MUMBAI: On July 31, when 30-year-old Andheri resident Babu was wheeled into the casualty of a super-speciality hospital in Juhu, he had a very high fever, low blood pressure, and his breathing was erratic. Initial scans and rapid tests revealed a scary picture: His platelet count was low, he was bleeding into his lungs, he had acute respiratory distress syndrome as well as jaundice, and his kidneys were non-functional.
In the next two hours, the doctors at Nanavati Hospital, Juhu, had a diagnosis that Babu or his family hadn’t heard in the nursing home he had spent three days before transferring here: Leptospirosis.
Leptospirosis is a bacterial infection that one gets after wading through flood water contaminated with the urine of an infected animal. Like gastroenteritis or malaria, it’s one of the monsoon maladies that usually gets resolved with medicines given by the neighbourhood doctor. However, in a small percentage of patients such as Babu, rain-related diseases wreak havoc and need ICU admissions, costing between Rs 15,000 and Rs 25,000 or more per day depending on the intensity of treatment and the hospital’s address.
“It’s not only the money, the entire family goes through emotional trauma as they wait for some good news,” said senior consultant Dr Pratit Samdani, who asks people to be careful during monsoon because he has had patients in the last month whose viral infection metamorphosed into pneumonia in three days. Moreover, he added, “bugs are stronger than drugs”.
In Babu’s case, though, according to his treating doctor Dr Harshad Limaye, there was a 90% risk of mortality given the severity of his leptospirosis infection. “He pulled through very well because he’s young,” said the infectious diseases specialist. Babu was strapped to a ventilator for more than five days, had to undergo regular dialysis, take platelet as well as blood transfusions along with potent medicines in the intensive care unit. On Friday, 10 days after he entered the ICU, he was wheeled into a general room where he is likely to stay for another week. “His kidneys may take another couple of months to heal so he needs to continue with dialysis,” said Dr Limaye.
Roughly 25km away from Babu’s hospital bed, a street hawker’s teenage son took him to Fortis Hospital in Mulund as he was worried about his father’s “extreme weakness”. His father’s diarrheal bout had started roughly 24 hours back on July 30 and none of the oral medicines had worked. Infectious diseases specialist Dr Anita Mathew, who inspected the hawker, decided it was most important to know the pathogen that had damaged his kidneys and wasn’t showing signs of stopping. “We decided to do a biofire test (a rapid PCR-based panel test for multiple pathogens) and found out in a few hours that he had cholera,” said Dr Mathew. He was started on the cholera treatment of doxycycline, but needed ICU stay for dehydration and kidneys. “He recovered well and was discharged after a week’s stay,” said Dr Mathew.
BMC’s fortnightly health data showed a rise in dengue and malaria in late July. Senior consultant Dr Gautam Bhansali concurred, stating patients with dengue, H1N1 and other flu needed hospitalisation because of their high temperatures and respiratory symptoms. Consider Cuffe Parade resident Pravin Shah, who came to Bombay Hospital with high fever and cough. “I am prone to severe chest infections and my cough was so violent that Dr Bhansali suggested I get admitted for better management,” said Shah who tested positive for H1N1-flu.
Another family that had to shell out a bill of Rs 2.5 lakh for their patient’s one-week stay in a south Mumbai hospital said they were just relieved. In terms of mortality, monsoon diseases rank much lower than non-communicable diseases such as heart diseases and hypertension that account for most of the annual deaths in the country. But monsoon maladies pose a big public health risk because, as intensivist Dr Rahul Pandit from H N Hospital, Girgaum, puts it: “We see a big proportion of patients in three short months. From the second week of June to Sept, we see a mixed bag of problems, from dengue to malaria.”
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