San José, Costa Rica, since 1956

Leptospirosis Outbreak Spreads Nationwide

The recent outbreak of a rare disease spread by animal urine has developed into a nationwide epidemic, claiming 16 lives and infecting hundreds of people in nearly every region of the country. The Nicaraguan government declared a national health emergency Oct. 16.

This week the health ministry reported 10 new cases of leptospirosis, bringing the total number of identified cases to 434 in all 15 departments of the country, plus the North Atlantic Autonomous Region (RAAN).

The South Atlantic Autonomous Region (RAAS) is the only part of the country that has not been affected by the leptospirosis outbreak.

The most affected region is the northern Pacific department of León, where there have been 138 cases and 10 deaths.

Leptospirosis, also known by the more frightening-sounding name of “hemorrhagic jaundice,” is a bacterial disease spread by the urine of infected rodents, pigs and dogs. In most cases, people who are infected will report “flu-like symptoms” – chills, fever and headache – lasting up to 10 days.

But in more serious instances – roughly 20 percent of all cases – leptospirosis afflicts the patients’ kidneys or liver, causing jaundice, hemorrhaging and even death.

If detected in time, leptospirosis can be treated with common antibiotics. Since declaring the national health emergency earlier this month, Sandinista health brigades have visited 31, 660 homes across the country and prescribed preventive antibiotic treatment to 1.3 million people – or roughly one out of every four people in the entire country.

But because the incubation period for the disease is 10 to 20 days, the detection of new cases this week means the outbreak could last for another several weeks, according to Dr. Leonel Argüello, the former head epidemiologist for the revolutionary Sandinista government in the 1980s.

“We have to wait at least 20 days without any newly reported cases to be sure the epidemic is really over,” Argüello told The Nica Times this week.

In the meantime, he said, the best way to combat the epidemic is to attack it at its cause: the animals that transmit the disease.

“The areas of outbreak and the sick animals need to be identified and treated,” the epidemiologist said. “The sick dogs can be treated with medicine and the mice need to be exterminated.”

Argüello said the recent outbreak of leptospirosis has been worsened by the recent flooding caused by heavy rains over the past two months (NT, Oct. 22).

As heavy rains and swollen lakes flood thousands of homes, mice have retreated to higher grounds – moving from their garden and floorboard abodes to rafter and ceiling sanctuaries. So when the mice urinate from their new perches, their urine can spray onto people’s eating surfaces such as kitchen counters, plates and glassware. There have also been cases of mice urinating on stacked cases of beer and soda cans in sundry storage rooms, infecting the can for unsuspecting customers.

Plus, Argüello said, many people who come into contact with flood water mixed with rodent urine are greatly increasing their chances of exposure to leptospirosis through cuts on their hands or feet, or by handling food without washing their hands properly beforehand.

The infectious disease expert said the government should do more to raise permanent awareness about the health risks posed by rodents. In rural Nicaragua, Argüello said, many people view rodents as a risk to crops and house infrastructure rather than a risk to public health.

The government is, however, taking steps to wipe out rodents now that disease has struck. With help from Cuba, which last week provided 12 tons of “Biorat,” a Cuban-produced rodent poison that is spread among mice to kill entire colonies, the health brigades have launched a door-to-door offensive against mice.

The Sandinista government says it’s responding to the outbreak using the “model of Citizen Power.”

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