Mass prophylaxis treatment not necessary - CMO

Mass prophylaxis treatment not necessary – CMO

Jan 14, 2009 News

Despite the fact that more and more suspected cases of leptospirosis are being uncovered every day, the Health Ministry is adamant that it will not commence the distribution of mass prophylaxis treatment until the number of positive cases increases.
This is according to Chief Medical Officer Dr Shamdeo Persaud who noted that despite the numerous calls for the distribution of the antibiotic treatment, the ministry stands firm in its position since the actual number of confirmed cases remains very low.
He reiterated that of the 38 cases being monitored, a mere ten have been confirmed.
He noted that even though it has already been determined that the majority of suspected cases do not have the bacterial infection, they continue to be monitored as a means of finding out what is wrong with them.
Dr Persaud divulged that it was actually found that many of the persons that went to medical institutions after exhibiting some of the symptoms associated with leptospirosis recorded a ‘differential diagnosis’ in that more than one infection was detected.
“We continue to monitor persons because we have to find out what is really wrong with them. We will not just send them home … The fact that they exhibited the symptoms in the first place means that they were not well. Whenever a leptopsirosis case comes to us we normally conduct about three tests and in some cases it is found to be something else like dengue fever or Malaria.”
Dr Persaud noted that the Ministry is using what is know as the ‘epidemic channel’ which measures the level of leptospirosis infection within the last three years, to determine when and if mass prophylaxis treatment should be given.
With this index, when the levels of bacteria are shown to have reached above the midway point of infection of the three years under review, it becomes problematic enough for the antibiotics to be administered on a mass scale since it could be deemed as reaching epidemic proportions.
“Mass prophylaxis treatment has to be based on mass diagnosis of the disease and at this point, the fact is that we are just below that middle line.”
He noted that the reason that many persons are calling for the antibiotic to be distributed is because they are of the incorrect impression that it (the prophylaxis) acts as immunization against the bacteria.
He dispelled this belief explaining that like any antibiotic treatment its function is to eliminate traces of the bacteria in persons already infected.
Since this is so, he stated that to wantonly distribute the prophylaxis to populations with a low prevalence of the disease could result in the bacteria developing a resistance to the antibiotic.
“And since a complete dose of the treatment takes seven days, that would mean that next year if we have a flood again and need to use the prophylaxis, it will be less effective and the huge supply of the drug that we have would be useless and we may have to go to the United States for a stronger dose of antibiotic treatment,” Dr Persaud noted.
As such, selective distribution is being carried out to persons related to or in close proximity to those diagnosed with leptospirosis.
Dr Persaud also reiterated the side effects of using the antibiotic treatment, especially to women.
Health Minister Dr Leslie Ramsammy had related to this newspaper that after the 2005 flood, the country saw heightened incidences of a number of sexually transmitted infections among women, including Pelvic Inflammatory Disease (PID), Clamydia and Candidiasis.
“ Putting people at risk in this kind of manner does not make sense… the huge number of persons that were becoming infected during the 2005 flood decided that the benefits outweighed the risks … We don’t yet have that urgent need this time around, “he had noted.
Some 5,000 persons, mostly in the affected geographical regions of 3, 4 and 5, have been treated to date as a result of the flooding.
Most of the conditions dealt with are acute respiratory infections, skin rashes, coughs and colds and diarrhoea.

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