Epidemiological trend and change in mortality of leptospirosis: An emerging public health threat post-flood in a tertiary care centre in North Kerala

Abstract

Introduction: Leptospirosis is considered to be one of the most widespread and emerging zoonosis in the world. Climate change and global warming is affecting the rainfall and flood episodes which leads to the outbreak of disease. Analyzing the trend and change in the mortality pattern of disease is needed to make necessary public health interventions and strategies. Objective: To study the epidemiological trend of leptospirosis cases reported to our institute over the last 5 years (2018–2022) and to identify the factors associated with the mortality of leptospirosis. Materials and Methods: Secondary data regarding all admitted cases of leptospirosis reported to the surveillance unit of our institution was used. Data were also collected from reports of death audits conducted at frequent intervals. Results: Total number of leptospirosis cases reported during the last 5 years was 3102, with 401 deaths (case fatality rate 12.9 %). A varying trend of cases was noted. A maximum number of cases was reported in 2018 after the flood. The mean age was 44.6 ± 16 years. Males were predominantly affected (77.2%). Occupational risk was reported by nearly half of the patients (46%), whereas a history of exposure to contaminated water was present among more than half of them (52%). Less than one-third of the total cases (28%) were confirmed by laboratory diagnosis. Hepatorenal syndrome (55.7%), Myocarditis (50%), and acute respiratory distress syndrome (30%) were the major causes of death. Conclusion: An increase in leptospirosis cases was reported post-flood in our institution. Early diagnosis and treatment are essential. Preventive measures should be strengthened and proper sanitation, health education, and intersectoral collaboration are essential to keep the disease under control.