Leptospirosis – Weil’s Disease
Leptospirosis is an infectious disease (septicemia) caused by the bacteria spirochete Leptospira.
Leptospirosis primarily affects animals and occasionally infects humans. This bacterial disease spread through the urine of infected animals.
Pathogenic spirochete of the genus leptospira that have two species-
1. Leptospira interrogans and
2. Leptospira Biflexa
Leptospirosis infectious causative organisms carried by many domestic animals and wild animals, most commonly rodents and lives in their kidneys.
Humans get leptospirosis, infected through direct contact with urine from animals or through water, food or soil contaminated with their urine.
Without treatment, leptospirosis can lead to kidney and liver damage and death can occur. Antibiotics treatment clear the infection.
Epidemiological Triad
Agent – The causative agent of leptospirosis is spirochete bacterium Leptospira.
The causative organism is excreted in the urine of infected cattle and rodents and causing soil contamination.
Host – More frequently in males as compare to females. It is high between the age group 20-30 years.
Agriculture workers.
Environment – Contaminated stagnant water by urine of cattles and rodents. Water or soils contaminated by the urine, At onset of rainy season, Occupational exposure; Agriculture workers are at high risk because of exposure to contaminated environment and infected animals such as rodents, cattle, sheep and goat as being reservoir of infection.
Mode of Transmission
1. Contact with environment contaminated by urine of rodents, carriers or infected animals.
2. Contact with urine (or other body fluids, except saliva) from infected animals, coming into contact with the eyes, mouth, nose or broken skin. The bacteria can enter into body through broken, cut, wound, scratch, skin or contact with mucous membranes of eyes, nose, or mouth.
3. Spread through contact with contaminated water, food or soil with the urine of infected animals.
Incubation Period
The incubation period of leptospirosisis usually 5–14 days, with a range of 2–30 days.
Clinical Manifestation
Leptospirosis is typically described under two clinical forms: anicteric laptopirosis and lcteric laptopirosis.
1. Anicteric laptopirosis
Signs and symptoms can range from mild to severe (bleeding in the lungs or meningitis).
Onset is usually sudden and can present with –
1. Fever with chills, rigors
2. Throbbing headache -Increased force or rapidity
3. Cough
4. Non-pruritic rash
5. Muscle pain
6. Painful abdominal and lumbosacral muscles
7. Conjunctival suffusion – Raddish discoloration of conjunctiva
8. Anorexia
9. Diarrhea
10. Acute renal failure
11. Haemorrhage
2. Icteric leptospirosis- Icterohaemorrhagic
Icteric leptospirosis is a severe infection, characterized by multiorgan involvement or even failure. It can involve liver and kidney. If kidney and liver involvement occurred, then the condition kinown as weil’s syndrome.
The clinical manifestation include-
1. On involving Liver
1. Hepatomegaly and tenderness
2. Jaundice
2. On Renal involvement
1. Decreased urine output
4. Oedema on face and feet
3. On involving Lungs
1. Chest pain and cough
2. Blood tinged sputum
3. Tachypnea
4. Crepitation at base of lungs – Abnormal breath sounds (crackles) heard on auscultation only in the bases of the lungs
5. Breathlessness, convulsion, delirium and altered level of consciousness
6. Lung lesions
4. On involving Heart
1. Disseminated intravascular coagulation (DIC) – Causes abnormal blood clotting throughout the body’s blood vessels.
2. Petechiae
3. Purpura
4. G.I bleed
5. Thrombocytopenia – blood platelet count is low
6. Shock
7. Arrythmias
Icteric leptospirosis is a much more severe infection than anicteric leptospirosis form. Mortality rate is high due to pulmonary alveolar haemorrhage.
Leptospirosis – Risk of Exposure
People who work with animals or outdoors occupations or, such as-
1. Farmers
2. Slaughterhouse workers
3. Veterinarians
4. Animal caretakers
5. Dairy farmers
6. Military personnel
7. Mine workers
8. Sewer workers
Lab Diagnosis
1. Blood culture
2. Urine sample
3. CSF sample
5. Serological tests
6. Microscopic Agglutination Test (MAT)
4. Biopsy tissue of kidney or liver
Treatment of Leptospirosis
Leptospirosis disease is commonly treated with antibiotics, such as doxycycline or penicillin.
Patient with more severe symptoms Intravenous antibiotics may be required.
Prevention and Control
1. Early diagnosis and treatment
a. Myalgia
b. Conjunctival suffusion
c. History of contact with animals
Once case are diagnosed, adequate treatment should be given.
The presumptive treatment (treatment administered at the time of testing) is tablet Doxycycline.
All the patient of leptospirosis should be treated with injection Pencillin.
2. Protection against contagious material
3. Vaccination for the cattle
Vaccine such as Leptavoid, Spirovac are used for cattle.
4. Control of rodents
5. Environment sanitation
6. Chemoprophylaxis
Doxycycline is the recommended post-exposure chemoprophylactic agent for leptospirosis.
Leptospirosis – Frequently Asked Questions
1. What is leptospirosis?
Leptospirosis is infection is also known a Weil’s Disease caused by the spirochete Leptospira bacteria, spread through by coming contact the urine of infected animals. Leptospirosis primarily affects animals and occasionally infects humans.
2. What are the causes of leptospirosis?
People become infected through direct contact with urine from animals or through water, food or soil contaminated with infected animal urine.
3. How Leptospirosis transmitted?
Spread through contact with contaminated by urine of rodents, or contact with contaminated water, food or soil with the urine of infected animals or other body fluids, except saliva from infected animals, which contact with the eyes, mouth, nose or broken skin.
The bacteria can get into the body through broken skin, cut, wound, scratch, or contact with mucous membranes of eyes, nose, or mouth.
4. How is Leptospirosis Treated?
Leptospirosis infection is commonly treated with doxycycline or penicillin antibiotics. Patient with more severe symptoms Intravenous (IV) antibiotics may required.
5. Whar are the prevention of Leptospirosis?
Prevention included; Vaccination for the cattle, Protection against contagious material, control of rodents, not swimming in water that may be contaminated with animal urine, Chemoprophylaxis; Doxycycline is the recommended for post-exposure for leptospirosis. Wear protective clothing or footwear when exposed to contaminated water or soil for activities.
6. What are Symptoms of leptospirosis?
Sign andSymptoms of of leptospirosis include; High fever, chills, headache, muscle pain, red eyes, bleeding, vomiting, abdominal pain, Jaundice (yellow of skin and eyes). If leptospirosis is not treated, it may lead to kidney and liver damage.
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