Cases of Leptospirosis after typhoon Ondoy (international name: Ketsana) seen at the emergency department: the Philippine General Hospital experience

摘要

Emergency care physicians are at the forefront of receiving patients in conditions of widespread flooding such as what happened when Typhoon Ondoy poured heavy rain on September 26, 2009 and brought the worst rainfall to Metro Manila among recorded typhoons according to PAGASA (Philippine Atmospheric, Geophysical, and Astronomical Services Administration). Luzon was declared in a state of calamity. Flood water levels reached a record 20 feet high in rural areas. More than 2,089 people have been treated for bacterial infection in Manila and surrounding provinces and 162 people have died, more than five times the number of Leptospirosis deaths in the entire country in 2008. This study is a chart review of the clinical outcome of admitted patients diagnosed with Leptospirosis during Typhoon Ondoy from October to November 2009. This covered those patients' charts designated under the ICD (International Classification of Disease) A27 and showed their clinical outcome based on the following predictors such as age, gender, duration of hospitalization, presence or absence of complications particularly bleeding diathesis, renal failure, cardiac, neurologic and muscular complications on admission. The majority of mortalities is associated with bleeding diathesis. Cardiac involvement is common but may be underestimated. Having in mind the complications of Leptospirosis and predictors of mortality, early detection and intervention, interim guidelines on management and public health measures can respond better to expected cases especially during an epidemic/disaster.