Kerala has seen an alarming rise in leptospirosis deaths in the past two years, making it the leading infectious disease in terms of mortality.

Key Highlight of Leptospirosis Spread

• In 2024, Kerala reported 5,999 cases and 386 deaths, a 36.8% increase from 2023.
• In just the first two months of 2025, there were 567 cases and 37 deaths.
• The disease primarily affects farmers, agricultural laborers, and people exposed to contaminated water/soil but is now being reported among urban residents as well.

About Leptospirosis

• Leptospirosis is a zoonotic bacterial infection caused by Leptospira interrogans.
• It commonly occurs  in tropical regions with heavy rainfall.
• It is also  known as “rat fever” due to its transmission through rodent urine.

How is it Spread?

• Infected rodents, cattle, pigs, and dogs shed bacteria in their urine.
• The bacteria survive in contaminated water and soil for weeks to months.
• Humans get infected through skin cuts, abrasions, or prolonged contact with waterlogged areas.
• It does not spread from  person-to-person, except in rare cases.

Symptoms of Leptospirosis

• Incubation period: 2-30 days.
• Phase 1 (Mild Symptoms): Fever, chills, headache, muscle aches, vomiting, and diarrhea.
• Phase 2 (Severe Cases, 5-10%):
• • Kidney or liver failure
  • Meningitis (brain inflammation)
  • Severe respiratory issues, multi-organ failure

Challenges in Kerala’s Leptospirosis Management

• Over-Reliance on Doxycycline: Doxycycline is widely used for prevention, but poor compliance and limited impact on mortality raise concerns.
• Challenges in Diagnosis: Symptoms resemble other tropical diseases, and co-infections with dengue (8% cases) complicate early detection.
• Delayed Treatment and Critical Care Gaps: Late diagnosis, self-medication, and ICU shortages contribute to high mortality.
• Possible Misdiagnosis: Similar symptoms and past suspected cases highlight the need for targeted hantavirus testing.

Preventive Measures and Future Strategies

Strengthening Public Health Efforts

• Improve awareness campaigns to educate high-risk groups.
• Encourage early medical consultation for fever with muscle pain.
• Better risk communication to ensure proper use of prophylactic measures.

Multi-Sectoral Approach for Prevention

• One Health Framework: Collaboration between clinicians, veterinarians, microbiologists, and environmental experts.
• Environmental surveillance for contaminated water sources.
• Improved diagnosis protocols for leptospirosis and potential hantavirus infections.

By expanding diagnostic capabilities, improving critical care, and adopting an integrated disease prevention approach, Kerala can effectively tackle the rising threat of leptospirosis.