Dr. Manny: Rat epidemic in New York a dire warning for other cities

(AP)

Many of our country’s major cities have severe infrastructure and housing challenges. This has led not only to poor living conditions but also places individuals’ health in grave danger. In New York City, among our many housing woes, we have a rat infestation epidemic. Rats have become so common to our residents that the media celebrated a rat carrying a pizza from the subway, and even gave it a name. An important message gets lost in the hoopla over something like “Pizza Rat,” and it’s about the danger that rodents pose to humans and our health.

Remember the Black Death? It was one of the most devastating pandemics in human history that swept through Europe in the 1300s claiming upwards of 100 million lives.  The cause was the bubonic plague, which is an infectious disease caused by the Yersinia pestis bacteria that humans can get through either infected flea bites or direct contact with an infected animal. Human-to-human transmission is rare, but an infected person can transmit plague pneumonia to another through cough droplets in the air.

Plague can be successfully treated with antibiotics, but a suspected case requires immediate medical attention. According to the Centers for Disease Control and Prevention (CDC), patients must be given antibiotics as soon as possible to avoid death. The most common vector of the disease during Black Death was rats.

And here we are, in 2017, in danger of another bacterial disease linked to rats called leptospirosis. Already in New York’s Bronx borough, the disease has killed one person and left two others clinging to life. Sure, the city’s deputy commissioner of the Health Department wants you to be encouraged by the two patients’ recovery, but what you should be is concerned that these three people were infected because of where they live. All three cases came from a one-block radius over the past two months.

Leptospira bacteria thrive in warm, moist environments, and most human cases are associated with exposure to rats or rodent-infested environments. Disturbingly, humans can become infected through contact with rat urine or water, soil or food that has been contaminated by the urine.

Doctors want anyone with suspected symptoms to report them to the health department and seek immediate medical attention. You could experience a wide range of symptoms, like fever, headaches, nausea, vomiting, muscle pain and other awful ailments, or you may experience nothing at all. If you’re in the latter category, how would you know to seek treatment? Without treatment you could suffer kidney damage, meningitis, liver failure, respiratory distress or even death. Infection during pregnancy may result in severe fetal and maternal morbidity or mortality.

I know I talk a lot about the importance of disease prevention like getting vaccines and keeping up with routine care, but this time, we can only blame city officials.

How did they let the rat infestation get this out of control? How could they not have known during routine health inspections that rat infestations could lead to death? I’m well aware that in a budget crunch, things like pest control are the first to be cut, but we are talking about the hygiene of our city.

Big cities’ health departments, especially in a place like New York, cannot continue function the way they do today. They are always reactive, never proactive. The city health departments should be the first ones to ring the bell to alert city officials and citizens that there is a health problem brewing. We should not have to wait until people have to be removed from their homes and hospitalized before anybody begins to think about how to react.