A Raincheck on Leptospirosis

Every monsoon, conversations revolve around waterlogging, potholes and delayed trains and buses. Yet, hidden beneath the murky floodwaters is another annual visitor that rarely receives the same attention: leptospirosis, a bacterial disease that quietly surges alongside rising water levels. Health authorities across several Indian cities have already urged residents to remain vigilant as prolonged flooding and poor sanitation create ideal conditions for leptospirosis to spread.

Unseen Passenger in floodwaters

“Leptospirosis spreads through water contaminated with urine from infected animals, especially rats,” says Dr Venkata Krishna Kumar Talluri, a Consultant Physician and Diabetologist at Renova Century Hospitals, Hyderabad. Heavy rainfall and waterlogging create the perfect breeding ground for the infection, turning seemingly harmless floodwaters into a silent conveyor of disease. As rainwater mixes with urine from infected animals, particularly rodents, the bacteria can enter the body through cuts and abrasions or even via the eyes, nose and mouth, making every careless step through stagnant water a potential health hazard. Dr Venkata Krishna says, “Leptospirosis often begins with the sudden onset of fever, severe body aches, particularly pain in the calf muscles — headache, red eyes, chills and vomiting.”

He notes that symptoms such as jaundice, reduced urine output, breathlessness, bleeding or confusion may signal severe disease and require urgent medical attention. Early diagnosis and prompt treatment are crucial in preventing life-threatening complications.

Dr Safaa Muneer Ahmed, Group Head, Clinical Microbiology and Hospital Infection Control, Renova Century Hospitals, Hyderabad says, “The biggest challenge is recognising the disease early. A history of wading through floodwater or working in contaminated environments is an important clue that should not be overlooked.”

Monsoon Maladies

But the monsoon doesn’t just bring relief from the heat; it also amplifies the risk of waterborne infections like leptospirosis. Rains swamp streets. Floodwaters can turn from a seasonal nuisance into a silent carrier of disease. Rainwater mingles with contaminated soil and the urine of infected animals, particularly rodents, creating the perfect breeding ground for Leptospira bacteria. The bacteria slip into the body through cuts and abrasions on the skin, or via the eyes, nose and mouth after contact with contaminated water. Dr Venkata says, “People exposed to floodwater, such as farmers, sanitation workers, sewage workers, rescue personnel and residents of flood-prone areas, are at a higher risk.”

Early Diagnosis Matters

In the race against leptospirosis, time is the strongest ally. Dr Safaa says that laboratory confirmation largely depends on the stage of the illness. During the first week, PCR is the preferred investigation as it can detect the Leptospira bacteria before the body’s immune response develops. After five to seven days, antibody-based tests such as IgM ELISA become more reliable. She emphasises that no single test remains accurate throughout the course of the disease, making it essential to interpret laboratory findings alongside the patient’s symptoms and history of exposure. She adds, “If left untreated, leptospirosis can progress rapidly, affecting the kidneys, liver, lungs and even the brain.”

Prevention Better than Cure

While the infection is treatable with timely antibiotics, avoiding exposure remains the most effective line of defence. Avoid walking through flood water whenever possible. Dispelling common myths surrounding the disease, Dr Venkata says that one of the biggest misconceptions is that leptospirosis is merely a seasonal viral fever, or that only visibly dirty water poses a risk. In reality, he explains, any flood water contaminated with the urine of infected animals can transmit the infection. However, if exposure is unavoidable, wear protective footwear, cover cuts and abrasions with waterproof dressings, and wash thoroughly with soap and clean water afterwards. Anyone who develops fever or flu-like symptoms after contact with flood water should seek medical attention without delay and inform their doctor about the exposure, as early intervention can make all the difference.

• Avoid walking or wading through floodwater and stagnant water.

• Wear waterproof boots and gloves if exposure is unavoidable.

• Cover cuts and wounds with waterproof dressings before stepping out.

• Wash thoroughly with soap and clean water after floodwater exposure.

• Drink safe, clean water and eat hygienically prepared food.

• Keep your surroundings clean to prevent rodent infestation.

• Wear protective gear while cleaning drains or handling waste.

• Seek immediate medical attention if a fever develops after floodwater exposure.

• Don’t ignore flu-like symptoms, especially during the monsoon.