Kerala’s health department has issued a high alert for leptospirosis, commonly referred to as rat fever, after the water-borne disease killed 28 people, including nine people in the past one week, since August 1, the Hindustan Times reported. The state health department has requested for more medicines from the Union health ministry.

Leptospirosis is a zoonotic disease (transmitting from animals to humans) and the possibility of contracting it is high after floods as urine of infected rats or other rodents contaminate water, passing it on to human beings who come in contact with the water. Elderly and those suffering from kidney or liver ailments are more vulnerable to the disease. Its symptoms include high fever, headache, chills, abdominal pain and rashes.

Three flood relief workers are among those who died and at least 300 suspected cases were reported from the state in the past three days, an unidentified senior health official said.

In Kozhikode district, where 17 people had died in the Nipah virus outbreak, at least 14 people have died of leptospirosis till Saturday evening, reported Malayala Manorama. Though the impact of the flood was relatively low in the district, most number of leptospirosis deaths have been reported from here.

Fifteen nurses under the National Rural Health Mission have been deployed in the district’s medical college hospital. Isolation wards, which were set up during the Nipah outbreak in the district, have been converted into ‘fever’ wards. Representatives from Indian Council of Medical Research are also camping in the state to review the post-flood situation.

Cases of leptospirosis have also been reported from Thiruvananthapuram, Thrissur, Kannur, Palakkad and Malappuram districts. On Friday, as many as 134 people approached various hospitals across the state showing symptoms of the disease, reported Mathrubhumi.

On Tuesday, the Directorate of Health Services issued a leptospirosis alert following a sudden increase in cases in Thrissur, Palakkad, Kozhikode, Malappuram and Kannur districts, The News Minute reported.