What is leptospira? by – Dr.Anand TiwariDr.Anand Tiwari
What is leptospira?
- It is a bacterial disease, caused by bacteria leptospira, spread through the urine of infected animals
- Most commonly spread through rodents like rats, mice
- Most common in warm climates
- In developing country like India-most commonly affects farmers
- Transmitted by water /soil contaminated by urine of infected animals coming in contact with breaks in skin, eyes, mouth, nose
What are the presenting symptoms?
- Incubation period i.e the time from infection to symptom onset is: 7-12 days
- some infected people may have no symptoms
- disease may occur in 2 phases
- wide range of symptoms from mild to severe
- high fever,headache,chills,muscle aches,vomiting,jaundice,abdominal pain,diarrhea, rash
- after the first phase of above mentioned symptoms –the patient may recover for a time and become ill again
- if second phase occurs-it is more severe, may cause –kidney failure, liver failure or meningitits, and lung hemorrhages
How can one get infected?
- Rats, mice, and moles are important primary hosts
- A wide range of other mammals including dogs, deer, rabbits, hedgehogs, cows, sheep, swine, raccoons, and certain marine mammals carry and transmit the disease as secondary hosts
- Transmitted through contact with water, food, or soil that contains urine from infected animals
- Through swallowing of contaminated food or water
- Can also get transmitted through the skin, mucosal contact
What are the various tests that can be done?
- For the first 7 days, bacteria is detected in Blood & CSF
- After 7-10 days of bacteria detected in Urine
- Diagnosis is confirmed with tests such as enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR)
- MAT (microscopic agglutination test) is considered the gold standard in diagnosing leptospirosis
- kidney function tests and liver function tests may also be deranged
What conditions can mimic leptospirosis?
- dengue fever and other hemorrhagic fevers
- hepatitis of various causes
- viral meningitis
- typhoid fever
- mild forms should be distinguished from influenza and other related viral diseases
What are the preventive measures?
- Effective rat control
- Avoidance of urine contaminated water sources
- During outbreaks in endemic regions-prophylaxis with Doxycycline once a week, with doctors advise is used to minimize the risk of infection
What are available medical therapy?
- Effective antibiotics include
- doxycycline or penicillin
- For more severe cases: cefotaxime or ceftriaxone are preferred antibiotics
- In cases with kidney damage-dialysis may be required
- corticosteroids in gradually reduced doses is recommended by some specialists in cases of severe hemorrhagic effects.
- Administration of organ-specific care and treatment are essential in cases of kidney, liver, or heart involvement.
- other supportive symptomatic treatment is given as required