Sri Lanka: Leptospirosis 2011, 89 fatalities.

[Ronan Kelly]

Mysterious deaths in Anuradhapura hospital
YASARATNE GAMAGE and Anuradhapura Central Special Corr

Anuradhapura teaching hospital sources revealed that seven patients admitted to the hospital with fever died during last week.

The reason for their deaths have not been determined at the post mortem. Chandrani Dissanayake of Eppawala 52, R M Malinda Senaratne of Mahakanadarawa 35, Ajith Pathmasiri of Thalawa 40, S A Wimalawathie of Nochchiyagama 74, P Rathnayake of Andarawewa 51, and U G Janaka Sampath of Rajanganaya 36, died while they were being treated at the hospital.

Anuradhapura forensic medical officer Dr D C Waidyaratne is to produce further reports after extensive investigations.

It was further revealed that all diseased came from a farming community in the North Central Province.
http://www.dailynews.lk/2011/02/21/news36.asp

 

[Ronan Kelly]

Re: Sri Lanka: 7 undiagnosed fever deaths in Anuradhapura hospital

Re: Sri Lanka: 7 undiagnosed fever deaths in Anuradhapura hospital

SUDDEN DEATH OF 4 FARMERS: RAT FEVER SUSPECTED
.February 18, 2011: The sudden death of four farmers in Anuradhapura has prompted an investigation to ascertain whether the deaths had been caused by Rat Fever.



?The farmers died in the Intensive Care Unit of the Anuradhapura hospital,? said Dr. W. Atapattu, Health Director of the North Central Province.

Dr. Atapattu also said that 13 suspected cases of Rat Fever were being treated at the Anuradhapura hospital.

http://www.newsfirst.lk/index.php?o...er-suspected&catid=97:news-items-2&Itemid=294

 

[alert]

Re: Sri Lanka: 7 undiagnosed fever deaths in Anuradhapura hospital - suspected leptospirosis

Re: Sri Lanka: 7 undiagnosed fever deaths in Anuradhapura hospital - suspected leptospirosis

http://www.lankapuvath.lk/index.php/latest-news/general/12566-rat-fever-kills-four-in-anuradhapura

Rat fever kills four in Anuradhapura Thursday, 17 February 2011 15:42 News - General


(Colombo Lankapuvath) Four persons have died during the past four days in the Anuradhapura district, medical sources disclosed.

They said investigations carried out have revealed that the cause of death was rat fever.

However, more investigations are carried on specimens obtained from the deceased persons.

 

[alert]

Re: Sri Lanka: 7 undiagnosed fever deaths in Anuradhapura hospital - suspected leptospirosis

Re: Sri Lanka: 7 undiagnosed fever deaths in Anuradhapura hospital - suspected leptospirosis

Yeah, I agree. Rat fever is another name for leptospirosis.

Nice find, RoRo. And nice timing, too.

 

[Ronan Kelly]

Re: Sri Lanka: 7 undiagnosed fever deaths in Anuradhapura hospital - suspected leptospirosis

Re: Sri Lanka: 7 undiagnosed fever deaths in Anuradhapura hospital - suspected leptospirosis

Fever hits A'pura Sunday, 20 February 2011 08:16

A fever which is spreading in Anuradhapura has claimed the lives of at least six people so far including two last evening, health authorities said today.

The Health Ministry has launched a special probe to try and indentify the cause of the fever and initial suspicion is that it is rat fever.

...

Anuradhapura was among the areas worse affected by the recent floods.
(Report by Upali Anand for News Now.lk)



http://www.newsnow.lk/latest-news/fever-spreads-in-apura

 

[alert]

Re: Sri Lanka: 7 undiagnosed fever deaths in Anuradhapura hospital - suspected leptospirosis

Re: Sri Lanka: 7 undiagnosed fever deaths in Anuradhapura hospital - suspected leptospirosis

http://www.dailymirror.lk/news/9924-beware-of-rat-fever.html

Beware of rat fever Monday, 21 February 2011 17:35

The health authorities today cautioned the public on the possibility of the spread of leptospirosis widely known as ?rat fever?, with the flood waters receding in many areas.

?There are reports of incidences of leptospirosis lately from flood affected areas where the disease has not been reported earlier. There has been a sudden increase of leptospirosis in the last few weeks in Anuradhapura and Polonnaruwa, two flood affected districts. The health ministry has instructed provincial health authorities to be extra vigilant during the post flood period,? Ministry spokesman W.M.D.Wanninayaka said.

He added that patients with prolonged high fever, severe pain on the spinal cord, unbearable headache and muscle pains must seek immediate medical treatment. (Sandun A. Jayasekara)

 

[alert]

Re: Sri Lanka: 7 undiagnosed fever deaths in Anuradhapura hospital - confirmed leptospirosis

Re: Sri Lanka: 7 undiagnosed fever deaths in Anuradhapura hospital - confirmed leptospirosis

http://www.dailynews.lk/2011/02/22/news03.asp

Flood victims with fever:

Seek immediate treatment - Ministry
Nadira Gunatilleke

The Health Ministry yesterday requested flood victims suffering from fever to seek immediate medical treatment. Two persons from Anuradhapura had died from rat fever (Leptospirosis) and 50 others are receiving treatment, a Ministry spokesman said.

According to the spokesman out of seven persons who died from fever in the Anuradhapura hospital recently, two had died from rat fever. Blood samples of others are being tested at the Medical Research Institute (MRI).

The Health Ministry yesterday sent a special team to Anuradhapura to probe the deaths of seven persons who were suspected of having Leptospirosis symptoms.

Vulnerable people, especially farmers should contact the PHI or MOH and obtain Doxycychine tablets. They should take two tablets before they start work.

 

[alert]

Re: Sri Lanka: 7 undiagnosed fever deaths in Anuradhapura hospital - suspected leptospirosis

Re: Sri Lanka: 7 undiagnosed fever deaths in Anuradhapura hospital - suspected leptospirosis

http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,87230

Archive Number 20110224.0605
Published Date 24-FEB-2011
Subject PRO/AH/EDR> Leptospirosis, fatal - Sri Lanka: (NC)

LEPTOSPIROSIS, FATAL - SRI LANKA: (NORTH CENTRAL)
*************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Tue 22 Feb 2011
Source: Daily News [edited]
<http://www.dailynews.lk/2011/02/22/news03.asp>


The Health Ministry yesterday [21 Feb 2011] requested flood victims
suffering from fever to seek immediate medical treatment. A Ministry
spokesman said 2 persons from Anuradhapura [North Central province]
had died from rat fever (leptospirosis) and 50 others are receiving
treatment.

According to the spokesman out of 7 persons who died from fever in
the Anuradhapura hospital recently, 2 had died from rat fever. Blood
samples of others are being tested at the Medical Research Institute
(MRI).

The Health Ministry yesterday sent a special team to Anuradhapura to
probe the deaths of 7 persons who were suspected of having
leptospirosis symptoms.

Vulnerable people, especially farmers should contact the PHI [public
health inspector] or MOH and obtain doxycycline tablets. They should
take 2 tablets before they start work.

[Byline: Nadira Gunatilleke]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[Leptospirosis is a zoonosis caused by the spirochete _Leptospira_.
This disease characteristically occurs during periods of flooding and
is endemic in Sri Lanka. For a discussion of leptospirosis, see the
prior ProMED-mail post Leptospirosis - Australia: (QL) alert
20110121.0246.

Doxycycline in a single 200 mg oral dose, (or weekly, in cases of
prolonged exposure) has been used to prevent leptospirosis in exposed
persons. The single dose of doxycycline is thought to provide
protection for about a week. However, different clinical trials to
assess the efficacy of chemoprophylaxis of leptospirosis have had
conflicting results
(<http://www.cdc.gov/ncidod/eid/vol9no6/02-0751.htm>,
<http://www.wiziq.com/tutorial/40553-Doxycycline-chemoprophylaxis-for-leptospirosis-a-brief-review>).

The results of one randomized placebo-controlled trial study
indicated that doxycycline prophylaxis did not prevent leptospiral
infection in an endemic area during a seasonal outbreak, but had a
significant protective effect in reducing the morbidity and mortality
(<http://www.ncbi.nlm.nih.gov/pubmed/10755239>). Another randomized
placebo-controlled study of US soldiers training in Panama
demonstrated a 95 percent protective efficacy with a weekly dose of
200 mg doxycycline for 3 weeks, compared to placebo (Takafuji ET et
al: An efficacy trial of doxycycline chemoprophylaxis against
leptospirosis. N Engl J Med. 1984; 310(8): 497-500; abstract available
at <http://www.nejm.org/doi/full/10.1056/NEJM198402233100805>). A
Cochrane review of clinical research testing whether taking
doxycycline can prevent leptospirosis found that data from trials,
which "targeted different kinds of people -- travellers and people who
live in at risk areas, encompassing soldiers, farmers, and students",
"did not support the practice in all cases, though short term
travellers with a potential for high risk exposure may be helped."
(<http://www.thecochranelibrary.com/userfiles/ccoch/file/Water%20safety/CD007342.pdf>).

The Anuradhapura District, located in north-central Sri Lanka, with a
population in 2001 of 745 693, is one of 2 districts in the North
Central Province of Sri Lanka
(<http://en.wikipedia.org/wiki/North_Central_Province,_Sri_Lanka>).
The city of Anuradhapura, the capital of the North Central Province,
is one of the ancient capitals of Sri Lanka and is famous for its
well-preserved ruins of ancient Lankan civilization
(<http://en.wikipedia.org/wiki/Anuradhapura>). The city lies on the
banks of the Malwatu Oya River, which flooded with the release of
water from 2 reservoirs, Nuwara wewa and Tissa wewa. The reservoirs
were constructed by the city's ancient rulers to irrigate paddy lands
and also to supply water to the city
(<http://srilanka.travel-culture.com/anuradhpura.shtml>). For a map of
the city, see <http://iguide.travel/Anuradhapura/Eating#/Map>.

The flooding, due to torrential rains that began in January 2011 in
Sri Lanka's North Central and Eastern provinces, displaced almost a
million people, and caused widespread devastation
(<http://makanaka.wordpress.com/2011/02/13/sri-lanka-floods-we-dont-have-a-harvest/>,
<http://www.lankaweb.com/news/items/2011/02/15/anuradhapura-needs-all-the-help/>,
and
<http://srilanka.travel-culture.com/articles/floods-in-srilanka.shtml>).

 

[Ronan Kelly]

Re: Sri Lanka: 7 undiagnosed fever deaths in Anuradhapura hospital - suspected leptospirosis

Re: Sri Lanka: 7 undiagnosed fever deaths in Anuradhapura hospital - suspected leptospirosis

Antibiotic arrives this week
Nadira Gunatilleke

The Western Province has recorded the highest number of rat fever (Leptospirosis) cases. A total of 417 rat fever cases had been reported by February 25, a Health Ministry spokesman said.

According to the spokesman 230 rat fever cases were reported in January and another 187 cases in February. Colombo district recorded 42 rat fever cases. Ratnapura district 39 and Anuradhapura district 32 rat fever cases. Crystalline Penicillin, the antibiotic required to treat rat fever patients will reach the country this week.

...

http://www.dailynews.lk/2011/03/01/news25.asp

 

[Shiloh]

Re: Sri Lanka: Leptospirosis 2011

Re: Sri Lanka: Leptospirosis 2011

Source: http://www.nation.lk/2011/03/06/news7.htm

Rat fever kills 11

Outbreak spreads to non-endemic areas

By Carol Aloysius
Leptospirosis, commonly known as ?rat fever,? which erupted again after the heavy rains and floods, is now threatening to become an epidemic.
It has already claimed 11 lives in the first two months of this year. The highest number of deaths, 3, has been reported in Hambantota.
The number of reported cases has also zoomed, in the space of just one month, steadily mounting towards the 1,000 mark. The number of cases has also exceeded those reported in January and February 2010, which was 608.

The latest Epidemiology Unit figures reveal a frightening leap in the numbers of reported cases during the first two months of 2011. From 230 reported cases in January, the numbers almost trebled to 708 by February end. In 2010, 4,545 persons were affected by rat fever resulting in 122 deaths.
An unusual departure from the traditional districts affected by rat fever, to areas where previously there was a low incidence of the disease and in non-endemic areas, has also raised concerns among health authorities. Heads of all state hospitals and Regional Directors of Health have been asked to beef up their surveillance of potential victims in these areas, and initiate early detection to prevent complications leading to death.

In an urgent circular addressed to health officials of all provinces last month, Dr Paba Palihawadana, Chief Epidemiologist said, ?We have witnessed an outbreak of Leptospirosis in certain parts of Sri Lanka. Some of the increased reporting is from districts which traditionally had a low number of cases and non-endemic areas. The most affected areas are Kurunegala and Anuradhapura. All RDHS (Regional Directors of Health Services) are advised to consider control and prevention of Leptospirosis following the floods as a priority health issue.?
She has also requested them to establish a district level Leptospirosis Activity Coordinating Committees that include key stakeholders of public health and curative sector as well as other relevant sectors. Additionally, she has told them to ensure that adequate stocks of Doycycline are available for chemoprophlaxis (if necessary) and to discuss with clinicians in their respective hospitals to ensure that necessary drugs including antibiotics are also available for management of cases in the hospitals.
To increase community awareness on preventing the disease, the Ministry has begun distributing posters in Sinhala and Tamil.

Of the districts affected by Leptospirosis, Kurunegala leads the rest by far, with a total of 224 cases as of March 4, with no deaths. Most of the cases were in February when there were 208 cases compared to 16 in January. Other districts have less than a 100 cases, but the numbers could rise with the rains, authorities warned. Anuradhapura had 55 with two deaths, Colombo 50 (no deaths), Gampaha 49 (one death), Ratnapura 43 (no deaths) Trincomalee 30 (no deaths), Kegalle 29 (one death), Ampara 19 (no deaths), Hambantota 18 (three deaths), Kalmunai two cases and no deaths and Jaffna one case (no deaths).

Human Leptospirosis was first recorded in Sri Lanka in 1953 and has remained endemic in the country for over a decade, with an outbreak once every four-five years...

 

[Ronan Kelly]

Re: Sri Lanka: Leptospirosis 2011

Re: Sri Lanka: Leptospirosis 2011

Rat fever under control in A?pura
Disna Mudalige

Rat fever in Anuradhapura is under control, North Central Province Health Services Director Dr W Atapattu told the Daily News yesterday. He said that a well organized program has been implemented by medical officers to control rat fever in the area.

He said that about 98 cases of rat fever have been reported so far. Five people are suspected to have died from rat fever Dr Atapattu said adding that

...

http://www.dailynews.lk/2011/03/07/news50.asp

 

[Shiloh]

Re: Sri Lanka: Leptospirosis 2011

Re: Sri Lanka: Leptospirosis 2011

Source: http://print.dailymirror.lk/news/news/38248.html

snip:

"...Meanwhile, 1220 positive cases of Leptospirosis ( Rat Fever) had being reported for the past 70 days of this year and eleven of them died. Most number of deaths was reported from the Matara district. Three out of 32 patients died in Matara. The number of positive cases of Rat Fever reported from Polonnaruwa district was 27 and the number of deaths two. One death each was reported from Gampaha, Kandy, Matale, Hambantota, Batticaloa and Kegalle districts. The most number of patients was 562 reported from Kurunegala District, but no deaths were reported from the district."

 

[Shiloh]

Re: Sri Lanka: Leptospirosis 2011

Re: Sri Lanka: Leptospirosis 2011

Source: http://www.nation.lk/2011/03/27/newsfe7.htm

Leptispirosis (Rat Fever) running wild
By Carol Aloysius

At first, the numbers were relatively small, with 230 cases of Leptispirosis (Rat Fever) recorded officially by the Government Epidemiology Unit (GEU) at the end of January 2011. Then like a gathering storm, they doubled to 5,676 in February end and by March 22, tripled to 1883, leaving twenty dead.
The victims were mainly farmers (over 80 per cent) and mostly males (over 90 per cent).

While Rat Fever as it is better known, is an annual occurrence, still this year?s outbreak has raised concerns among health officials, whose main worry is that is it no longer adhering to its usual pattern of outbreaks in traditional areas, but instead infiltrating non endemic areas across the country...

 

[Ronan Kelly]

Re: Sri Lanka: Leptospirosis 2011

Re: Sri Lanka: Leptospirosis 2011

From April 3rd;

Rat fever spirals leaving 24 dead
By Carol Aloysius
Despite Health Ministry?s efforts to control the disease, Leptispirosis (Rat fever) continues on its runaway trend, as it mounts in districts which have traditionally had a low incidence of the disease, and spills into non-endemic districts.

Although very much worried, Health Ministry officials claim they have set up all the backup requisites for containing the deadly disease such as; district level activity coordinating committees that include key stakeholders of public health and curative services; ensuring adequate stocks of Doycyline for chemoprophylaxis; and increasing community awareness, there seems to be a few signs of the disease letting up.
Starting with just 231 in January this year, doubling to 572 the following month, and tripling to 1,491 cases by end March, the total number of cases now stands at 2,294 with 24 deaths, according to the latest data from the Epidemiology Unit, on April 1, the highest number being recorded in Hambantota (six).
While Kurunegala continues to be the worst affected area with 977 cases (two deaths), Gampaha has now overtaken Anuradhapura in numbers with the second highest number of cases (183 and two deaths). Anuradhapura has 163 cases (no deaths). Hambantota has the fourth highest cases (144) while the number of deaths recorded here are the highest (six).

...

http://www.nation.lk/2011/04/03/news17.htm

 

[Shiloh]

Re: Sri Lanka: Leptospirosis 2011

Re: Sri Lanka: Leptospirosis 2011

Source: http://www.colombopage.com/archive_11/Apr26_1303802114CH.php


Leading News from Sri Lanka::

* Sri Lanka's Health Ministry warns of a dengue and rat fever epidemics
Tue, Apr 26, 2011, 12:45 pm SL Time,
ColomboPage News Desk, Sri Lanka.

Apr 26, Colombo: Sri Lanka's Health Ministry has alerted the public of possible outbreaks of dengue and leptospirosis (rat fever) due to the prevailing rainy weather.

According to the Epidemiology Unit of the Health Ministry 31 deaths from leptospirosis have been recorded among 2,785 cases so far this year. The month of March has seen 1,576 and there have been 407 cases so far in April...

 

[Shiloh]

Re: Sri Lanka: Leptospirosis 2011

Re: Sri Lanka: Leptospirosis 2011

Source: http://www.dailynews.lk/2011/04/29/news50.asp

Over 2,840 rat fever cases in four months

Nadira GUNATILLEKE

The Health Ministry warns the public on the rapidly increasing numbers of Rat Fever (Leptospirosis) cases in the country. Around 2840 Rat Fever patients had been reported from all parts of the country while 31 patients (most of them farmers) had died from the disease during past four months, Health Ministry spokesman said...

...The highest number of deaths, seven had been reported from Hambantota district. Four deaths each reported from Matara and Kurunegala district respectively. Three deaths each reported from the Gampaha and Anuradhapura district respectively. The highest number of patients, 1039 had been reported from the Kurunegala district. The number of patients reported from the Gampaha district was 244. The number of patients reported from Hambantota was 212, he said.

March 2011 recorded the highest number, 1576 of rat fever patients. The prevailing rainy weather condition is the main reason behind this situation...

 

[Ronan Kelly]

Re: Sri Lanka: Leptospirosis 2011

Re: Sri Lanka: Leptospirosis 2011

Rat fever patients rise in Wayamba
Ariyapala Wansathilake, Kurunegala Central Special - Correspondent

One hundred and ninety nine patients with rat fever are receiving treatment in provincial hospitals in Wayamba. Sixty three patients have been reported from Gamgamuwa, Ehatuwewa, Saliyapura and Ambanpola areas, sources said.

A Provincial Health Ministry Spokesman said medical teams are on alert while volunteers visited those areas and warned the public if they have any wounds or cut injuries, to take immediate medical treatment.

http://www.dailynews.lk/2011/05/03/news60.asp

 

[Ronan Kelly]

Re: Sri Lanka: Leptospirosis 2011

Re: Sri Lanka: Leptospirosis 2011

DANGUE RAGES IN COLOMBO
By Carol Aloysius


...

Meanwhile Leptospirosis ( Rat Fever) too has surged to a new high hitting the 3,200 mark with 31 deaths, despite the figures declining last month (April) compared to March.
The cumulative number of cases reported on April 29 stood at 2969. The worst affected district is Kurunegala which had 1056 cases with four deaths. Gampaha comes 2nd with 251 cases and Hambantota which also had the highest number of deaths (7) comes 3rd with 227 cases.
A surprisingly high number of cases have also been reported from Colombo ? 137 with one death. Special Commissioner Kamil said that several householders in Colombo had complained of rats and bandicoots in their gardens. ?We have Public Health Departments in five CMC wards which cover the entire Colombo district. If anyone wants our help to get rid of rats or bandicoots we can help them with traps and cages?. he said.

http://www.nation.lk/2011/05/01/news17.htm

 

[Ronan Kelly]

Re: Sri Lanka: Leptospirosis 2011

Re: Sri Lanka: Leptospirosis 2011

Rat fever: Rubber boots for farmers Thursday, 12 May 2011 01:21
By Sandun A. Jayasekera

The Health Ministry will provide paddy farmers with gumboots (galoshes) free of charge to protect them from leptospirosis, a Ministry spokesman said.

Ministry spokesman W.M.D. Wanninayaka said rubber gumboots imported from Thailand have been distributed among farmers in the North Central Province in a pilot project. The team of officials of the Ministry is monitoring the reaction of the farmers to them.

?In Thailand, all paddy farmers wear boots and no leptospirosis has been reported among paddy farmers in that country. Studies by the Health Ministry Epidemiology Unit confirm that paddy farmers get infected with the leptospirosis virus when they stay long hours in muddy waters contaminated with the virus. The farmers are advised not to stay long hours in muddy waters,? Mr. Wanninayaka said.




...

http://print.dailymirror.lk/news/news/43719.html

 

[Ronan Kelly]

Re: Sri Lanka: Leptospirosis 2011

Re: Sri Lanka: Leptospirosis 2011

Rat fever claims 45
Thursday, 19 May 2011 09:00 News - General1


(Colombo Lankapuvath) Rat fever or leptospirosis has claimed the lives of over 45 persons and another 3335 contracted, the Epidemiology Unit of the Health Ministry said.

...

http://lankapuvath.lk/index.php/latest-news/general1/15125-rat-fever-claims-45