This page aims to highlight the effects of this water-borne (Leptospirosis) disease which is responsible for the most deaths resulting from flood water. We hope that it comes under control soon and does not spiral into an epidemic, given the ease with which it could be contracted and how readily it shuts down the human system once one is infected. So far in Guyana the disease has been said to have been brought on due to the presence of (infected) animal urine or excrement in the water, with which humans come into contact via broken skin (cut, cruise etc.), ingestion of this contaminated water or use of contamined food. A number of the cases which have resulted in death thus far have occurred as a result of individuals having cuts or bruises acquired as they moved about in the water. It is obvious from reading the reports, that many people did not respond to their symptoms because they believed themselves to be affected by influenza (flu), which means that the ministry of health failed to provide early and adequate warning (see editorial extract below). As o February 9, 2005, 16 people have died of Leptospirosis.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FOR MORE INFOMATION, SEE THE LEPTOSPIROSIS INFORMATION CENTER

PLEASE SEE THE FOLLOWING PAGE FOR IMAGES OF FLOOD VICTIMS

 

 

First female case of 'Lepto' death suspected
SN: February 10; A mother of five succumbed on Tuesday night to symptoms of leptospirosis just four days after being admitted to the public hospital. Jesmin Ramkissoon, 58, of Better Hope South, East Coast Demerara would be the first woman to have died from the disease which has already been linked to the deaths of seventeen men. Relatives thought her death unlikely as her recovery seemed guaranteed during their recent visits to the hospital where the woman was receiving treatment for the bacterial disease. Leptospirosis can be contracted by contact with water contaminated by bacteria from animal waste. Patients sometimes appear to be recovering but then relapse into the more serious form of the illness.

Dilip Ramkissoon believes that his wife contracted the disease one week ago when she injured her right leg while wading in floodwater that overwhelmed the low-lying area up to the start of last week. But he and other relatives feel that had they known earlier about the disease and its causes her life might have been saved. This statement has been echoed by the relatives of others who have died. Nearly everyone in the village was talking about the woman's death while a small black flag was flying at her home. Dilip Ramkissoon said last Tuesday in the midst of the flood his wife ventured out to check a report that they had received about water seeping into the family's minibus parked a corner away.

At the time the water in the low-lying section of the village stood between three to four feet. But while she was wading through the murky water she fell into a hole in which she punctured her right shin. Little was thought of it but in the two days that followed the woman developed a fever accompanied by vomiting and diarrhoea. "She said she could walk and she never get back up since then," Dolly Jainarine, her sister, said yesterday, adding that the woman was unable to sleep at night and would scream because of the pain. The family took her to the Georgetown Hospital early the next morning but the hospital staff were slow to react with scores of others with similar complaints also waiting for treatment, she explained, saying that while they took her about 8 am she was only admitted as a patient about 6 pm. She added that they never expected her sister to die as she seemed to improve after she was admitted. "Last night when we went to look in on her she was talking good, laughing and everything. We didn't expect her to die like that," Jainarine said yesterday. But they wished they had known more about the disease then they might have been able to get treatment earlier. "We never know that the virus could havepenetrated the puncture," Dilip Ramkissoon reflected. The family is awaiting a conclusive diagnosis from the post-mortem before burying her.

'Lepto' blamed in death of Wortmanville man
By Iana Seales
SN Wednesday, February 9th 2005
Emotions are high in one Wortmanville household following the death of Patrick Hollingsworth at the public hospital yesterday, most likely of the bacterial disease leptospirosis. The father of three was admitted to the hospital on Monday and died within 24 hours. Hollingsworth, who had kidney failure, was seen by doctors on two separate occasions before his admission to the public hospital but was given the assurance that everything was going to be okay.

Hollingsworth is one of sixteen persons to have died from the deadly disease which is transmitted when a person comes into contact with water contaminated with the droppings of infected animals. Thrown into shock at her husband's passing, wife Michelle Hollingsworth told Stabroek News she accompanied Patrick to the hospital on Sunday night and he was seen by a doctor. The doctor later cleared him of being in any serious danger and sent him home. But that night things took a turn for the worse and they alerted a practising doctor in the area. She said as soon as the doctor saw her husband, he arranged for Patrick to be taken back to hospital, but this time to be admitted. She said her husband visited a city laboratory last Friday and underwent a series of tests but nothing came back positive. At that time, she said Patrick had not eaten a proper meal in days, had trouble excreting and was not urinating. But after he was cleared by the lab, she said they returned home and held out hope that things were going to be fine. However, his condition got worse on Sunday so he visited the doctor. The woman said she had fears about the disease, leptospirosis when her husband fell ill but he was unable to take the doxycycline tablets like the rest of the family did. She said Patrick could not eat a proper meal so he decided against the prophylactic treatment given the fact that a meal should be eaten before taking the drug. Then he started showing symptoms of renal failure which went on for a few days before he visited the lab.
Relating what happened to her husband before he fell sick, the wife said Patrick went into the floodwaters when Bel Air was deluged and had a minor accident. She said a dog pen fell on her husband's hand and left him with a wound. After the accident, she said Patrick visited the hospital daily for the wound to be dressed. During this time he fell ill but no one suspected he was experiencing early symptoms of leptospirosis. She said he continued working during the heavy rainfall and brushed aside the cold and flu he came down with. On Monday night, Michelle recalls she visited her husband at the hospital and found him sweating more than usual. He also had trouble breathing and was taking saline. His condition was cause for alarm, the woman said, but there was nothing she could have done but hope for the best. However, when she returned to the hospital yesterday morning she was informed that Patrick had passed away during the night. Patrick was an ex-solider, who later joined the block-building business with his wife. Another relative of the dead man turned up at the home while Stabroek News was there and voiced his anger over the passing. He said the government erred by not putting the public on alert for these diseases that people are now being told about. According to him, the Ministry of Health had a duty to let people know what was going on.

Kaieteur News journalist succumbs to leptospirosis
Kaieteur News journalist Joseph `Lil Joe' Thomas succumbed to the killer disease leptospirosis at around 23:00hrs last night in the Georgetown Hospital's Intensive Care Unit (ICU). Thomas, 31, had been hospitalised since Thursday, but was only placed in the ICU on Sunday evening after he took a turn for the worse. His mother, other close relatives, as well as Kaieteur News General Manager Glenn Lall and other staffers were present at the hospital during his last hours. Thomas's wife, Telitta, said her husband first showed symptoms of illness two Fridays ago when he complained of having a headache.

However, at the time, her husband assumed that he had contracted malaria from a recent trip to the interior. Mrs. Thomas said she tried to contact staffers from the Georgetown Hospital Malaria Clinic by phone. However, she was unsuccessful since the phones did not appear to be working. On the following day, Joseph developed a fever and she gave him a dose of Tylenol. The fever was gone by Sunday, but on Monday, the fever returned, along with diarrhea and vomiting. Mrs Thomas said she suggested to her husband that he should see a doctor, but he declined. She said by this time, she had learned about the potentially fatal disease, leptosporisis. She recalled that Joseph had travelled to the flooded East Coast of Demerara two Sundays ago on assignment. “He told me that he got a splash of water (on him) and he didn't like how it smelt,” she said. “I told him to get a check-up, but he said that he was okay.” Durban Backlands where Joseph lived, was also flooded during the initial period of heavy rainfall.

Mrs. Thomas said she contacted a pharmacy and was given medication to treat her husband's symptoms. He took the medication and the symptoms stopped. “On Tuesday his condition seemed to improve, but he was not eating as he used to. He thought that he had gas.” By Wednesday, Joseph seemed to have recovered to the extent that he told his wife that he would call his workplace and inform his editor that he was ready to resume work next day. Joseph told the editor he believed that he was suffering from dehydration. Thomas' wife said that on Thursday evening, while watching a local television newscast, she realized that her husband may have contracted leptosporisis. According to Mrs. Thomas, Joseph finally agreed to be tested for the disease. She accompanied her husband to the Georgetown Hospital, where medical staffers at the Accident and Emergency Unit reportedly informed her that Thomas had jaundice. He was given a saline solution and admitted to a ward. Joseph did not appear to be very ill when his relatives visited him next day. “He was getting up and going to the bathroom: But he needed some help because of the needle (for the IV drip) in his arm.” But by Sunday, he had taken a turn for the worse, Mrs. Thomas said. “He did not look like the Joseph we had seen on Saturday night. Sunday is when he started looking really bad.” Doctors were forced to transfer him to the Intensive Care Unit.

His mother, Linda Thomas, recalled that her son's breathing became laborous. Soon, he was unable to communicate with relatives. Kaieteur News Publisher, Glenn Lall said that on Sunday, he contacted hospital officials and doctors to see if Thomas could be taken overseas for better treatment. “I wanted to fly him to Trinidad for treatment, but the hospital administration and doctors advised me that nothing could be done for him, because of the state in which he was.” Thomas's condition worsened yesterday evening ,and he eventually passed away after slipping into a coma. Joseph Thomas first worked as a reporter at the then Guyana Broadcasting Corporation around 1992, covering the City Council and crime beats. He became employed at Kaieteur News late last year. Thomas was also a popular, but controversial calypsonian. Known as ‘Lil Joe,' Joseph Thomas won the calypso monarchy some years ago with the hit song ‘Pagalee Man.'

Plaisance Village Council Chairman dies of suspected Leptospirosis

KN: The Plaisance Village Council Chairman, Thomas Sandiford became one of the latest victims of the suspected killer Leptospirosis on Monday evening at the Georgetown Public Hospital Corporation (GPHC). Sandiford, who was also a former Sports Organiser for the National Sports Commission, was 74 years old and resided at West Road , Plaisance. His widow Mrs Julia Sandiford said she was told that her now-deceased husband, some two Sundays ago, fell face-down in the flood waters in his yard. “My husband fell in the water on Sunday, but he didn't take it as anything serious. However, on Monday evening (the following day), he said he wasn't feeling good.” Mrs Sandiford said her husband felt he was suffering from gas. Mrs Sandiford added that it was not until January 26 that her husband started to vomit, and he visited a private doctor who directed him to the hospital. Once at the GPHC, his wife said they started to give him saline and pumped water out of this body. Her granddaughter Cherry Ann Sandiford said that a quantity of black fluid was drained from his body on the said day.

He returned home the evening and continued to vomit and then suffered from diarrhea. “When we call the doctor, he said that diarrhea was a normal thing and there was nothing wrong, but then we carried him back to the hospital on Thursday and they had admitted him,” Mrs Sandiford said. She said he spent one week in the hospital and was discharged on Thursday last, but his condition did not improve. Mrs Sandiford further added that from the time of his discharge, he became weaker and she mentioned that she told him of the Leptospirosis she was hearing about. “Monday about 4 pm I told him that he wasn't looking too good and we should carry him to the hospital, but he said he will go and see his doctor today (Tuesday): but we had to rush him back to the hospital Monday night,” she said. She said that Mr Sandiford, who was the recipient of the Golden Arrowhead of Achievement award, was rushed to the hospital sometime between 22:00-23:00hrs, but succumbed there. “I would say that he died like about five minutes after he got there. I was told that the doctor checked his pulse and then shook his head.” His granddaughter added, “They said that his eyes looked lemon as if he had jaundice.”

Likely dengue cases surface and 'Lepto' rising
By Iana Seales
Wednesday, February 9th 2005
SN: Minister of Health, Dr. Leslie Ramsammy says the country now has three suspected cases of dengue while the number of leptospirosis deaths has jumped from 12 to 16 within a 24-hour period. Dengue is a flu-like viral disease spread by the bite of infected mosquitoes that usually starts suddenly with a high fever, rash, severe headaches and muscle and joint pain. This is one of the flood-related diseases that had been predicted.

Ramsammy said too that 20,000 mosquito nets are already being distributed at clinics across the country. He said not everyone can show up and expect to receive a bed net since they are only being handed out to mothers who are registered in the antenatal care programme. The bed nets were being distributed as a preventive measure to combat the spread of dengue. Speaking at a press conference yesterday, Ramsammy said there are now 25 flood-related deaths, 16 of which are linked to leptospirosis. He said another 80 persons are hospitalised, possibly with the deadly disease. The majority of these persons are being monitored at the public hospital. At least three persons are admitted every day at the institution with symptoms of the disease.

According to the health minister, women make up seventeen per cent of the leptospirosis cases being tracked at the Georgetown Public Hospital Corporation, but no woman has died of the disease to date. He said no child is being monitored for leptospirosis at the hospital or elsewhere nor has any child died from the disease. Even though there has been at least one recorded death of leptospirosis in the country daily, Minister Ramsammy said it is not an epidemic and there is no need to evacuate persons from their East Coast homes. "Should there be an increasing incidence of leptospirosis a recommendation will be made for evacuation. But at this present time, I am in no position to advise the President on forced evacuation."

Dr. Bernadette Theodore Gandi, PAHO representative to Guyana, endorsed Ramsammy's statement at the press conference. Dr. Gandi said a person's wellness needs to be taken into consideration before moving them from their homes. In addition, she said people's rights need to be respected if they have a desire to stay and secure their property. According to her, the situation on the East Coast after three weeks is stable which makes it unlikely that there may be a forced evacuation. However, she noted that a massive change in disease patterns would result in the decision of evacuation being revisited.

Responding to questions as to whether PAHO/WHO has any protocol/guidelines for persons living in floodwaters in excess of three weeks, Dr Gandi said they would usually recommend early disease surveillance, which the health minister had in place from the onset, as well as place a focus on early detection and management of diseases. She said there are usually incubation periods when health officials would look for a particular disease and that process is ongoing throughout.

Out of the 81 specimens that were sent to the Caribbean Epidemiology Centre (CAREC) in Trinidad for testing 16 cases have been confirmed as leptospirosis. Ramsammy said the other specimens that came back negative were not tested for any other disease but will be further analysed when the specimens are sent to the US Centers for Disease Control (CDC), Atlanta. Seven of the specimens sent overseas were taken from a group of persons who were among the first reported cases of leptospirosis.

According to Ramsammy, his ministry has a separate mortality surveillance team that is tracking all deaths linked to the disease, as well as others that may have occurred before word got out. He said another team is conducting community surveys to find out whether people may have died at home from the disease. He said this is to get a comprehensive picture of what is really happening in the country.

Putting to rest rumours that a student of the Bygeval Secondary school had died from leptospirosis, Ramsammy said no student of the school has been listed as critical. He said two students were admitted to the hospital, while another who was treated returned yesterday and was admitted. He said the students are being monitored closely. So far, the doxycycline drug has been handed out to 250,000 persons and the numbers may be around 300,000 taking into consideration that people purchased or received the drug at private clinics and pharmacies. This is according to Ramsammy who said the dose would be repeated for many persons starting Friday. He said there are enough drugs in the country to repeat the dose, adding that more supplies are expected soon.

Meanwhile, people continue to crowd the public hospital seeking medical attention. The hospital was forced to set up two additional desks at the Accident and Emergency unit to ease the build-up. People turned out in such record numbers that many of them had to be diverted to the outpatient clinic at the hospital. ...Several patients expressed dissatisfaction with the health effort in light of the leptospirosis deaths. Others said the hospital lacks the capacity to deal with such a large influx of patients.

Dengue Fever

Description: Dengue fever and dengue hemorrhagic fever (DHF) are viral diseases transmitted by Aedes mosquitoes, usually Ae. aegypti. The four dengue viruses (DEN-1 through DEN-4) are immunologically related, but do not provide cross-protective immunity against each other.
Occurrence: Dengue, a rapidly expanding disease in most tropical and subtropical areas of the world, has become the most important arboviral disease of humans. More than 2.5 billion persons now live in areas at risk of infection, and an estimated 50 million-100 million cases of dengue fever occur each year, 200,000-500,000 of which are DHF. The case-fatality rate for DHF averages 5%.
Prevention: No vaccine is available. Persons should be advised that they can reduce their risk of acquiring dengue by remaining in well-screened areas when possible, wearing clothing that adequately covers the arms and legs, and applying insect repellent to both skin and clothing. The most effective repellents are those containing N,N-diethylmetatoluamide (DEET).

Eleven deaths maybe linked to leptospirosis- Minister Ramsammy says evacuation risky
Sunday, February 6th 2005

SN: Health officials have linked 11 deaths to leptospirosis, while eight others are also connected to the flooding situation. Four of these deaths are by drowning, three are from gastroenteritis and one is associated with haemoptysis (spitting of blood while coughing), Minister of Health Dr Leslie Ramsammy said yesterday. Meanwhile, another person succumbed to leptospirosis at the Georgetown Public Hospital Corporation (GPHC) yesterday. At present, more than 35 cases of leptospirosis are being monitored at the public hospital.

The Guyana Medical Association called on Friday for persons to vacate the East Coast, which is still inundated. But Ramsammy said such a decision would have to be weighed before it is taken, and people would have to be willing to leave. In the event that relocation remains the only option, he said, it would be a forced evacuation spearheaded by government. The GMA said much of the water is unlikely to dissipate in the near future and the health risks will progressively increase. It added that the number of confirmed and presumed leptospirosis cases, along with the deaths, is an indication of the degree of contamination and the risks to persons in these areas.

But there would be great risks either way, the minister said yesterday, because evacuation would mean thousands of people housed together in one place where diseases could easily be transmitted. Acknowledging that the water on the East Coast has become dangerous, Ramsammy said he can only ask the people to defend themselves and have less contact with the water at this time. However, should there be an outbreak of leptospirosis, he said, a formal recommendation will be made to government for a massive evacuation to take place. As it stands, he said, the decision to evacuate at this stage does not lie with him but with a higher authority instead. He said voluntary evacuation had been an option from day one, but many people rejected it, so the ministry's focus right now is to reduce the risk by putting people on a prophylactic and asking them to stay inside as they wait for the waters to recede.

"We told people about voluntary evacuation when the water was neck high in several areas, but no one wanted to leave. The suggestion of moving them is not relatively new because it came up and no one showed interest. Now that people can potentially spread diseases, we have to decide whether it is wise to put them all together. But the critical question would be to put them where?" However, observers have noted that hundreds of people have been housed in shelters for weeks, where the threat of disease has existed for some time now. The case of one shelter was cited where flood evacuees were forced to dispose of excreta in a water tank. And it was also noted that stagnant water still surrounds several shelter compounds.

Ramsammy said the old New Amsterdam hospital, which can comfortably house 800 people was prepared as a possible place to relocate some people, and even though no one took up the offer it remains an option. The minister reiterated that he is aware that the floodwater is not safe, and this is why he is pleading with people to take the necessary care and have minimal or no contact with the water if possible. According to him, it is good that medical professionals are making recommendations since what they say will weigh in the decisions that are ultimately made. Earlier, President Bharrat Jagdeo had said that any evacuation decision would hinge on advice from medical experts. But some medical sources have said the prophylactic treatment the ministry is offering can be of little effect, given the fact that people are returning to the waters. From a clinical perspective, they say this cannot be the final answer to the problem in the light of the danger other water-borne diseases pose.

Persons are still rushing to get their hands on the antibiotic doxycycline, which is being used to combat the possibility of a large-scale outbreak of leptospirosis. The Ministry of Health issued an advisory yesterday, urging members of the public not to purchase the drug from pharmacies for more than $10 per tablet. The ministry said the drug is being distributed free at health centres, mobile clinics or the Georgetown Public Hospital. The tablets are being retailed at some pharmacies at $25 each.

People are also being asked to pay close attention to the instructions before using the pills. Pregnant women, lactating mothers and children under eight years of age are not allowed to take doxycycline; anyone falling in these categories is to visit the hospital for treatment. With regard to the number of people turning up at the public hospital seeking immediate attention, Ramsammy said he was pleased that people are heeding advice and visiting the doctor, but he is not satisfied with the behaviour of some. He said that people should exercise patience and also understand that the hospital will not turn away any person, which means everyone will be attended to. According to him, the public hospital has the situation under control and it is likely to remain that way.

No evidence of widespread leptospirosis -Health Minister
Fifteen cases being tracked
By Iana Seales
Thursday, February 3rd 2005
SN: Health Minister Dr Leslie Ramsammy last night said there was no evidence of a widespread outbreak of the possibly fatal disease leptospirosis (see sidebar on this page) but 15 cases are being tracked and medical sources told Stabroek News that five persons may have already died from the infection and 40 infected. Following widespread speculation all day yesterday about the disease hitting the badly affected East Coast communities, Ramsammy said that there are a "few" suspect cases being attended to and as a precaution they are being treated for leptospirosis. The ministry also pointed out that the symptoms of the disease are also consistent with other afflictions.
Rammsammy later told Stabroek News that 15 cases are being tracked and that samples are being sent to the Caribbean Epidemiology Centre (CAREC) lab in Barbados and to the US Centers for Disease Control headquarters in Atlanta. The results, he said, would be returned in a week.
Yesterday afternoon the Georgetown Public Hospital began dispensing treatment for the disease to all persons who have been in contact with floodwaters. The drugs are being handed out from a guard hut in the compound. The treatment is effective for one week and would be repeated if necessary. According to Ramsammy a strategy was thought out and being implemented to tackle illnesses associated with floods.
In an earlier press release yesterday, the Ministry said "leptospirosis was one of the serious conditions we had anticipated. We had maintained from the first day a high suspicion index for (it) … It is for this reason that a prophylactic treatment programme was included as part of the package of services we would provide to the population of the affected area".

Ramsammy's statement last evening said medical teams are in all of the flood-hit areas dispensing the medication a prophylactic. However, some observers have questioned why the ministry had not issued a public warning much earlier about leptospirosis, its symptoms and treatment. The first warning about the disease was sounded last week in Georgetown by CAREC's Director Dr James Hospedales at a press conference. Observers also say the risk of widespread infections from this bacteria is one reason why flooded communities should have been moved to safer areas instead of having to continue living in infected waters. Other sources point out that the facilities may still not exist to handle a mass evacuation from the East Coast.

Heath surveillance teams, which have been tracking leptospirosis and a number of other clinical conditions and diseases that are associated with flood conditions, were up to yesterday still collecting data, finding out facts and setting up responses. But, the Ministry of Health is monitoring all patients admitted to hospitals from flooded areas to determine the exact cause of their ailments. In addition, they are following up on all mortalities from flooded areas to determine the cause of death. So far, three persons have died at the Georgetown Public Hospital Corporation (GPHC) and two more succumbed at private hospitals; all suspected cases of leptospirosis.
Among the victims is a young child, who reportedly died yesterday morning...