In Indonesia, the Gunungkidul medical office in Yogyakarta Special Region, central Java island, recorded 22 cases of leptospirosis in 2022, of which 4 patients died. According to health authorities, there is an upward trend and the number of cases may continue to increase. Cases are reported in wet agricultural areas.
Tourists come to the Yogyakarta region for its proximity to Borobudur, an impressive 9th-century Buddhist temple complex, and Prambanan, a 9th-century Hindu temple complex.
Reminder about leptospirosis.
Leptospirosis is a disease caused by bacteria worldwide. Leptospirosis is caused by bacteria Leptospira’s interrogator. This is quite easily maintained in the external environment (fresh water, muddy soil), promoting pollution. The seasonal nature of the disease is pronounced, with outbreaks from summer to fall related to temperature and rainfall.
bacteria of the genus Leptospira capable of infecting a large number of wild mammals (rodents and insectivores: rats, tengues, shrews, etc.) and domestic animals (cattle, sheep, goats, pigs, dogs), they act as receptacles and excrete them in the urine. Bacteria can survive for several months in a warm, humid environment. There are more than 250 serovars of Leptospira species, with some serovars endemic to a certain geographical area.
Certain occupations (farmers, herdsmen, drainage workers, garbage collectors, etc.) and people who practice water sports (swimming, canoeing, kayaking, fishing, hunting) shooting, canyon digging, etc.) are especially at risk. In humans, this bacterium enters mainly through injured skin or mucous membranes.
The disease is usually mild, but complications can occur, including kidney failure which can lead to death in 5 to 20% of cases. The incubation period lasts from 4-14 days.
- In the moderate form, the disease begins with high fever accompanied by chills, headache, myalgia and diffuse arthralgia. In 20% of cases, it is complicated by hemorrhagic syndrome.
- Severe forms (icterohemorrhagic or Weil’s disease) are associated with acute renal failure, neurological impairment (convulsions, coma) and profuse bleeding (pulmonary, gastrointestinal).
Nonspecific initial clinical signs (headache, fever, myalgia) can lead to delays in diagnosis and treatment by confusion with differential diagnoses such as influenza, chikungunya, or dengue.
Precautions and personal protection against leptospirosis:
- Avoid swimming in fresh water, especially when you have an injury, and when the water is cloudy or muddy;
- Avoid contact with water, nose, mouth and eyes;
- Avoid walking barefoot or wearing open sandals on muddy ground, standing water, ravines (especially in surgical departments);
- Protect the wound from contact with water with a waterproof dressing;
- Wear protective equipment when:
- high-risk occupational activities (livestock, drainage workers, garbage collectors, farmers, working on land, etc.) include boots, gloves, wading gear, protective clothing, even including splash-proof glass in case of a splash hazard;
- practice white water sports such as canyoning, kayaking, including protective suits, boots and gloves;
- Control rodents, which are reservoirs of disease.
After taking the risk:
- Wash with potable water and disinfect the wound;
- Consult a doctor immediately in the event of the appearance of symptoms, informing him of the risky operation carried out in the previous two weeks.
These measures will be strengthened during the rainy season.
There is a vaccine against leptospirosis. Its effectiveness is limited to certain strains of leptospira, it is rarely done in practice, mainly involving specialists.