As the monsoon clouds gather over India, hospitals brace for their annual influx of patients battling high fever and body aches. Hidden within this seasonal wave of "viral" illnesses is a more sinister threat: leptospirosis. This bacterial infection, transmitted from animals to humans, poses a significant public health risk, particularly during and after the rains.
What is Leptospirosis and How Does It Spread?
The disease is caused by the spiral-shaped bacterium Leptospira. The primary source of infection is water or mud contaminated with the urine of infected animals, especially rats. Infection occurs when this contaminated material comes into contact with breaks in the skin, or the mucous membranes of the eyes, nose, or mouth.
In the Indian context, common risk scenarios include walking barefoot through stagnant or floodwater, working in waterlogged paddy fields, or cleaning clogged drains and sewers. However, urban residents are equally at risk. Leaking sewage lines, rodent-infested building basements, and poorly drained streets after a heavy downpour can all become hotspots for the bacteria.
The Critical Early Signs You Must Not Ignore
The major challenge with leptospirosis is its deceptive onset. Early symptoms closely mimic a common viral fever, leading to dangerous delays in diagnosis and treatment. Medical experts highlight several early warning signs that are frequently overlooked.
Sudden High Fever with Severe Muscle Pain: The illness typically begins abruptly with high fever, chills, and intense muscle pain. A distinctive clue is severe pain localized in the calf muscles and the lower back. When this symptom complex follows recent exposure to potentially contaminated water or mud, leptospirosis must be considered.
Red Eyes Without Discharge (Conjunctival Suffusion): This is one of the most characteristic early signs. Both eyes become noticeably red and bloodshot, often with a watery appearance, but crucially, without the sticky discharge typical of common conjunctivitis. This subtle sign is easy to miss but, in a patient with fever and leg pain, it is a significant indicator.
Severe Headache and Overwhelming Fatigue: Patients often experience a debilitating headache and a level of exhaustion that seems disproportionate to the fever. These are commonly dismissed as part of a generic "viral fever" or flu. Gastrointestinal symptoms like nausea, vomiting, abdominal pain, and loose stools are also common early features, further muddying the diagnostic picture.
When to Seek Immediate Medical Help
If you develop a high fever with severe body pains (specifically in calves and back) along with red eyes, and you have had recent exposure to floodwater, paddy fields, sewage, gutters, or rodents, you must consult a doctor immediately. It is vital to explicitly mention your history of exposure to contaminated water or environments to your physician.
Simple blood tests can help confirm the diagnosis, and early administration of appropriate antibiotics is lifesaving. If left untreated, a small percentage of patients can progress to severe, life-threatening complications within days. These late-stage signs include jaundice (yellowing of eyes and skin), reduced urine output, confusion, and coughing up blood—indicating damage to the liver, kidneys, and other organs.
Dr. Muahmmed Niyas, Consultant in the Department of Infectious Diseases at KIMSHEALTH, Thiruvananthapuram, emphasizes the importance of awareness. During the Indian monsoon and post-flood season, not every fever is benign. Recognizing the triad of fever, calf pain, and red eyes after contact with dirty water can be the key to seeking timely care and preventing serious health complications from leptospirosis.
