US embassy cable - 05NEWDELHI6295

UNCLAS NEW DELHI 006295 
 
SIPDIS 
 
 
HHS PASS TO NIH 
 
STATE PASS TO USAID 
 
PASS TO HHS/OGHA (STEIGER/BHAT), CDC (BLOUNT/MCCRAY), 
NIH/FIC (HYRNKOW/EISS) 
 
E.O. 12958: N/A 
TAGS: TBIO, KSCA, IN 
SUBJECT: POST FLOOD DISEASE WAVE IN MUMBAI 
 
 
1. (U) SUMMARY: Mumbai is facing a wave of post flood 
infectious diseases. Newspaper reports have put the death 
toll at 66 for Mumbai and suburbs. Most of the deaths have 
been attributed to leptospirosis and dengue. Maharashtra 
health authorities believe that while the incidence is high, 
the disease burden is manageable. END SUMMARY. 
 
2. (U) Mumbai was devastated by floods a fortnight ago and 
now is facing threat of leptospirosis outbreak. 
Leptospirosis is a bacterial disease caused by a spiral 
bacterium, Leptospira and transmitted by rat urine. The 
organism passes through minute abrasions when contaminated 
floodwater comes in contact with abraded skin. Leptospirosis 
can present as fever, vomiting, jaundice, hemorrhages, acute 
respiratory distress syndrome and even multi organ failure. 
 
3.(U) At least 66 deaths due to leptospirosis and dengue (a 
mosquito borne viral disease) have been reported in and 
around Mumbai by newspapers since 29th July. Typical 
presentations have been high fever, vomiting, and acute 
respiratory distress syndrome. The state government has 
invoked special provisions of the Epidemic Act adding 
leptospirosis to the list of notifiable diseases thus making 
it obligatory for practitioners to treat fever cases and 
notify suspected leptospirosis cases. 
 
4. (U) A team from Central Government, comprising of an 
epidemiologist, microbiologist and entomologist from 
National Institute of Communicable Diseases, New Delhi has 
been sent to Mumbai for evaluation and control of the 
situation. On 11 August 2005, the Director General Indian 
Council of Medical Research and Director National Institute 
of Communicable Diseases have been sent to assess the 
situation. According to the Dean of KEM Medical College and 
hospital in Mumbai, the focus is on early diagnosis, 
treatment and prevention. Surveillance work is also being 
carried out. 
 
5. (U) According to health authorities in Mumbai, the 
situation is tense but under control as leptospirosis is an 
easily treatable disease. Local media is reporting lack of 
preparedness by health authorities in Mumbai and have blamed 
policy makers for the health crisis in Mumbai. This is 
corroborated by the fact that the disaster management and 
health group of Red Cross had written a report of threats 
and needs for preparedness immediately after floods. 
 
6. (U) In their report Red Cross had put leptospirosis as 
the topmost threat and the need to stock doxycycline as 
highest priority. Prior to writing this report, the Red 
Cross had consulted with HHS staff at the embassy about the 
threats. This consultation formed the basis of their report. 
HHS staff followed up with Red Cross today and they informed 
that no steps were yet initiated in response to their 
report. 
 
BLAKE 
 
 
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