TYPHOON MIRINAE - Death toll rises in Manila

The Philippines have been battered by yet another deadly typhoon. Over the weekend, Typhoon Mirinae has killed at least 20 people as crews struggle to restore the damage from Typhoon Mirinae. The relentless floodwaters from a series of typhoons in the region are making people sick from Leptosphirosis, a disease passed through animal urine, usually rats. Eighty-nine people in the capital have died of the illness, as have more than 100 in outlying regions.

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Typhoon Mirinae ripped through Manila and the surrounding provinces over the last two days and has subsequently added to the pools of stagnant water throught the northern region of the Philippines. The flood is only being worsened by the smelly piles of garbage and other waste that is blocking drainage systems. The rat population in Manila has grown through the progression of these storms, an epidemic which is adding to the outbreak of Leptosphirosis.
"We have a lot of people in the hospital because of leptospirosis," says mother of 2, Jillian Ramirez. Leptosphirosis is a bacterial infection which is acquired when people with open wounds come into contact with dirty water. Treatment for Leptosphirosis is complex and failure to treat in time can result in death. According to Philippine Health officials, at least 2,000 people are in hospital suffering from leptospirosis which has no vaccine.

Typhoon Mirinae weakened Sunday as it headed over the South China Sea towards Vietnam's central coast. Vietnamese Prime Minister Nguyen Tan Dung has already ordered residents to begin evacuating high-risk areas of five coastal provinces and ordered Vietnamese fishermen in the South China Sea to seek shelter immediately.


Leptospirosis (also known as Weil's disease, Weil's syndrome, canicola fever, canefield fever, nanukayami fever, 7-day fever, "Fort Bragg fever," and "Pretibial fever") is a bacterial zoonotic disease caused by spirochaetes of the genus Leptospira that affects humans and a wide range of animals, including mammals, birds, amphibians, and reptiles. It was first described by Adolf Weil in 1886 when he reported an "acute infectious disease with enlargement of spleen, jaundice and nephritis". Leptospira was first observed in 1907 from a post mortem renal tissue slice.

Though being recognised among the world's most common zoonoses, leptospirosis is a relatively rare bacterial infection in humans. The infection is commonly transmitted to humans by allowing water that has been contaminated by animal urine to come in contact with unhealed breaks in the skin, eyes or with the mucous membranes. Outside of tropical areas, leptospirosis cases have a relatively distinct seasonality with most of them occurring August–September/February–March.

In humans, leptospiral infection causes a wide range of symptoms, and some infected persons may have no symptoms at all. Leptospirosis is a biphasic disease that begins with flu-like symptoms (fever, chills, myalgias, intense headache). The first phase resolves, and the patient is briefly asymptomatic until the second phase begins. This is characterized by meningitis, liver damage (causing jaundice), and renal failure; because of the wide range of symptoms the infection is often wrongly diagnosed. This leads to a lower registered number of cases than there really are. Symptoms of leptospirosis include high fever, severe headache, chills, muscle aches, and vomiting, and may include jaundice, red eyes, abdominal pain, diarrhea, and/or a rash. The symptoms in humans appear after a 4–14 day incubation period.


Leptospirosis treatment is a relatively complicated process comprising two main components: suppressing the causative agent and fighting possible complications. Aetiotropic drugs are antibiotics, such as cefotaxime, doxycycline, penicillin, ampicillin, and amoxicillin (doxycycline can also be used as a prophylaxis). There are no human vaccines; animal vaccines are only for a few strains, and are only effective for a few months. Human therapeutic dosage of drugs is as follows: doxycycline 100 mg orally every 12 hours for 1 week or penicillin 1–1.5 MU every 4 hours for 1 week. Doxycycline 200–250 mg once a week is administered as a prophylaxis.[citation needed] In dogs, penicillin is most commonly used to end the leptospiremic phase (infection of the blood), and doxycycline is used to eliminate the carrier state.

Supportive therapy measures (esp. in severe cases) include detoxication and normalization of the hydro-electrolytic balance. Glucose and salt solution infusions may be administered; dialysis is used in serious cases. Elevations of serum potassium are common and if the potassium level gets too high special measures must be taken. Serum phosphorus levels may likewise increase to unacceptable levels due to renal failure. Treatment for hyperphosphatemia consists of treating the underlying disease, dialysis where appropriate, or oral administration of calcium carbonate, but not without first checking the serum calcium levels (these two levels are related). Corticosteroids administration in gradually reduced doses (e.g., prednisolone starting from 30–60 mg) during 7–10 days is recommended by some specialists in cases of severe haemorrhagic effects. Organ specific care and treatment are essential in cases of renal, liver or heart involvement.