Leptospirosis: Treatment, symptoms, advice and help
Leptospirosis is a serious bacterial infection caused by spirochaetes of the genus Leptospira, which can affect humans and animals. The infection is usually spread by animals and no human to human transmission is yet observed. It is a rare bacterial infection with a good rate of recovery in most of the affected individuals. The disease was first described by Adolf Weil in 1886 and is also called Weil’s disease.
Leptospirosis: Incidence, age and sex
Leptospirosis is a rarely encountered bacterial infection. It can be seen worldwide; however it is more common in tropical and temperate climatic regions. It can affect an individual of any age and gender. Individuals like farmers, paddy field workers, veterinarians and fish workers are more prone to this infection. It is one of the most common zoonotic diseases, favoured by a tropical climate and flooding during the monsoon. Annual rates of infection vary from 0.02 per 100,000 in temperate climates to 10 to 100 per 100,000 in tropical climates. No evidence suggests that leptospirosis affects persons of various races, ages, or sexes differently.
Signs and symptoms of leptospirosis: Diagnosis
The clinical features of Leptospirosis mimics flu like features like fever, chills, headache and muscle pain. Individuals may also complain of dry cough, nausea, vomiting and diarrhoea.
The incubation period averages 1-2 weeks. There is high fever accompanied by weakness, muscle pain and tenderness (especially of the calf and back), tense headache, photophobia and sometimes diarrhea and vomiting. Conjunctival congestion is the only notable physical sign. The illness comes to an end after about 1 week.
The condition usually worsens within few days progressing to skin rashes and jaundice (yellow discolouration of skin and eyes). The appearance of jaundice signifies increased severity of disease. This may also progress to dysfunction of kidneys.
Certain blood tests like complete blood count, liver function tests, kidney function test may help in detecting the condition. Antibodies against offending bacteria are usually found in blood. Definitive diagnosis of leptospirosis depends upon isolation of the organism, serological tests or the detection of specific DNA.
Causes and prevention of leptospirosis
Leptospirosis is caused by different strains of bacteria belonging to genus Leptospira, mainly caused by the organism Leptospira interrogans. The bacteria are transmitted to humans from urine, saliva and droppings of contaminated animals, mostly rodents. Other animals like cattle, dogs, pigs and horses are also involved. The infection cannot be transmitted from human to human. It mainly affects individuals when exposed to fresh water contaminated by infected animals.Leptospires may also enter their human hosts through intact skin or mucous membranes but entry is facilitated by cuts and abrasions. Prolonged immersion in contaminated water will also favour invasion. Leptospirosis is common in the tropics and also among freshwater sports enthusiasts.
Preventive measures like avoiding stagnant water, maintaining proper hygiene, and using protective clothing may help in keeping this serious infection at bay. Prevention is mainly by rodent control and establishment of a proper drainage system. Infection with L. interrogans can also be prevented by taking prophylactic doxycycline 200 mg weekly.
The complications of Leptospirosis are infrequent and occur only when the disease is not managed timely. These complications include damage to kidney and liver. Sometimes meningitis (inflammation of membranes around brain and spinal cord) has also been documented in occasional individuals. Icteric leptospirosis (Weil’s disease) occurs in less than 10% of symptomatic infections. There is fever, hemorrhages, jaundice and renal impairment. Renal failure may occur. Leptospirosis may also be associated with myocarditis, encephalitis and aseptic meningitis. Uveitis and iritis may appear months after apparent clinical recovery.
Leptospirosis can be treated by antibiotic medications like chloramphenicol, erythromycin and penicillin are usually prescribed. These medications can be given either orally or intravenously, depending upon the severity of the disease. Therapy with either doxycycline or intravenous penicillin has been reported to be effective but many not prevent the development of renal failure. Parenteral ceftriaxone 1 g daily is as effective as penicillin .The general care of the patient is also important. Haemorrhage should be treated by prompt blood transfusion. Renal damage caused is reversible and peritoneal dialysis or haemodialysis may be life-saving.