Leptospiroses

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Leptospiroses

  1. 1. Shakera Sadiq Gill
  2. 2.  Weils disease  Acute systemic infections of humans and animals caused by various serovars of Leptospira interogans
  3. 3.  Leptospires are  Motile  Gram negative  Spiral shaped  Terminal hooks
  4. 4.  Fletcher medium is used for culture  Culturing at 28-30o C  The organisms are detected by dark field microscopy
  5. 5. L interrogans serovars Reservoirs Icterohaemmorrhagiae Rat Gripotyphosa Mouse Australis Mouse Pomona Cattle Canicola Dog Hardio cattle
  6. 6.  Worldwide distribution  Prevalent in the tropics  Carried by >100 animal species  Wild animals can also be infected  Excrete large number of leptospires in their urine
  7. 7.  In human population peak incidence is during summer and fall  Agricultural workers  Veterinarians  Breeders  Abattoir workers  Butchers
  8. 8.  People handling meat  Cooks  Dog owners  Hunters  Animal trappers  Sewage workers
  9. 9.  Skin lesions from professional exposure  Swimming or walking with bare feet  Bites of rats, mice, hamsters  Animal urine voided at the time of bite is most likely source of infection  Lesions in the nose, mouth and mucosa are also the portal of entry
  10. 10.  Divers  Swimmers  Canal workers  Leptospiroses also observed after flooding  Adventure tourists
  11. 11.  Leptospires are able to invade any organ  They damage epithelial cells by means of cytotoxic glycoprotein and induce bleeding and ischemic lesions  90% of the infections are self limited nonspecific febrile illnesses
  12. 12.  Incubation period is 5-14 days (range 2-26 days)  Leptospires follow a diphasic course  Bacteremic phase  Immune phase
  13. 13.  Phase of 4-7 days  Sudden bout of fever up to 40oC  Chills  Malaise  Headache  Meningeal irritation  Non productive cough
  14. 14.  Hepatospleenomegaly  Mild jaundice  Abdominal pain  Loss of appetite  Nausea  Vomiting
  15. 15.  In blood  In CSF  Kidneys  Urine  More than 50% of the cases the disease goes into second immune phase
  16. 16.  1-30 days period  Meningitis  Iridocyclitis  Jaundice  Renal failure  Anemia
  17. 17.  Leptospires can also cause miscarriage  Mortality rate ranges from 5-40 %which is due to hepatic or renal failure
  18. 18.  Acute febrile illness  Jaundice  Anemia  Haematuria  Abortion  Mostly asymptomatic
  19. 19.  History including occupational and recreational activities  During first week organism is detected from CSF or urine by culturing on fletcher medium  Guinea pigs and hamsters are used to propagate organism  Microagglutination-lysis is the test of choice for detecting antibodies against leptospires
  20. 20.  ELISA  Diagnosis in animals  Agglutination lysis test
  21. 21.  In first week  Influenza  Salmonellosis  Brucellosis  Malaria dengue  In second week  Hepatitis  Meningitis  Glomerulonephritis
  22. 22.  In severe cases  Pencillin G  Ampicilin  In less severe cases  Amoxicilin should be administered orally for 7 days
  23. 23.  Animals should be treated with tetracycline and streptomycin
  24. 24.  Rat and mouse control  Protective clothing  Water tight boots ,gloves and goggles should be used for high risk population  Walking bare footed and swimming in stagnant should be discouraged  Chemoprophylaxis with doxycyclin is >95 efficacious
  25. 25. End

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