He was trembling, had a horrible headache, and a temperature that kept on rising. But Suhandi, 42, thought what he had was just an ordinary fever. So he popped a couple of pills for his headache, slathered some medicinal cream onto his body and then went to sleep.

When he woke up the next morning, however, his headache was even worse, and he was now sore all over as well. Recalls Suhandi: 'I could no longer sit or stand.

He did not protest when his wife packed him off to the hospital. There he was diagnosed as having contracted leptospirosis, as had four of his friends who had apparently been taken there earlier.

Indeed, all over Jakarta, thousands of other people were falling ill from the disease soon after the devastating floods in recent months.

Official public health statistics say that at least 3,000 people s friends. Tarakan Public Hospital director Soekirno Soekin says, This illness attacks the kidney and liver very fast.

Jakarta Public Health official Evi Zelfino says that the leptospirosis outbreak was caused largely by the floods that inundated as much as 80 percent of the metropolis in January and February.

But observers say another major factor was the governments inability to anticipate what kinds of diseases such floods could bring and to advise residents early on illnesses such as leptospirosis.

Epidemic

In fact, they say, local public health officials have yet to conduct a widespread information campaign on the disease despite the apparent epidemic that up to now continues to bedevil Jakarta.

Leptospirosis is a bacterial disease that affects humans and animals such as rats, pigs, cows, sheep, dogs, bats and birds. Handling soil contaminated with the urine of infected animals urine increases a persons chances of getting the sickness.

But the most common way people get ill with leptospirosis is through wading unprotected in floodwaters contaminated with the urine of infected rats — which was exactly how many Jakarta residents wound up with it.

Experts explain that the bacteria could enter the body as the dirty water washes over the eyes or cuts in the skin, but that the disease would not manifest itself until as late as four weeks after.

The symptoms of leptospirosis include high fever, severe headache, chills, muscle aches, and vomiting. Some people may also suffer jaundice (yellow skin and eyes), red eyes, abdominal pain, diarrhoea, or a rash.

Many of these symptoms, of course, can be mistaken for those of other illnesses. Some people ill with leptospirosis also show no symptoms at all. The correct diagnosis, however, can be made easily through laboratory testing of a blood or urine sample.

If someone with leptospirosis is not treated, the patient could develop kidney damage, meningitis (inflammation of the membrane around the brain and spinal cord), liver failure, and respiratory distress. Yet while it can be fatal, experts say, the disease rarely takes lives.

In truth, some observers find in curious why any of those who came down with the disease here in Jakarta died at all. Soekin, whose own hospital failed to save seven of the 557 patients diagnosed with leptospirosis, himself notes that the medicine to treat the disease are readily available.

So community clinics that are scattered all over the capital can actually solve the problem, he says. But even big hospitals fail to do that, they are incapable. So this is the matter of ignorance.

Prevention is simple

To be sure, preventing the spread leptospirosis is also supposed to be a simple matter. Clean surroundings, for one, would help. As Soekin puts it, Clean habit is very effective in preventing the disease.

Advising people to cover themselves up as well as possible if they are to brave the floods is another. But that should come after informing the public first about leptospirosis, as well as other flood illnesses they could be exposing themselves to.

Such information can be life-saving in a metropolis that many have given up as being flood-prone.

Points out private firm employee Aris Fachrur: Jakarta has no drainage system. Even when the government construct the drainage systems in every corner of the city, people will acquire the places and transform them into food stalls or slum settlements.

Both the government and the community are not aware of the vitality of health environment, he laments.

Jakarta Public Health Office head Chalik Masulili himself believes that so long as the Jakarta administration is unable to solve the flooding problem, the capital may only see repeated outbreaks of leptospirosis.

Then again, perhaps that should be a signal for the Public Health Office to start making the rounds and inform people about leptospirosis — and how they can avoid getting it. (IPS)