracetamol and medicine which I was told could help protect against leptospirosis,” he said.

Areas in Pasig that remain submerged include Pinagbuhatan, Sitio Nagpayong, parts of Maybunga, Kalawaan and Bambang, Eusebio said.

In Marikina City, Mayor Marides Fernando said there were many residents afflicted with leptospirosis although local health officials do not yet have an official figure. –Dona Pazzibugan, Philippine Daily Inquirer with DJ Yap