Leptospirosis is a bacterial disease spread by infected animals like cattle, pigs, and rodents. It has affected over 600 people in Kerala since January 2018, killing 30. It is caused by bacteria called Leptospira interrogans found in infected animal urine. People can get infected when the bacteria enter breaks in skin or mucous membranes. Symptoms include fever, headache, muscle pains and jaundice. It is diagnosed through blood or urine tests and treated with antibiotics. Preventive measures include proper sanitation, killing rats, and avoiding contact with contaminated soil or water.

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Shemil
Clinical instructor
DM WIMS
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Leptospirosis

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Leptospirosis is caused by bacteria belonging to the
genus Leptospira.
It is a zoonosis – an animal disease that can spread to
humans – affecting domestic and wild animals such as
cattle, dogs, cats, pigs, and rodents.
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In Kerala
From Jan 2018 to Aug /28/2018
665 peoples are diagnosed to have leptospirosis(146
in Aug)
30 people had died since Jan 18
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Other names
 7-day fever,
 Harvest fever
 field fever
 Canefield fever
 Mild fever
 Rat catcher's yellows
 Fort Bragg fever
 Pretibial fever
 (RAT Fever / RAT BITE FEVER is not Leptospirosis)
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History
The disease was first described by Adolf Weil in
1886 when he reported an "acute infectious
disease with enlargement of spleen, jaundice,
and nephritis

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Causes
 Leptospirosis is caused by a bacterium
called Leptospira interrogans.
 The organism is carried by many animals(cattle, dogs,
cats, pigs, and rodents ) and lives in their kidneys. It
ends up in soil and water through their urine.
 Up to 13 different genetic types of Leptospira may
cause disease in humans

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If you’re around soil or water where it contaminated
with Leptospira, the germ can invade your body
through,
 Breaks in your skin like scratches/ open wounds
Nose.
Mouth.(also contaminated food/water)
Eyes.
 Genitals.

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Human to Human transfer of Leptospirosis.
It’s hard to get it from another human, though it
can be passed through,
 sex
Breastfeeding
Mother to fetus

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What Happens after infection
 After infection, leptospires appear in the blood and
invade practically all tissues and organs.
 They are subsequently cleared from the body by the
host’s immune response to the infection.
 They may settle in the convoluted tubules of the
kidneys and be shed in the urine for a period of a few
weeks to several months and occasionally even longer.
 They may persist in the eyes for much longer.

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The incubation period is usually 7–10 days, with a
range of 2–30 days
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Signs & Symptoms
In about 90% of infected people, leptospirosis symptoms
are not serious and potentially fatal form of leptospirosis
is called Weil syndrome.
•Leptospirosis usually occurs in two phases:

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First phase: About 5 to 14 days after infection occurs.
Fever
Headache
 Sore throat
Severe muscle aches in the calves and back
Chills occur suddenly.
The eyes usually become very red on the third or
fourth day.(conjunctival suffusion )
 Cough blood, and have chest pain.
Most people recover within about 1 week.

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Conjuctival suffusion
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Second (immune) phase: In some people, symptoms
recur a few days later. (weil syndrome)
 The fever returns
Meningitis
Jaundice
 kidney failure
Epistaxis
Hemoptysis
Pulmonary haemorrhage with respiratory failure
Bleeding may occur within tissues in the skin, less
commonly, digestive tract.
Anemia can develop.

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Diagnosis
• Careful assessments of the history of the patient.
• Culture studies of,
 Blood
 Urine (after 10 days)
 CSF
• RFT
• LFT
• PCR(polymerase chain reaction)
• ELIZA (presence of IgM)

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• CBC
• MAT-Microscopic agglutination test ( Determination
of antibody tite)
• Doctors suspect leptospirosis when characteristic
symptoms occur in people where an outbreak is
occurring.

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Treatment
1.Antibiotics
 Penicillin G
 Ampicillin
 Amoxicillin
 Doxycycline.
2.In more severe cases,
 Cefotaxime
 Ceftriaxone
3. IV fluids

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 Dialysis is used in serious cases.
 Elevations of serum potassium are common and if the
potassium level gets too high special measures must
be taken.
 Serum phosphorus levels may increase to
unacceptable levels due to kidney failure.
 Administration of corticosteroids in gradually
reduced doses (e.g., prednisolone) for 7–10 days is
recommended by some specialists in cases of severe
hemorrhagic effects.
 Organ-specific care and treatment are essential in
cases of kidney, liver, or heart involvement

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Prevention
 Kill/Control Rats.
 Enviourmental and personal hygiene.
 Wash hands with soap and water after contacting
with animals.
 Avoid contacting water with open wound or
abrasions or use boot and rubber gloves.
 Take preventive measures in the epidemic areas.
 Drink boiled water
 Cover foods and water and eat warm foods/water

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Oral administration of doxycycline – 200 mg once-
weekly can give short-term protection in high-risk
environment

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