Kerala leptospirosis toll rises: 49 deaths in July, prevention stressed

Thiruvananthapuram: Leptospirosis has claimed 49 lives in Kerala in July alone, with 30 confirmed and 19 probable deaths, according to the State Health department's Integrated Disease Surveillance Programme. The daily death list shows five to six deaths due to the disease over the past two days.

So far in 2026, Kerala has reported 1,381 confirmed and 922 probable cases of leptospirosis. The total number of deaths stands at 115, including 52 probable deaths.

Health officials say manual and agricultural labourers, farmers, dairy workers and gardeners are the most affected, as their work brings them into regular contact with contaminated water or soil.

The State health system has long relied on doxycycline prophylaxis for high-risk groups, but compliance has been poor. A senior Health official said the rationale behind the strategy has not been effectively communicated to those with high occupational exposure.

Dr. R. Aravind, Head of Infectious Diseases at Government Medical College Hospital, Thiruvananthapuram, explained that while antibiotics have little direct effect on reducing overall mortality once the disease is severe, they play a crucial role as prophylaxis and early treatment. Starting antibiotics early can shorten the duration of fever, reduce symptom severity, and clear bacteria from the body.

He stressed that during the southwest monsoon, when leptospirosis surges, high-risk groups must comply with the Health department's directive to take doxycycline twice a week.

Leptospirosis symptoms range from mild, non-specific fever to severe outcomes like liver and kidney failure, pulmonary haemorrhage, meningitis and septic shock. In 5-10% of cases, the disease worsens significantly and the prognosis becomes unpredictable.

A clinical death audit conducted by the Health department for 2025 showed that 62% of deaths occurred in people aged 48 to 52, most of whom had co-morbidities such as diabetes or hypertension. However, deaths in younger age groups occurred within 4.5 to 5 days due to severe leptospirosis triggering a cytokine storm, leaving little time for medical intervention.

Health officials noted that many patients self-treat with analgesics during the initial days of fever, only coming to hospital when pulmonary involvement or multi-organ failure has already set in. Such patients require mechanical ventilation and dialysis.

Officials emphasise that prevention remains the best strategy. Protective gear such as gum boots and thick gloves should be provided to manual workers and farm labourers, as the bacteria enters the body through skin abrasions or minor cuts. Doxycycline has also been found effective even after exposure to the bacteria, if taken promptly.