Leptospirosis

I received the following news from my friend, Dr. Nap Santos, of Las Vegas:

“On Sunday, at a picnic, a family drank soft drinks directly from cans. Days later, two family members were admitted to the ICU. One died. Autopsy showed this was Leptospirosis.”

What is Leptospirosis?

Leptospirosis is a bacterial disease that affects both humans and animals. The cause is a bacterium, the genus Leptospira, which could come from infected animals like rodents, pigs, horses, dogs, livestock, and wildlife. One popular source is from drinking directly from beverage cans, which have been contaminated with the urine or any body fluids of infected mice in warehouses. The bacteria could be on any surface, like top of beverage cans (soft drinks, tea, coffee, beer, etc.) or any canned foods.

How long can the bacteria survive?

Under the right condition, especially in moist or wet areas, the leptospira bacteria can survive up to 180 days. Without water, they die. Dryness kills them.

What are the symptoms?

            The symptoms may not be present at all. Usually it starts between 5 -14 days, and may even start 30 days after exposure. The symptoms could occur abruptly and include fever, chills, muscles aches, red eyes, skin rash, cough, headaches, abdominal pains, vomiting, diarrhea, jaundice (yellow skin). The incubation period (time duration between exposure to actual disease) is two days to 4 weeks.

Who are at risk?

            People who work outdoors (farmers, miners, campers, kayakers, hunters, soldiers, sewer workers, veterinarians, etc.), those who drink beverage directly from unwashed cans, drinking water from unsafe sources (floods, stream, rivers, especially with heavy rains and flooding), or eating food contaminated with urine of rodents, wading or bathing in flood water, or contaminated fresh water, and working with contaminated soil or objects, especially without gloves, increase the risk of getting leptospirosis. Children getting this infection is increasing. Knowledge and awareness of this disease entity and hygienic vigilance are the key to preventing this illness and many other forms of infectious diseases.

How does one avoid leptospirosis?

            To minimize catching the disease, one should be conscious about this condition and not touch or drink water that could possibly be contaminated. Bottled water in cups or glasses are safer. If needed, boil the water. The portable water filters on the market are not effective since they filter out chemicals but not bacteria, fungus, or viruses. Keep food covered or in a refrigerator or proper shelves. Do not wade in flood water or in body of water that could be contaminated by rodent urine or that of other animals. Preventing rodent infestation by proper garbage storage and disposal and getting rid of rodents are essential. Pets could also be contaminated by infected by rodent urine.

What is the treatment?

The potential complications of leptospirosis (second phase of the disease following the initial symptoms) include kidney and liver failure, meningitis, shortness of breath, bleeding, and death. When you think you are exposed to leptospirosis bacterium, with or without any of those symptoms above, consult your physician right away. The earlier the contamination or exposure is medically managed, the better the recovery is. If the diagnosis is confirmed, the physician may use antibiotics, like doxycycline, cephalosporins, ampicillin, or penicillin, oral or intravenous, according to the severity of the illness.

Leptospirosis is one potentially deadly disease we can avoid with awareness, consciousness, and vigilance.

Warning: Teething tablets/gel

The US-FDA warned that “homeopathic teething tablets and gels should not be used as they might put infants and children at risk for seizures and other adverse events, like trouble breathing, excessive sleepiness, skin flushing, constipation, muscle weakness, difficulty urinating. The products are sold at CVS, Hyland’s, and “possibly others,” the agency added. The adverse events have been known since 2010, 8 years ago. The Hyland Teething tablets were recalled then because of safety concerns. FDA said it never approved this homeopathic product. The use of herbal medications, especially in children, is of great concern. Many of these are crude and not tested for safety or efficacy, for side-effects and complications.

Non-smokers COPD

            Chronic Obstructive Pulmonary Disease, which chronic tobacco smokers inevitably acquire after years of exposure (firsthand or secondhand) to the countless toxic agents in cigarettes, could also result from other causes, like environmental chemical pollution, and rarely, from a genetic disorder called alpha-1 antitrypsin deficiency, a hereditary condition. Unbeknownst to many, COPD could also be caused by GERD (Gastro-Esophageal Reflux Disease), where the valve between the stomach and the esophagus (foodpipe) is incompetent (loose), allowing stomach hydrochloric acid (which normally helps in food digestion) to backup to the esophagus and higher up. The acid could also flow into the windpipe, frequently causing small coughs, and over the years, leading to inflammation in the respiratory track, leading to COPD, with lung congestion, bronchial spasm, some shortness of breath and wheezing, similar to asthmatic attacks. For this, metered dose inhalers (MDI) with bronchodilators, some with steroids, is part of the treatment, besides the use of Proton Pump Inhibitor (PPI) to reduce acid formation, abstention from spicy foods/alcohol, and sleeping with the head of the bed elevated.

Oral cardiac health link

There is an intimate relationship between oral health and cardiac health. Any infection in the mouth, dental/oral, causes bacterial invasion and inflammatory processes that increase the risk for the development of heart attack adn stroke. In the USA, greater than 80 percent of Americans have undiagnosed periodontal or gum disease. This is the reason why it is vital to have maximal oral health by maintaining good oral hygiene and having dental checkup at least two times a year. As we have alluded to in this column in past articles, inflammation in oral cavity or any part of the body, evidenced by elevated C-reactive protein, is the cause of most major illnesses known to man.

Genetics, genomics, mapping

The new frontier in screening tests for cancer are in the area of genetics and genomics. On such test searches for BRCA1 and BRCA2 genes, which predispose women to develop breasts and ovarian cancers, like in the case of renowned actress Angelina Jolie, who had her breasts and ovaries surgically removed as a prophylactic measure. Today, there is also a home test that detects changes in feces that identify colon cancer. Another great advance in cancer care is the mapping of the genetic blueprints of 33 cancer types. This would identify their treatment vulnerabilities.

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