Why You Should Think Twice About Swimming In The River


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Summer time, morning dip. While submerging your body in the lake/river and splashing water at your friends sounds pretty much like a good idea, promise me to do the same when you finish reading this article. This is not about the haunted river, not about water current swallowing lives, and definitely not about the crocodile encounter. This is about leptospirosis, a bacterial disease which affects humans and animals.



Leptospirosis is a disease that humans get from the animals. Yes, people do catch an infection from the animals from time to time but this is something different because the organisms (leptospires) are excreted in the animal’s urine and enter the host through any skin abrasion or through an intact mucous membrane. Exposure to food or water contaminated with the infected animal’s urine is particularly hazardous too.

How does it spread?


Rats and other rodents are the most common carriers of the bacteria but it can infect all kinds of wild and domestic animals including humans. The urine of these animals can contaminate soil and mud and can be spread rapidly to human populations through fresh water or flooding. Examples of animals that have a higher tendency to infect are rats, cats, dogs, cows, goats, pigs, horses etc.

 

So since when did swimming in the river become harmful?


The thing about leptospirosis is, once you are infected, the symptoms could vary from mild to severe to the need of ICU admission. The symptoms usually occur 2 days to 4 weeks from the time of exposure, and these include:

  1. High fever

  2. Headache

  3. Chills and shivering

  4. Muscle aches

  5. Respiratory disease (a cough without phlegm)

  6. Vomitting

  7. Lack of appetite

  8. Jaundice (yellow discoloration of skin and mucous membrane)

  9. Red eyes (conjunctival suffusion)

  10. Abdominal pain

  11. Diarrhea (with or without blood in stool)

  12. Rashes




In the severe phase, there will be liver and kidney failure, anemia, circulatory collapse, coma, and eventually death. Several deaths had been reported from the intensive care unit due to the severe phase of leptospirosis. Even with full supportive care, the mortality rate is around 10%, rising to 15-20% in the elderly.

 

Here’s a true story (case study) about Leptospirosis


 

There was once a group of friends having fun in the river, swimming and playing with water like confetti. And just like every other story, there was always a kid who would not join the rest of the group during the fun. He took off his shoes and sat alone by the river, pondering about life and promising himself he would never ever want to be like one of the misfits. That was one of the reasons he came with the group too. He soaked his legs into the cool water, letting the water caress his skin gently. A week later, he started having a fever and developed rashes all over his body. Among the group of friends who went for a swim, he was the only one having the symptoms. Everyone was curious about the ‘how when why’.

In fact, it has been found that the bacteria are most prevalent in a mushy/muddy area with stagnant surface water. This explains why the kid was the only one infected. Heavily irrigated pastures are also common sources of infection.

Once again, who is at risk?


Places with high rat populations are clearly the most dangerous area. Several activities are of higher risk for example:

  1. Swimming and scuba diving

  2. Kayaking and canoeing

  3. Sailing, windsurfing, fishing, skiing

  4. Caving

  5. Underground operations

  6. Working in a food premise of low hygiene



Well, any idea on how to manage this?


Early antibiotic therapy will limit the progress of the disease, but treatment should still be initiated whatever the stage of the infection. Intensive supportive care is needed for those patients who develop liver and kidney failure.

To minimize the chances of infection, the only truly effective way is to avoid contact with contaminated areas or animals, thus avoiding the exposure to the bacterium. Clearly, there are problems in preventing exposure in the high-risk activities. Being aware of the symptoms and seeking early treatment is the only way out. Unfortunately, there has not been any breakthrough in the development of the vaccine.

 



For those working in a high-risk area or with the animals, they ought to wear a pair of boots and rubber gloves to prevent direct contact in case there is a wound.

Swimming or not, spread this piece of information to people you care about, to increase the awareness. Because, why not?

References:

Centres for Disease Control and Prevention

PetMD

MyHEALTH


Angie Loh

by Angie Loh

A medical student with nothing but passion and a pen. Poems and novels never fail to make me feel alive. I'm inspired to make the world a better place and fill it with a little bit more love. But first, where's my coffee? View all articles by Angie Loh.




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