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Straight, No Chaser In The News: New Public Health Consequences & Lessons from Puerto Rico – Leptospirosis

By Jeffrey Sterling, MD August 20, 2019

This is a post on a public health matter, not a political one. Please appreciate the difference. Three weeks after Hurricaine Maria rendered the nearly 3.5 million US citizens living in Puerto Rico without normal living conditions, there has been a sudden uptick – a tripling, actually – in the death count. Oddly, the major cause of this surge is not from the over 100 individuals who still remain unaccounted for after all this time. This situation is an illustration of the fundamental roles of government in a society and the consequences that occur when those roles are abdicated or aren’t performed competently.
You may not know that for most of recorded history, diarrhea and dehydration was the world’s number one cause of death. As a public health consideration, the ability to purify water has saved more lives than any other initiative, including antibiotics, immunizations and medical procedures. The situation in Puerto Rico is a stark reminder of what it looks like when citizens don’t have access to clean water; in up to a third of the Puerto Rican population, there still is no access to water, prompting them to drink from local streams and whatever other sources they can access.

The issue here is a disease called leptospirosis. Leptospirosis is a particularly nasty disease that is not uncommon in tropical locations and tends to show up after huge rainfalls. The disease is notable for being spread by drinking water contaminated by animal urine, especially rodents (rats) and even domestic pets that may have gotten into the native water. Symptoms sound like it’s a serious disease; they may include headache, vomiting, high fever, and jaundice (yellow pigmentation). The disease can include liver failure, kidney failure, bleeding from the lungs and infections of the brain. Death rates from this disease alone can reach thirty percent (30%). This is a horrible disease to have and a horrible way to die, even before considering that prevention – simply meaning access to fresh water – is the best cure.

Given that many deadly infectious diseases, including leptospirosis and a host of presumably upcoming mosquito-borne illnesses, can take several weeks to incubate and cause symptoms of a disease, one can assume things will get worse before they get better. In the meantime, there are at approximately 19,000 federal, civilian and military personnel assisting Puerto Rico. Can someone take the time to spread out some water, penicillin and doxycycline, which by the way only costs $1/day?
Feel free to ask your SMA expert consultant any questions you may have on this topic.
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