Published: 2021-09-28

Clinical profile of post flood fever in a tertiary care hospital in Kerala

Bhagyanath T., Anoop Joseph, Jacob K. Jacob, Suma Samuel, Rakhi R. Kurup, Reshnu Ravindran


Background: Floods are an important source of infection epidemic worldwide. Analysis of different infections presenting during floods can lead us to have a unified approach during such periods.

Methods: This study describes the clinical features of fever patients presented to a tertiary care hospital in Kerala after the 2018 flood. Clinical findings of the confirmed leptospirosis cases were also compared with non-leptospirosis cases.

Results: A total of 48 patients with fever and myalgia were studied and majority of them were males (77%). 40 patients had contact with contaminated water. But only 10 of them had taken prophylactic doxycycline. Complications were seen less among those who took prophylactic doxycycline. The mean time from the first symptom to first medical care was 4.4 days. Leptospirosis was seen among 15 patients and 2 patients had dengue fever. Hepatic involvement and renal involvement were seen significantly higher among leptospirosis patients.

Conclusions: This study emphasized the importance of prophylactic doxycycline and early initiation of antibiotics during flood outbreaks. Awareness among treating doctors and patients is required for the control of outbreaks and prevention of mortality during floods.



Flood, Post flood fever, Leptospirosis, Doxycycline

Full Text:



Shuman EK. Global climate change and infectious diseases. N Engl J Med. 2010;362(12):1061-3.

Lin CY, Chen TC, Dai CY, Yu ML, Lu PL, Yen JH, et al. Serological investigation to identify risk factors for post-flood infectious diseases: a longitudinal survey among people displaced by Typhoon Morakot in Taiwan. BMJ Open. 2015;5(5):7008.

WHO. Flooding and communicable diseases fact sheet. Weekly Epidemiological Record, 2005. Available at: Accessed on 01 July 2021.

Agampodi SB, Dahanayaka NJ, Bandaranayaka AK, Perera M, Priyankara S, Weerawansa P, et al. Regional differences of leptospirosis in Sri Lanka: observations from a flood-associated outbreak in 2011. PLoS Negl Trop Dis. 2014;8(1):2626.

Rachna P, Vipul S, Bansal RK, Pawar AB, Vandana D, Kalpana D, et al. Post-flood profile of leptospirosis cases at teaching hospital of municipal medical college in Surat city. Natl J Community Med. 2010;1(1):9-11.

Mendoza MT, Roxas EA, Ginete JK, Alejandria MM, Roman AD, et al. Clinical profile of patients diagnosed with leptospirosis after a typhoon: a multicenter study. Southeast Asian J Trop Med Public Health. 2013;44(6):1021-35.

Supe A, Khetarpal M, Naik S, Keskar P. Leptospirosis following heavy rains in 2017 in Mumbai: Report of large-scale community chemoprophylaxis. Natl Med J India. 2018;31(1):19-21.

Chusri S, Neil EB, Hortiwakul T, Charernmak B, Sritrairatchai S, Santimaleeworagun W, et al. Single dosage of doxycycline for prophylaxis against leptospiral infection and leptospirosis during urban flooding in southern Thailand: a non-randomized controlled trial. J Infect Chemother. 2014;20(11):709-15.

Schneider MC, Hernandez J, Min KD, Leonel DG, Carrasco D, Gompper ME, et al. The Use of Chemoprophylaxis after Floods to Reduce the Occurrence and Impact of Leptospirosis Outbreaks. Int J Environ Res Public Health. 2017;14(6):594.

Amilasan AS, Ujiie M, Suzuki M, Salva E, Belo MC, Koizumi N, et al. Outbreak of leptospirosis after flood, the Philippines, 2009. Emerg Infect Dis. 2012;18(1):91-4.

WHO. Human leptospirosis: guidance for diagnosis, surveillance and control, 2003. Available at: Accessed on 01 July 2021.

Kuriakose M, Eapen CK, Paul R. Leptospirosis in Kolenchery, Kerala, India: epidemiology, prevalent local serogroups and serovars and a new serovar. Eur J Epidemiol. 1997;13(6):691-7.