Causative Agent Incubation Period Mode of Transmission Clinical Manifestations Diagnosis and Treatment Nursing Management

 Also called as Weils Disease, Mud Fever, Trench Fever,

Flood Fever, Spiroketal Jaundice, Japanese Seven Days Fever  It is a worldwide zoonotic disease caused by bacteria leptospires.  Rat is the main host to leptospirosis although pigs, cattles, rabbits, hare, skunk and other wild animals serve as reservoir hosts.  It is an occupational disease affecting veterinarians, miners, farmers, sewer workers, etc.

 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

circulation IgM.

 Leptospira interrogans – gram negative, fine spiral

bacteria 0.1um in diameter and 6-20 um in length. Locomotion is achieved in a fluid medium by a whirling motion around the longitudinal axis and by a serpentine or corkscrew motion in a semisolid medium.

 Ranges from 7-19 days, with average of 10 days.

 Entry of the leptospira bacteria
 through wounds when in contact  with flood waters, vegetation,  moist soil contaminated with the  urine of infected animals,  especially rats.

 Fever

 Non-specific symptoms of muscle pain, headache
 Severe cases result to liver involvement, kidney failure

or brain involvement. Thus some cases may have yellowish body discoloration, dark-colored urine and light stools, low urine output, severe headache.

 By presenting clinical manifestations

 Culture
 Blood and CSF examination during the first week  Urine examination on the 10th day

 Antibiotics duly prescribed by a physician.
 Penicillins and other B- lactam antibiotics (PCN at 2M

units q6H IM/IV)  Tetracycline (Doxycycline at 100mg q12H PO)  Erythromycin (500mg q12H PO) – if allergic to Penicillin
 Early recognition and treatment within two days of

illness to prevent complications of leptospirosis, so early consultation is advised.

 Provide education to clients telling them to avoid

swimming or wading in potentially contaminated water or flood water.  Use of proper protection like boots and gloves when work requires exposure to contaminated water.  Drain potentially contaminated water when possible.

 Control rats in the household by using rat traps or rat

poison, maintaining cleanliness in the house.  Isolate the patient and concurrent disinfection of soiled articles.  Report all cases of leptospirosis.  Chemoprophylaxis can be done in a group of high risk infected hosts.

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