Press Interpreter

Nanjing Drum Tower Hospital treats three cases of Leptospirosis and stroke

03/06/08 -- Five years ago, Old Wang* never imagined that a careless cut on his hand from washing snails would lead to long-term high blood pressure and a sudden stroke that left him in the hospital and nearly crippled. Zhang Jun, the director of Nanjing Drum Tower Hospital’s Emergency Department, told reporters that beginning in January, the hospital had seen a series of three stroke cases brought on by Leptospira**. The other two cases besides Old Wang may have been infected from contaminated water that came into contact with their broken or injured skin.

Leptospirosis leads to stroke

One morning in January, Old Wang, who lives within the city limits of Nanjing, woke up unable to speak and with the characteristic facial paralysis of a stroke. His family rushed him to Nanjing Drum Tower Hospital. A physical examination revealed that although Old Wang was mentally alert, his body was extremely frail. His family described how Old Wang had suffered from hypertension for years, but that none of the medications he tried had been able to bring down his blood pressure.

Hospital experts felt that this might not be an ordinary stroke. A few days after the incident, doctors sent blood samples from Old Wang to be tested at a specialized laboratory. The results showed that Old Wang had Leptospirosis. Zhang Jun told reporters that this is an easily overlooked illness. In order to treat this kind of stroke, only antibiotic therapy—penicillin paired with some hormones is the first choice—can treat it and kill the microorganisms. The medicine worked like a charm, and, after a short period of recovery, the old man’s status showed marked improvement.

Hand laceration from washing snails is the cause

Because this type of disease presentation is rare, Director Zhang got a detailed medical history from Old Wang. “In the past, this type of illness has sprung up mostly in the villages; city folk love cleanliness and so you don’t see it as much.” After some promptings from the doctors, Old Wang realized that perhaps his own hobby was the source of the trouble. He told the doctors that he especially loved to eat snails and lobster. Five years previous, Old Wang had gone down to the river to score some periwinkles***. As he was removing the outer shells, he unwittingly cut his hand. Not longer after he cut his hand on the shells, he caught a bit of a cold. Then, a few months later, he felt ill and was diagnosed with hypertension. Despite these illnesses, Old Wang did not have too much physical discomfort until his stroke.

Director Zhang explained to reporters that this type of sickness camouflages itself very well. At first, Old Wang felt like he had cold, which was actually the first stage of sepsis caused by Leptospira. The symptoms are relatively mild and the damage to internal organs is also mild. With the passage of time, the disease slowly progresses until there is inflammation of the cerebral arteries, which leads to hypertension and finally stroke. The stroke has a high rate of disability and is very difficult to treat. Although Old Wang has recovered well to this point, his central nervous system will undoubtedly suffer some aftereffects from the stroke.

A series of three strokes caused by Leptospira

Since January, Nanjing Drum Tower Hospital has had three cases of stroke caused by Leptospira. Director Zhang explained that the two other cases live at the border of the suburbs and the city. These cases may have resulted from contact between skin wounds and contaminated water during farm work. Experts remind the public that the season for periwinkles and lobster is almost here. City residents should boil periwinkles before they eat them because Leptospira are fragile and will die after 10 minutes in 56°C water or after 10 seconds in 60°C water. Also, city residents should not eat them if they have open oral wounds.

*The title ‘Old’ as in ‘Old Wang’ is in most cases an honorific applied respectfully to people of advanced age (especially males).

** Leptospira is a genus of spirochete bacteria that often make their home in stagnant water.

*** In the strictest sense, periwinkles are snails of the species Littorina littorea. However, many types of snail species are referred to as periwinkles. Notably, In the city of Liuzhou in China’s Guangxi province, the local specialty dish is rice noodles spiced with chili and other local flavors in the broth of the snails referred to in this article (螺蛳).

[Full text]

Reporting by Liu Huiyan
Written by Modern Bulletin Reporter Liu Yun

--Translated by D. Owen Young

Go to original article: http://www.kuaibao.net/html/2008-03/06/content_60804323.htm