A cluster of the bacterial disease, leptospirosis, has prompted Malaysian health authorities to temporarily close a popular national park, according to a Star Online report.

map of Malaysia
Malaysia/CIA

The two week closure of the Jeram Toi waterfall and recreational park, located about halfway between Seremban and Kuala Kelawang, occurred after four children, aged 15 to 18, contracted the disease after swimming there. The condition of all four kids are stable and being treated at a local hospital.

State Health director Datuk Dr Zailan Adnan advises visitors of the park and falls not to throw food or waste in the area as this would attract rodents, as well as other animals which could be carriers of the disease.

Leptospirosis is a bacterial zoonotic disease caused by the corkscrew shaped organism, Leptospira. It goes by several other names depending on the locale; mud fever, swamp fever, sugar cane and Fort Bragg fever, among others. It is a disease of both humans and animals.

The rat is the main host to Leptospira. However, other animals such as cattle, pigs, horses, dogs, rodents, and wild animals can carry the bacterium.

People become infected by direct or indirect contact with the urine of these animals. Contact with urine-contaminated water is extremely important. Contaminated food and soil containing animal urine are other potential sources of infection.

The bacterium enters through contact with skin. Especially through cuts or breaks in the skin and through mucous membranes like the eyes.

Found worldwide, it was long considered an occupational disease (miners, farming, vets, and sugar cane harvesting and sewer workers), it is increasingly associated with recreational water sports andcamping.

Symptoms of leptospirosis, if present,  appear in up to 4 weeks after exposure. Sometimes the person will show no symptoms or mild flu-like symptoms.

According to the CDC, Leptospirosis may occur in two phases; after the first phase, with fever, chills, headache, muscle aches, vomiting, or diarrhea, the patient may recover for a time but become ill again. If a second phase occurs, it is more severe; the person may have kidney or liver failure (jaundice) or meningitis. This phase is also called Weil’s disease.

Leptospirosis is confirmed by laboratory testing of a blood or urine sample.

The infection can be treated with antibiotics (penicillin and doxycycline), especially if started early in the disease. For very ill patients, intensive care support and IV antibiotic may be necessary.

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