LEPTOSPIROSIS

Leptospirosis is a bacterial disease that affects humans and animals. It is caused by bacteria of the genus Leptospira. In humans, it can cause a wide range of symptoms, some of which may be mistaken for other diseases. Some infected persons, however, may have no symptoms at all.

Without treatment, Leptospirosis can lead to kidney damage, meningitis (inflammation of the membrane around the brain and spinal cord), liver failure, respiratory distress, and even death.

The bacteria that cause leptospirosis are spread through the urine of infected animals, which can get into water or soil and can survive there for weeks to months. Many different kinds of wild and domestic animals carry the bacterium.

These can include, but are not limited to:

  • Cattle
  • Pigs
  • Horses
  • Dogs
  • Rodents
  • Wild animals

When these animals are infected, they may have no symptoms of the disease.

Infected animals may continue to excrete the bacteria into the environment continuously or every once in a while for a few months up to several years.

Humans can become infected through:

  • Contact with urine (or other body fluids, except saliva) from infected animals.
  • Contact with water, soil, or food contaminated with the urine of infected animals.

The bacteria can enter the body through skin or mucous membranes (eyes, nose, or mouth), especially if the skin is broken from a cut or scratch. Drinking contaminated water can also cause infection. Outbreaks of leptospirosis are usually caused by exposure to contaminated water, such as floodwaters. Person to person transmission is rare.

Leptospirosis can cause a wide range of symptoms, including:

  • High fever
  • Headache
  • Chills
  • Muscle aches
  • Vomiting
  • Jaundice (yellow skin and eyes)
  • Red eyes
  • Abdominal pain
  • Diarrhea
  • Rash

Many of these symptoms can be mistaken for other diseases. In addition, some infected persons may have no symptoms at all.

The time between a person’s exposure to a contaminated source and becoming sick is 2 days to 4 weeks. Illness usually begins abruptly with fever and other symptoms.

Leptospirosis may occur in two phases:

  • After the first phase (with fever, chills, headache, muscle aches, vomiting, or diarrhea) the patient may recover for a time but become ill again.
  • If a second phase occurs, it is more severe; the person may have kidney or liver failure or meningitis. This phase is also called Weil’s disease.

The illness lasts from a few days to 3 weeks or longer. Without treatment, recovery may take several months.

DIAGNOSIS

Doctors make a presumptive diagnosis based on the patient’s history and physical exam. Only specialized labs perform serological tests for leptospirosis. Health-care professionals may perform definitive tests by isolating the bacteria from the patient (blood or CSF) or by a positive microscopic agglutination test (MAT). Other tests (ELISA, PCR, urine dipsticks) may provide additional evidence of infection. Patients with severe symptoms should be treated as confirmatory tests are time consuming.

 

TREATMENT

Leptospirosis is treated with antibiotics, such as doxycycline or penicillin, which should be given early in the course of the disease.

Intravenous antibiotics may be required for persons with more severe symptoms. Persons with symptoms suggestive of leptospirosis should contact a health care provider.

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