Multiple factors cause rise in communicable disease cases

Kochi: Kerala reported the highest number of fatalities due to communicable diseases in comparison to other states in the country. According to Union govt data, Kerala with a population of about 3.34 crore reported 332 deaths due to communicable diseases from Jan 2021 to Dec 3, 2024. In contrast, Maharashtra, with a population of over 10 crore, reported 331 deaths during the same period.
In Kerala, as per Union govt data, leptospirosis caused the most number of deaths at 103. However, state govt data shows that 220 people died of leptospirosis in 2024 alone. Meanwhile, state govt data pertaining to communicable diseases indicates that the reported cases and deaths are based on preliminary reports and are liable to change after lab tests and death audits.
A senior public health official said a major reason for the rise in the number of communicable disease cases is due to the geographical and climatic conditions of the state. "Kerala has high vegetation and water bodies where host agents of the infection proliferate, making it difficult to control. Besides, the density of the population in the state is high. In contrast, in other states or in north India, community living is limited to areas kilometres apart. Hence, an infection will be contained in that community only and will not spread to other areas," said the officer.
"Another factor is that disease resistance is coming down due to rising comorbidities caused by change in our lifestyle. We lost our innate immunity due to the rise in living standards. We cannot compare Kerala's health system with other states in India," he added.
"Earlier, there were no dengue fever, chikungunya and H1N1 infections in Kerala. Now those infections have become permanent and endemic to Kerala due to favourable climatic conditions. Rise in deaths due to leptospirosis is a reflection of the vulnerable population, including those coming in contact with polluted water not using doxycycline tablets despite it being distributed to them. Besides, the patients don't seek timely treatment, making their condition worse," said the officer.
Experts in the field said that the high number of deaths in Kerala is due to better reporting of infections and case finding as compared to other states in the country.
"Kerala has a well-oiled healthcare system built over decades reaching all the way to the grassroots level. In any society, the reported cases are only a fraction of the true disease burden in the population. Due to efficient detection and reporting, that fraction is relatively high in Kerala. Social determinants also affect the eventual reporting of cases. Importantly, people in Kerala, across all strata of society, have access to healthcare. Awareness, empowerment, literacy and self-sufficiency of women also contribute to successful reporting of health-related cases," said Dr Rajeev Jayadevan, convener of IMA research cell, Kerala.