Patient T.V.D, born in 1971 in Yen Bai city, was transferred from Yen Bai General Hospital to the Emergency Department, Central Hospital for Tropical Diseases in a state of unspecified sepsis, severe liver and kidney failure, sedated, on a ventilator, and maintained with vasopressors.
Recently, the patient's family lived in a storm and flood area, and the entire house was flooded. After that, the patient participated in flood prevention and cleanup, and had a lot of contact with water and mud. About a week before being admitted to the hospital, the patient had muscle pain and fatigue in his body.
On September 20, the patient developed chills with unknown temperature, increased leg muscle pain, loose stools many times a day, and pain in both calves.
On September 23, the patient went to the doctor with kidney failure, the disease progressed more severely, fever, low blood pressure, respiratory failure, decreased consciousness... The patient was intubated and transferred to the Central Hospital for Tropical Diseases.
At the Central Hospital for Tropical Diseases, the patient was diagnosed with: Sepsis with shock, monitored due to Leptospira (yellow spirochete disease), pneumonia, acute pancreatitis, acute renal failure, cirrhosis...
After 4 days of hospitalization, screening tests, urine tests, blood tests, and blood cultures were performed, and the patient tested positive for Leptospira.
After 9 days of treatment, the patient is awake, no longer needs vasopressors or oxygen therapy, and his liver and kidney function has improved. The patient can be discharged next week.
In addition to Mr. D, the Central Hospital for Tropical Diseases also admitted 5 people from Thai Nguyen with fever and fatigue. What is special is that all 5 people are related by blood (including 2 spouses and children and 2 grandchildren). The family was also recently flooded.
Based on epidemiological factors, especially the fact that Mr. C's family lived in a flooded environment for a long time and had direct contact with flood water, doctors suspected that he and four family members had Leptospira.
Dr. Pham Thanh Bang, Department of Emergency Medicine (Central Hospital for Tropical Diseases), said: Leptospirosis is an acute infectious disease caused by spirochetes of the Leptospiraceae family. Leptospira enters the human body through scratches on the skin and mucous membranes when in contact with contaminated water (fields, ponds, lakes, puddles).
Even if exposed to a contaminated environment for a long time, the bacteria can penetrate directly through the skin and intact mucous membranes. The disease often occurs during the rainy season because the bacteria spreads through water. The recent floods caused by Typhoon Yagi created favorable conditions for the spread of Leptospira bacteria, especially in pig farming areas where sanitation systems are not guaranteed.
In Vietnam, Leptospira still occurs sporadically, especially in flooded areas. Although it has decreased significantly compared to previous decades, the disease is still a health threat to people in direct contact with floodwaters, especially in livestock farming areas.
“To prevent Leptospira, livestock farms, slaughterhouses, etc. must be high, well-drained, regularly cleaned and disinfected. At livestock farms, slaughterhouses, swimming pools, etc., waste must be regularly or periodically checked to promptly handle rat prevention and environmental sanitation. People working in floodwater or barns must be fully equipped with protective clothing, boots, and gloves to minimize the risk of infection,” Dr. Bang advised.
