SURAT, Aug 25: Rats were hounded out when plague in Surat set off an international scare in 1994, now they are again on the run in South Gujarat with the spread of leptospirosis.

But unlike plague, leptospirosis does not harm rats; they shed leptospirae in their urine. Monsoon brings in its wake the annual scourge in the rat infested sugarcane fields though rats are not the only carriers of the disease. August and September see the worst of the leptospirosis cases and during this season 20 persons have already perished while scores are under treatment.

The victims are mostly sugarcane labourers, who are afflicted when the microbes enter their body through wounds or cuts. The leptospirae was relatively innocuous; it has got a virulent strain now. It has started affecting central nervous system - earlier it took its toll on kidneys and lungs.

The rising toll has prodded the administration into action, something that was amiss when leptospirosis cases were first reported from Pardi, Dharampur and Kheragam from Valsad district. It has spread to more talukas - Vansda, Chikhli, Valsad and Navsari of the district and to Mahuva, Bardoli and Vyara talukas of the neighbouring Surat district.

Private practitioners kept on sounding the administration about possible outbreak for they were the once to treat leptospirosis patients since 1989. The government apparently did not take them seriously, and a majority of doctors admit that leptospirosis deaths continued to pass as caused due to more common diseases like cholera, jaundice and malaria.

Relatives of patients dying in government hospitals would have continued to carry wrong death certificates had it not been for alarming rise in flow of patients in a private hospital. The hospital, like a couple of other private clinics and unlike government hospital, had facilities for treatment of the disease. When it was flooded with patients and eight of them died, it invited Minister of State for Health Dr K C Patel for a visit.

Suddenly, the fear stricken administration got its act together, rushing equipment and experts from Ahmedabad, Gandhinagar and Surat to Valsad. Twelve more deaths later, the government has now decided to have a permanent facility at Valsad Civil Hospital at an expenditure of Rs 32 lakh.

``No one took us seriously, even our colleagues ridiculed us when we diagnosed the disease,'' says Dr Devang Desai, a leading practitioner in a Doctor House in Valsad, who has been treating leptospirosis patients since 1989.

In fact, he along with Dr Kanti Patel, had presented papers on the spread of the disease in their area at conferences organised by Indian Medical Association.

Government inaction was all too evident and the delay in opening up proper facilities for treating the disease is now attributed to the ``threat not being too serious earlier'' by the Health Minister Anil Joshiara.

Joshiara is waiting for tests before he can finally conclude the disease afflicting South Gujarat is leptospirosis. Analyses of 40 samples at Surat's New Civil Hospital had confirmed 17 positive cases and 17 low positive cases.

Symptoms of the killer disease

It is manifested by fever, headache, chill and vomiting, muscular aches and conjunctivitis. Occasionally, meningitis and rash may occur.

Jaundice, renal insufficiency, haemolytic anaemia and haemorrhage in skin and mucous membranes are of infrequent occurrences.

Rats, small field rodents and pigs are susceptible to the infection and develop nephritis or may shed leptospirae in urine.

Besides domesticated animals like cattle, sheep, goat, horses, dogs, cats, rats and many other wild rodent animals carry leptospirae asymptomatically as silent carriers.

Copyright © 1997 Indian Express Newspapers (Bombay) Ltd.