Leptospirosis18 1-14

2. LeptospirosisLeptospirosis
An Emerging Infectious DiseaseAn Emerging Infectious Disease
Soumya ranjan parida

3. Synonyms

4. Over View
• First description by Weil in 1886.
• Most common, underdiagnosed zoonosis
• India - cases are reported from Kerala, Tamil
Nadu, AP, Karnataka, Maharashtra, Gujarat &
Andamans.
• Source - Animals (rodents and domestic animals)
Epidemiological factors
• Contaminated environment, Rainfall
• High risk groups, endemic in all states of India

5. Over View continued
• Rural > Urban
• Male > Female (10 : 1)
• Clinical Features –mild to severe life threatening
• Mimics many common febrile illnesses
• Diagnosis - difficult to confirm
• Treatment – effective, if started early (<5 days)

6. EPIDEMIOLOGY
LEPTOSPIRA
HUMAN CONTAMINATED
ENVIRONMENT, RAINFALL
LEPTOSPIROS
IS

8. Leptospira under the Microscope
Long, Thin, Highly CoiledLong, Thin, Highly Coiled
Dark Field Microscopy FLDark Field Microscopy FL

9. Reservoirs of Infection
• Rodents:- Rattus rattus
• Dogs
• Wild animals
• Domestic animals
• Caged game animals
Leptospira are excreted in the urine.

10. Modes of Transmission
1. Direct contact with urine or tissue of infected animal
Through skin abrasions, into mucus membrane
2. Indirect contact
Broken skin with infected soil, water or vegetation
Ingestion of contaminated food & water
3. Droplet infection
Inhalation of droplets of infected urine

11. Transmission

12. HOST FACTOR
Age: Children > Adult
Occupational exposure
•Farmers – Rice, Sugarcane, Vegetables, Cattle, Pigs
•Sewerage workers; Abattoirs, Butchers
•Vetenarians, Lab staff, Miners, Soldiers
•Fishermen – Inland (not on the sea)
Recreational activities
•Swimming, Sailing, Marathon runners, Gardening

13. Environmental Factors
• Rainfall; Contaminated
environment,
• Poor Sanitation; Inadequate
drainage facilities,
• Presence of rodents, cattle &
stray dogs,
• Walking/ working bare foot
poses high risk.

14. PATHOGENESIS
Incubation Period: 10 days(4-20days)

15. Clinical Presentation

16. Anicteric Presentation
Fever
Myalgia
Severe headache
Conjuctival suffusion
Abdominal pain
Epistaxis

17. Icteric Leptospirosis
LIVER
o Jaundice
HEART
o Vascular injury
o Hypotension
o Cardiomyopathy
o Haemorrhagic myocarditis
KIDNEY
o Nephrotoxicity
o Renal failure
CNS
o Meningitis

18. Laboratory Tests
• TC / DC / ESR / Hb / Platelet count
• Serum Bilirubin / SGOT/ SGPT
• Blood Urea, Creatinine & Electrolytes
• Chest X-Ray; ECG
• Tests for diagnosis of Leptospirosis
– Culture for Leptospira & PCR
– MAT; Sero conversion or 4 fold rise/ high titer
– ELISA / MSAT : positive

19. DifferentialDiagnosis

20. Treatment
Oral Treatment 7 to 10 day IV Treatment 5 to 7 days

21. Special Measures

22. Prognosis and Mortality

23. Prevention