Leptospirosis Leptospirosis is an acute anthropo-zoonotic infection of worldwide significance caused by spirochaete Leptospira interrogans
What is leptospirosis? Leptospirosis, also known as canicola fever, hemorrhagic jaundice, infectious jaundice, mud fever, spirochetal jaundice, swamp fever, swineherd's disease, caver's flu or sewerman's flu, is a bacterial infection resulting from exposure to the Leptospira interrogans bacterium. There is an acute form of human infection known as Weil's disease, where the patient suffers from jaundice, though this term is often (incorrectly) used to describe any case of infection.. Leptospirosis – A Major Zoonotic Infection Weil's disease is comparatively rare, though 'mild' cases of leptospirosis happen everywhere there are carriers, and it is believed that leptospirosis is one of the most common zoonotic infections in the world. Millions of people are infected each year, but information and treatment can be limited, especially in the developed world where cases are considered 'rare' by the medical community.
Animals spread Leptospirosis Rats, Mice, Wild Rodents, Dogs, Swine, Cattle are principle source of infection The above animals excrete Leptospira both in active infection and Asymptomatic stage o The Leptospira survive and remain viable for several weeks in stagnant water.
What causes Leptospirosis Leptospirosis is a bacterial disease that affects humans and animals. Leptospira bacteria are found worldwide and there are many different types or serovars capable of causing disease. Disease caused by Leptospira bacteria is most common in temperate or tropical climates and appears to be rare in North America.
Pathogenesis Leptospira are present in the water bodies Enter through breaks in the skin ( cuts and abrasions ) and mucous membranes Enters through Mouth – Nose – Conjunctive Rarely enters though ingestion. Incubation period 1 – 2 weeks When multiples blood stream produces fever. May establish organ involvement in Kidney and Liver, May produce hemorrhage and necrosis in the tissues and initiates dysfunction of these organs
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Sequence of Leptospira Infection May present with
and a reduction in the blood&apos.
Hepatitis . signs of kidney damage and liver injury appear. Kidney abnormalities may cause blood in the urine and painful urination. Tissues Microscopic examination 3 Urine to be collected with great care to avoid contamination 4 Serum for agglutination tests
. which leads to bleeding within tissues. stiffness of neck. Serious Manifestation
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May present with Major Complications
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Nephritis Hepatitis.Leptospirosis Kidney involvement in animals produce chronic disease of the kidney and the infected animal starts shedding large number of leptospira and main source of environmental contamination of bacteria and results I human infections o Human urine also contain Spirochetes in the second and third week of infection
Early and Prompt Diagnosis is Highly Essential The development of simpler. stupor.s ability to clot.Hemorrhage Nitrogen retention The Illness is Biphasic with initial temperature when the second phase comes with raise of IgM titers raise o Aseptic meingitis – initial headache. pleocytosis of Cerebro spinal fluid o Presenting with Jaundice is significant and Important.Leptospirosis Hepatitis is the frequent complication Elevation of serum creatine phosphilipae enzyme raise differentiates from Viral hepatitis where the enxyme is not raised
Nephritis .s syndrome is a severe form of leptospirosis that causes a continuous fever. Liver injury tends to be mild and usually heals completely. Blood tests reveal anemia. Manifestations in eye Muscular lesions Many infections are mild and subclinical
Weil’s Syndrome Weil&apos. rapid assays for diagnosis has been based largely on the recognition that early initiation of antibiotic therapy is important in acute disease but also on the need for assays which can be used more widely. By the third to sixth day.
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Specimens 1 Blood to be collected in a heparin tube 2 CSF.
o If the patients are genuinely hypertensive to Penicillin opted with Erythromycin 250mgs four times a day for a period of 5 days.Occupation Certain occupational groups such as agriculture workers in rice and cane fields. as the urine of Rodents chronically infected contaminate water sources Children get infected when in contact with infected Dogs
.ELISA Several Immunoassays are available as commercial kits Detection of IgM and razing titers of IgG will guide in association with clinical history will help in Diagnosis
Treatment Antibiotic of choice is Benzyl Penicillin given by injection in doses of 5 mega units in a day. other materials contaminated with excreta and animal flesh. it has been necessary to supplement such media with a source of fatty acids.
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Agglutinating antibodies raise to very high titers 1 : 10. miners and sever cleaners are potential victims
How Man gets Infected
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Water the great source Drinking Swimming Bathing. for 5 days. In order to obtain the desired rapid and abundant growth of organisms necessary for the efficient production of vaccines.Blood and Urine be cultured in Fletcher’s semisolid agar or other media chemically defined protein-free media for the growth of leptospires have been proposed. o Animal carriers often excrete up to 100million leptospira per ml of urine
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Epidemiology .Other alternatives
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The leptospirosis can be effectively treated with Doxycycline Ampicillin Amoxicillin Severe patients need administration Intravenous Pencillin or Amoxcillin
Epidemiology Leptospirosis causes several animal infections Most wide spread zoonotic infection in Nature Human infections are accidental associated with contamination of water.
Treatment .000 or higher occurs 5 – 10 weeks after onset of infection
Human’s should avoid contact with water contaminated with animal contact. o Animals immunized experimentally with polysaccharide derived from Leptospira LPS linked to diphtheria Toxoid were protected against challenges o Several other vaccines in use to suit local needs. tropical conditions. in military operations. in wet rice planting and harvesting.Control of Leptospirosis
Rodent control is most important. o Yet no universally accepted vaccine is available for humans
Vaccination of Animals Vaccinating animals have a dual purpose 1 Protecting animals 2 Protecting humans who may contract leptospirosis from them It is probably true as that immunization of animals will prevent leptospirosis in people in contact with them.
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Chemoprophylaxis Doxycycline 200 mg orally once a week is simple effective measure. When heavy exposure is anticipated
Vaccination in humans Vaccination for humans is justified where they cannot be separated from animal sources or where the animals cannot be immunized successfully o Necessity of human vaccinated will arise where people live and work in proximity to rodents in wet. or working in sewers. o It proved true in 1980 when extensive vaccination of dairy cows in New Zealand lead to marked decreased incidence in Humans.