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) Leptospirosis is a worldwide zoonotic disease caused by bacteria called leptospires, Leptospira interrogans. Rat is the main host to leptospirosis although pigs, cattles, rabbit, hare, skunk and other wild animals can also severe as reservoir hosts. It affects veterinarians, miners, farmers, sewer workers, abbatoir workers, etc. Etiologic agent: Leptospira interrogans – fine spiral bacteria 0.1 urn in diameter and 6-20 urn in length. Appears straight with 1 or both ends hooked. Locomotion is achieved in a fluid medium by a whirling motion around the longitudinal axis and by a serpentine or corkscrew motion in semisolid medium. Incubation Period: Ranges from 7-19 days, with average of 10 days. Mode of Transmission: through contact of the skin, esp. open wounds with water, moist soil or vegetation contaminated with urine of infected host. Signs and Symptoms Clinical manifestations are variable with different degrees of severity. It has two Clinical Phases: 1. Leptospiremic phase – leptospires are present in the blood and Cerebro Spinal Fluid (CSF). Onset of signs and symptoms are abrupt with fever, headache, myalgia, nausea, vomiting, cough and chest pain. 2. Immune phase – correlates with the appearance of circulating IgM Diagnosis The diagnosis of leptospirosis is made by culture of the bacterial organism Leptospira from infected blood, spinal fluid, or urine. However, many doctors must rely upon rising Leptospira antibody levels in the blood in order to make the diagnosis, as the technique required to perform the culturing is delicate and difficult. Treatment The treatment of leptospirosis involves high doses of antibiotics. Antibiotic treatment (doxycycline, penicillin) is most effective when initiated early in the course of the illness. Severely ill patients may need hospitalization for IV fluid and antibiotic treatment. Severe liver and kidney manifestations of the infection may require intensive medical care and sometimes dialysis treatment. However, even in severe cases, liver and kidney function often does return after recovery from the illness. Mortality rates for severe illness with leptospirosis can range from 5%-40%, depending on the severity of organ dysfunction and the patient's general health prior to infection. Most previously healthy patients will make a full recovery. A vaccine for leptospirosis is available and used in Europe and Asia. It must be given every year like a flu shot. It is not currently available in the United States. Travelers who are going to an area where leptospirosis is common and who will be engaged in activities that increase likelihood of exposure, can take 200 mg of doxycyline per week by mouth starting before and during the time period of potential exposure.
INFLUENZA Etiologic Agent: Influenza Virus A. aches or pains in the back and limbs with prostrations. Mode of Transmission By direct contact. B. or by articles freshly soiled with discharge of nose and throat of infected person. Susceptibility. through droplet infection. It is. Period of Communicability: Probably limited to 3 days from clinical onset. • Infection produces immunity of unknown duration to the type and subtype of infecting virus. still reportable in some states. Public Health Nursing Responsibilties • . Methods of Prevention and Control • Education of the public as to sanitary hazard from spitting. Airborne. usually 24-72 hours. • Occurrence is variable. sore throat and cough. often unrecognized by reason of indefinite clinical symptoms. Incubation Period: Short. glasses and eating utensils. sneezing and coughing. however. • Avoid use of common towels. in local epidemics and as sporadic cases. in pandemics. chilly sensation or chills. but it was removed from the national CDC list of reportable diseases. Resistance and Occurrence • Universal but of varying degrees as shown by frequent unapparent and typical infection during epidemics. Source of Infection: Discharges from the mouth and nose of infected persons Description Acute highly communicable disease characterized by abrupt onset with fever which last 1 day to 6 days. most notably Hawaii.Leptospirosis was a reportable disease in the United States. C. Respiratory symptoms include coryza. • Active immunization with influenza vaccine provided prevailing strain of virus matches antigenic component of vaccine.