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The Honolulu Advertiser
Posted on: Wednesday, April 28, 2004

Rainy weather likely to blame for surge in leptospirosis cases

By Robbie Dingeman
Advertiser Health Writer

Health officials report a fivefold increase in leptospirosis cases in Hawai'i this year.

Disease causes flulike symptoms

• Leptospirosis is a bacterial disease that causes flulike symptoms and, in rare cases, death.

• People in Hawai'i commonly get it when wading or swimming in streams, ponds and other freshwater sources contaminated by animal urine.

• Symptoms include fever, nausea, chills, headache, vomiting, diarrhea and body aches. More serious symptoms include jaundice, kidney failure and heart failure.

• Stay out of fresh water and muddy areas if you have open cuts or blisters. Don't put your head underwater or drink stream water. See a doctor if symptoms arise.

Source: State Department of Health

As of yesterday there were 21 confirmed cases of the bacterial disease in 2004, compared with only four at this time last year, said Dr. David Sasaki, public health veterinarian.

Sasaki said rainy weather is the most likely cause for the increase because moist conditions allow the bacteria to survive longer. "This has been our educated guess," he said.

The 21 cases include the death of Big Island college student Simon Hultman in January.

The disease is transmitted from animals to humans, usually when people contact the bacteria through fresh water or mud that has been contaminated by the urine of infected animals, such as rats or mice.

Symptoms of the disease — fever, chills, headache, body ache, stiff neck, jaundice — occur with many illnesses and can show up from two to 30 days after exposure, making the disease harder to identify for those unfamiliar with the risks.

Sasaki, who is considered a leptospirosis expert, said there have been nine cases in January, seven in February, three in March and two so far this month. It usually takes two weeks to confirm the disease through tests, so the March and April counts may rise, he said.

Typically there are fewer cases early in the year because the weather is cooler and fewer people go into streams and ponds. With the number of cases already high, Sasaki said health officials want to raise awareness about the risks of the disease.

"People should be careful when they get exposed to fresh water," Sasaki said. "They shouldn't submerge their heads.

"There are antibiotics that are known to be effective against leptospirosis, especially if administered early."

Hultman, 22, of Pahoa, died Jan. 26, shortly after returning to school in Maryland. He spent the Christmas holidays with family on the Big Island, where he went hiking and swimming and spent time in Waipi'o Valley.

Sasaki said Hultman was the only fatality this year. He is among six deaths in the past decade from nearly 500 cases. Sasaki said many doctors here recognize the disease and diagnose it.

Hawai'i averages 44 cases a year with a high of 72 in 1997. More cases have been linked to the Waipi'o River on the Big Island than any other single source. The disease also has been traced to Maunawili Stream/Falls, Kapena Falls/Nu'uanu Stream and Kahana Stream on O'ahu; and on Kaua'i, to Waimea River, Wailua River and the Hanalei River.

Reach Robbie Dingeman at rdingeman@honoluluadvertiser.com or 535-2429.