Puerto Rico has reported at least 76 cases of suspected and confirmed leptospirosis, including a handful of deaths, in the month after Hurricane Maria, said Dr. Carmen Deseda, the state epidemiologist for Puerto Rico.
Two deaths involved leptospirosis confirmed through laboratory testing, and “several other” deaths are pending test results, Deseda said. The 76 cases, up from 74 last week, also include one patient with confirmed leptospirosis who is currently hospitalized.
Spiral-shaped Leptospira bacteria, which are found in the urine of rodents and other animals, tend to spread after floods through drinking water or infection of open wounds, according to the World Health Organization. In serious cases, infection causes organ failure and can be fatal.
“This bacteria, like any other bacteria, can kill you,” Deseda said.
The island typically sees between 63 and 95 cases per year, she said. Health officials had expected that there would be a jump after the hurricane.
“It’s neither an epidemic nor a confirmed outbreak,” Public Affairs Secretary Ramon Rosario Cortes said at a news conference Sunday. “But obviously, we are making all the announcements as though it were a health emergency.”
Leptospirosis may be treated with antibiotics, but many people recover on their own.
“The majority of the lepto cases is a mild, subclinical disease with no complications,” Deseda said. “But one out of 10 people who have leptospirosis develop severe illness.”
In the first stage of leptospirosis, symptoms vary widely from fever and headache to red eyes and rashes. Some people may have no symptoms at all. But a small number will develop dire complications: meningitis, kidney and liver damage, bleeding in the lungs and even death.
Doctors are required to report any potential leptospirosis cases to health authorities, Deseda said. Those cases must then be tested to confirm the bacteria, since the symptoms can be difficult to tell apart from other illnesses. After that, health officials may look for patterns or clusters and determine whether there is an outbreak.
The lab tests on the suspected cases have been sent to the US Centers for Disease Control and Prevention, Deseda said. The turnaround time is about five or six days.
Doctors on the island have expressed concerns about burgeoning health crises amid hospitals that are overwhelmed, undersupplied and sometimes burning hot. Influenza is another concern on the horizon, Deseda said. Drinking water is also hard to come by on many parts of the island.
Dr. Raul Hernandez, an internist in San Juan, told CNN that people were drinking water from whatever sources they could find, such as rivers and creeks. If that water contains urine from an infected rat, those people will be at risk, he said.
Deseda said people should be discouraged from walking barefoot, drinking or swimming in potentially contaminated waters.
“These diseases are everywhere, and there’s a way to prevent them,” she said.