Leptospirosis – A Lethal Killer Living Among Us

This article is part of Earth Journalism Network’s special collaborative project on One Health and meat in the Asia Pacific entitled “More Than Meats the Eye.”
04 Sep 2022 16:57
Leptospirosis – A Lethal Killer Living Among Us
Korobebe Village in Sabeto, Nadi, with the Sabeto River on the left of the photo. Photo: Leon Lord

For the first time, villagers of Korobebe Village in Sabeto, Nadi, lost two young lives to a lethal bacteria.

Families of the two victims, Kave­kini Tubuisusu and Marika Lagilo­lo, are still reeling from the sudden loss of their family members six months later.

The two, aged 17 and 22, died at the height of the outbreak of leptospi­rosis.

Leptospirosis, also known as Weil’s disease, is a bacteria that mostly spreads through the urine of in­fected animals and can cause severe flu-like symptoms in people. In some cases, it causes death.

Responding to emailed questions, the Ministry of Health and Medical Services (MOHMS) said leptospiro­sis was an endemic disease in Fiji and was responsible for substan­tial morbidity and mortality in the country.

MOH data indicated that in 2012, two large outbreaks occurred with 576 reported cases and 40 deaths.

In comparison, previous studies in Fiji reported 487 cases during a 13-year period from 1969-1981, and 576 cases during an eight-year period from 2000 – 2007 with 40 deaths.

This year alone, the death toll stands at 36 as of May 17. Every year, leptospirosis continues to claim peo­ple’s lives.

Experts argue that Fiji needs a One Health (OH) framework to tackle problems like leptospirosis. OH en­courages multisectoral collabora­tion where effective policies relating to animal, public and environmen­tal health can be formulated.

Such collaboration requires activi­ties that support the community to understand their own environment.

Associate Professor Global Disease Control at the University of Queens­land, Simon Reid, said developing a local strategy that reduced the risk of infection took longer.

“The most immediate thing we can do is reduce the risk of severe dis­ease and death, by educating people to present early to a health care fa­cility,” Mr Reid said.

Mr Reid conducts zoonotic re­search in the Pacific, including Fiji. One of the studies he co-authored explored the possibility for a OH col­laboration for leptospirosis in Fiji.

Brothers Tevita Saukuru (left) and Simione Dusilele, with a photo of their late brother, Marika Lagilolo, at their home in Korobebe Village, Sabeto, Nadi. Photo: Leon Lord

Brothers Tevita Saukuru (left) and Simione Dusilele, with a photo of their late brother, Marika Lagilolo, at their home in Korobebe Village, Sabeto, Nadi. Photo: Leon Lord


Korobebe is about a 40-minute drive from Nadi Town. It is in the in­terior of Sabeto Valley, surrounded by lush green forests, with a river on one side of the village.

The village has 303 registered resi­dents, according to headman Ropate Navilalutu.

Korobebe is blessed with land and a river that provides sustenance. Cattle rearing, raising chickens, pigs, and farming are all part of a day’s work.

Cattle and horses lazing around the village ground is a common sight. It’s the same ground the vil­lage youths use to play rugby.

During the COVID-19 lockdown, Korobebe youths occupied them­selves with games of touch rugby or idle swims in the river.

This would also mean swimming and playing during and after a heavy downpour.



While villagers had heard of the dangerous bacteria that existed in their midst, they lacked the knowl­edge of leptospirosis’ fatal impacts – that is, until the deaths of the two youths.

Leptospirosis is transmitted be­tween animals and humans and occurs indirectly through contact with water, mud or food contami­nated by urine from infected domes­tic animals including cattle, dogs, horses, pigs, or most commonly in Fiji, rodents. Leptospirosis can also be transmitted directly through ex­posure to infected animals.

Mr Navilalutu said Tubuisusu and Lagilolo were experiencing head­ache weeks prior to their death. Villagers had an awareness that something was wrong, and within days of showing severe symptoms of infection.

MOH said the incubation period for a single pathogenic leptospira was five – 14 days (range one – 30 days). But leptospira bacteria can survive in moist soil and mud up to 28 days under the right temperature, Mr Reid said.

“What that means is that soil is po­tentially one of the biggest issues, because if bacteria survive in soil, then the animal might not even be present anymore, because it’s con­taminated the soil,” he said.

“If there’s rainfall, that soil be­comes mud, that’s the transmis­sion to people. So, it’s transmission through water and muddle, or soil, which splashes through the eyes and the mouth, or cuts and abrasion in the skin.”

The Ministry of Health says clini­cal and epidemiological studies have identified males and young adults aged 20-49 years as high-risk groups, most likely related to great­er occupational and recreational exposure to animals, soil, mud, and water. The disease can however in­fect anyone.

Mr Reid said leptospirosis was a burden on Fiji’s health system when there were outbreaks, but not neces­sarily when there were only a few random cases.

Fiji has an estimated annual inci­dence of 39 cases per 100,000 people.

The family of the late Marika Lagilolo are still reeling from their loss. Photo: Leon Lord

The family of the late Marika Lagilolo are still reeling from their loss. Photo: Leon Lord



Tubuisusu and his siblings were usually tasked with taking the cattle out to graze in the nearby pastures every morning and bringing them back every afternoon.

Their cattle were usually tied on the slope close to their compound. Tubuisusu, 17, was to begin Year 9 at Ratu Navula College in Nadi, when school reopened after COVID-19 lockdown in February this year.

But his family’s back-to-school preparations were cut short when the infection took his life. Tubuisu­su died on February 3.

He was the youngest of five male siblings. He lived with his family in a church compound where his father, Josaia Lobau, was pastoring about seven minutes’ walk to the vil­lage. Tubuisusu had only informed his mother about a headache he suf­fered a week before his passing.

The headache had persisted for a week. He also started to develop chills and bloodshot eyes when his family rushed him to the hospital.

His mother, Merewairita Nai, said she was told by the private doctor that he had low pressure, which af­fected his breathing.

Upon the advice of the doctor, Ms Nai took her son to the Nadi Hos­pital. Tubuisusu was quickly put on an oxygen machine. Ms Nai was then informed that her son had an infection in his lungs and needed to be transported to the Lautoka Hos­pital.

“Because his pressure was low, they had to put a tube in him so that it could drain out the blood that was clotted in his lungs,” Ms Nai said.

At this stage, Tubuisusu had a 50 per cent chance of survival, and his parents were then informed he had leptospirosis.

An emotional Ms Nai said her fam­ily didn’t know that leptospirosis would quickly claim her son’s life.

“It was too quick,” she said. Tu­buisusu was a strong and active teenager, she recounted.

Like the other kids in the village, he was always eager to join his peers at the village ground or go for a swim.

“He usually played with the kids without proper shoes, even during bad weather. After a heavy rainfall, the kids would swim even when the river is still dirty.”

The death of Tubuisusu was a wakeup call for the family. They now make it a priority to take extra pre­cautions when out in the farms or carrying out their daily activities.

Kavekini Tubuisusu was 19 years old when he died. He is the brother of Flying Fijian Vilimoni Botitu.

Kavekini Tubuisusu was 19 years old when he died. He is the brother of Flying Fijian Vilimoni Botitu.



Lagilolo died a week after Tubuisu­su’s death. He was 22.

He was a former student at Fiji Na­tional University and returned to the village because of COVID-19.

Lagilolo also suffered similar symptoms as Tubuisusu. He had told his family about his headache just five days before his death.

He was cutting grass at his home on a Monday when he had told his sister-in-law about his head aching.

“I told him to rest and keep eating,” Menani Diwa said.

“He was not himself on Monday and Tuesday. On Wednesday he went up to his mother in the village. His mother was also sick.”

Ms Diwa said when Lagilolo start­ed developing bloodshot eyes, they had to rush him to the hospital the following Thursday.

But it was too late. His breath­ing worsened and his pressure had dropped. Just like Tubuisusu’s fam­ily, his family was informed by the doctors that he had leptospirosis.

“This is the first time people have died of leptospirosis in this village. Kids have always played on the same ground and swam in the same river, no one has ever died,” Ms Diwa said.

A relative, Jone Naveli, said he was still in disbelief because he had suf­fered the same ordeal a few years back. He had developed similar symptoms and had started to devel­op a yellowish skin colour. He said he received treatment at home.

Mr Naveli said he only visited the hospital because he was starting to develop muscle aches and other re­lated symptoms.

Kavekini Tubuisusu’s family (from left) Josaia Lobau (Jnr), Joeli Yabayaba, Kalioni Bere, Merewairita Nai (Mother) with baby Junior, Onisimo Qito, Vilimoni Botitu and Josaia Lobau (Snr). Photo: Leon Lord

Kavekini Tubuisusu’s family (from left) Josaia Lobau (Jnr), Joeli Yabayaba, Kalioni Bere, Merewairita Nai (Mother) with baby Junior, Onisimo Qito, Vilimoni Botitu and Josaia Lobau (Snr). Photo: Leon Lord


Like in Korobebe Village, there are Fijians who are oblivious and even ignorant to the fatal impact of lep­tospirosis.

For this year alone, the cases re­corded in the different divisions in Fiji are as follows:

  • Western Division 858 cases;image 02
  • Central Division 605 cases;image 01
  • Northern Division 367 cases; andimage 03
  • Eastern Division 58 cases.image 04

A health inspector for 10 years said the Western Division was always at risk because it was predominantly an agricultural region and was flood-prone. The health inspector, who spoke on the condition of ano­nymity because he was not allowed to speak to the media, said neglect­ing the advice by the health inspec­tors increased the number of cases.

Minister for Health and Medical Services Dr Ifereimi Waqainabete said statements indicating that the disease was prevalent among iTaukei communities were incor­rect.

“It’s not purely negligence, it’s just the fact that we [people] fail to un­derstand the depth of what source reduction is and if we don’t do it, what it can do to us,” he said.

“People don’t understand that with communicable diseases, people die within a week, within a few days af­ter the incubation period.”

The health inspector said the num­ber of infections had decreased dur­ing the COVID-19 lockdown because there was no movement by the peo­ple, but this changed when the lock­down was lifted.

A senior health official, who is not authorised to speak to the media, said medical officers were advised to be alert for those presenting with symptoms during and after a heavy downpour.

Asked about the impact of climate change on the number of outbreaks over the years, she said: “Climate change is affecting the pattern of the disasters.

Leptospirosis is associated with flooding when there’s a disaster, hence affects the outbreaks.”



Within village perimeters, health officials are tasked with carrying out awareness, including advising against the enclosure of animals such as horses, cattle, and pigs close to the village.

In instances where villagers do not abide by the warning, the village headman is involved, and matters are dealt directly by the Ministry of iTaukei Affairs (MoIA).

The villages and peri-urban settle­ments comprising mainly iTaukei are governed by the by-laws under the iTaukei Affairs Act, adminis­tered by the Ministry of iTaukei Af­fairs.

Despite the by-laws not being for­mally gazetted, there are guidelines that govern the villages.

Deputy chief executive officer for iTaukei Affairs Board Josefa To­ganivalu said if there’s an outbreak in the village, the village headman and community health worker would diagnose the situation before informing the district nurse.

image 05


MOH says leptospirosis is difficult to eliminate, therefore minimisa­tion is the best option for managing risk. One way this is carried out is through awareness about leptospi­rosis and its transmission cycle.

A study titled “A process for devel­oping multisectoral strategies for zoonoses: the case of leptospirosis in Fiji”, indicate that “leptospirosis only receives wide-spread attention in outbreaks when there is media coverage of deaths or a large num­ber of hospitalisations”.

Permanent Secretary for Agricul­ture Vinesh Kumar said the coordi­nation between the line ministries and relevant stakeholders must be strengthened.

Like the sporadic spread of lepto­spirosis, formal engagement among stakeholders to combat the disease seems disorganised.

To effectively address leptospirosis outbreaks, vigorous awareness ac­tivities must be carried out so that communities fully understand the cause and transmission of this dis­ease, and the best preventive meas­ures.

This article is part of Earth Journalism Network’s special collaborative project on One Health and meat in the Asia Pacific entitled “More Than Meats the Eye.” It brings together 8 media outlets from different countries and more than a dozen reporters to cover the impact of meat on animal, human and environmental health in the Asia-Pacific region.


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