Influenza and leptospirosis drive nearly 300 deaths in Kerala this season

Kerala has witnessed a significant surge in influenza and leptospirosis cases this season, with the two diseases together accounting for close to 300 deaths in the State. As on September 15, the State reported 10,244 influenza cases — predominantly A H1N1, A H2N3 and Influenza B — and 109 deaths from the infection, a sharp increase compared to previous years. Confirmed leptospirosis deaths stood at 100, with an additional 78 probable deaths. Health officials, however, maintain that the leptospirosis toll remains lower than in past years.

The rise in influenza cases is not confined to Kerala; almost all States have reported a spike in influenza A (H1N1) cases. Unpredictable weather patterns, high temperature and humidity, and possible mutations in seasonal flu viruses are among the factors suspected to have contributed to the surge. In Kerala, H1N1 cases have been climbing for several months and have claimed a disproportionately high number of lives among senior citizens, prompting public health experts to call for government investment in flu vaccination for the elderly.

Influenza typically presents with fever, chills, sore throat, cough and body ache, but can become serious for vulnerable groups. Under the Health department's influenza A H1N1 ABC guidelines, routine testing is not recommended for mild cases; only those with serious symptoms reaching hospital outpatient departments are tested. Consequently, the official tally under the Integrated Disease Surveillance Programme does not reflect the actual caseload in the community.

A health official noted that the virus spreads easily through the respiratory route and contaminated surfaces, stressing that people visiting hospitals with flu symptoms should wear masks and maintain respiratory hygiene to prevent hospitals from becoming transmission hubs. Patients with mild fever and cold symptoms do not require testing or Oseltamivir and can be managed with home isolation and supportive care. However, pregnant women and those with high-grade fever, persistent symptoms or other morbidity should consult a doctor and start Oseltamivir early. Red flag signs include breathlessness, chest pain and low oxygen saturation, which warrant hospitalisation and intensive care. Doctors advise against self-treatment and urge people to seek help if symptoms worsen or persist, as early Oseltamivir can make a substantial difference. In the private sector, physicians are recommending the annual flu vaccine for the elderly and those with comorbidities, as it can reduce the risk of infection and, even when infected, prevent severe disease, hospitalisation and death.

For leptospirosis, late diagnosis and rapid progression continue to claim lives. Because early symptoms overlap with those of viral fevers, doctors in peripheral areas are being instructed to start doxycycline in all fever cases without respiratory symptoms, as the drug has been found effective at any point in the illness. Despite advisories, workers for whom the disease is an occupational hazard — farmers, manual cleaning workers, gardeners and dairy farmers — continue to ignore the directive to take proper doxycycline prophylaxis. It has been pointed out that local self-governing bodies should provide protective gear to these categories of workers.