Leptospirosis: Three times more cases than previous years, one death identified in Réunion

The situation is alarming: the indicators of the leptospirosis epidemic currently spreading on the island are still increasing, surpassing the levels of previous years.

According to the latest figures from the Reunion Regional Health Agency (ARS), as of this Friday March 6, 2024, 83 cases of leptospirosis have been declared on the island since the beginning of the year. This is three times more than previous years during the same period.

Of these 83 cases, nearly 70% were declared in the month of February alone. A record number of monthly cases compared to epidemic peaks in previous years. For comparison, 49 cases were reported during the peak of the epidemic in April 2022.

This week, ARS also learned that a death associated with leptospirosis has been identified. Leptospirosis can actually be fatal, and with each outbreak, unfortunately one to three deaths are recorded in the department.

Since the beginning of the year, 48 people have been hospitalized due to an infectious disease carried by animals, mainly rats. 19 patients had to be kept in intensive care. 47 people called the emergency room for symptoms of leptospirosis.

Regarding the profile of sick people, the majority are men: 79 out of 83 cases have been reported. For an average age of 54 years. The youngest patient is 14 years old, the oldest is 80 years old. Although it is difficult to prove with certainty the place and time of their contamination, it is very likely that people have been exposed to leptospires during agricultural activities, during DIY or yard cleaning, or even during freshwater sports activities.

As a reminder, leptospirosis is contracted through contact with leptospires, pathogenic bacteria present in the urine and feces of animals. These bacteria can be found in water and moist environments after heavy rains, due to soil leaching. This is why it is so important to protect yourself with boots and gloves when carrying out agricultural activities in potentially contaminated environments, for example.

“The rainy season is favorable for the persistence of the bacteria in water and moist environments. Without effective protection, the risk of contamination by leptospirosis is also high while performing hazardous activities.”

Reunion Regional Health Agency

As a reminder, the activities considered at risk are numerous and varied, ranging from garden maintenance to market gardening and tree trimming, domestic poultry raising, freshwater fishing and swimming in rivers. And lakes, valleys… but work that is part of farmers’ daily life, especially affected: harvesting fruits and vegetables such as breeds and pineapples, cutting sugarcane…

All micro-regions of the island are affected. But it is in the south (62%) and to a lesser extent (20%) in the west that most cases of leptospirosis are observed. More than 8 out of 10 infected people live in these areas.

As a reminder, leptospirosis is a notifiable disease.

As soon as the disease is diagnosed, more serious forms can be prevented. Hence the importance of consulting at the first symptoms even if the diagnosis of leptospirosis is not the most obvious. Its symptoms can in fact be confused with those of dengue, covid or flu.

A few days after ingestion (average 4 to 19 days), leptospirosis manifests itself with the following symptoms (which can easily be confused with other infections like dengue, covid-19, etc.):

• High fever (often > 39°C) with sudden onset,
• great fatigue,
• Muscle, joint, stomach pain,
• nausea, vomiting,
• Severe headache.

“The disease can worsen 4 to 5 days after the first symptoms and spread to the liver, kidneys, lungs, meninges and can be fatal.

“, underlines the ARS.

“Administered early, antibiotic therapy reduces the risk of complications and alleviates symptoms,”

This is why it is recommended to consult your doctor quickly and inform him about the risky activities done in the previous three weeks.

In addition, pathogenic bacteria can enter the body through the skin, even through small wounds and micro-cuts. And even without a cut, leptospires can enter the body through mucous membranes such as the eyes, nose, and mouth.

This calls for effective protection against these bacteria by applying the following recommendations established by the ARS.

• Wear appropriate protective equipment (gloves, boots or closed shoes, glasses, etc.) for gardening, collecting trash, moving large objects, or “la coeur” breeding
• Do not walk barefoot or wearing slippersFor activities indoors or outdoors in wet or muddy environments (muddy ground, puddles, stagnant water, ravines)
• Protect your wound from contact with water (waterproof dressings), rinse with potable water and disinfect as soon as possible after exposure.
• for Farmers and breedersVigilance on Wear personal protective equipment is necessary. Regular hand washing is recommended.

In case of cloudy water, It is recommended to postpone leisure activities in fresh water.

“These prevention measures should be implemented especially after periods of heavy rainfall because the risk of contact with contaminated wetlands is increased.”

a vaccine exists against leptospirosis. it is Reserved for certain occupational categories at risk or people regularly practicing hazardous recreational activities, after evaluation by a doctor. This complements vaccination prevention measures.

Finally, the fight against leptospirosis also includes the fight against rodents, the carriers of the disease.

• Maintain your yard regularly (Absence of large objects or litter conducive to rodent proliferation etc.)
• Collect and dispose of your waste Regularly in suitable channels so as not to attract rodents
• Close your trash can properly
• Remove all food sources for rodentsIncluding pet food leftovers
• In that situationPoultry breeding at home, Make sure that food intended for these animals is not accessible to rodents (Food packed in waterproof containers, leftover food removed, fine mesh fence to prevent any intrusion into the hen house).