Leptospirosis (Occupational disease) prevention
• Dr.Ashok laddha
• Occupational Health
• MBBS, PGDC ,PGDD,
• Diploma in Workplace
Health and safety. MBAHA(In –Progress)
• Re-emerging infectious disease
• Leptospirosis is a re-emerging zoonotic
infection. In developing countries large
outbreaks have occurred in urban slums and
following floods. Individuals from developed
nations are also now more frequently exposed
to the infection as a result of international
travel and greater participation in certain
outdoor recreational activities.
Primarily occupational disesase
Caused by bacteria
Leptospirosis is distributed worldwide ,but is most common in the tropics.
The mortality rate in severe leptospirosis has been described as ranging
The mild form of the illness is rarely fatal, and an estimated 90% of cases
fall into this category.
Elderly and immune-compromised people are at the highest risk of
Most cases are self-limiting and unreported, underreported, or even
misdiagnosed, the true incidence is difficult to determine.
The incubation period of leptospirosis is usually 5–14 days, with a range of
• The disease was first described by Larrey in 1812 of fièvre
jaune among Napoleon's troops at the siege of Cairo.
• A little over 100 years ago, Adolph Weil published his
historic paper describing the most severe form of infection
that would be later known as Weil disease.
• n 1907, special staining techniques were used to confirm
that a spirochete was responsible for this illness
• In October 2010 British rower Andy Holmes died after
contracting Weil's Disease. His death has raised awareness
of the disease among the public and medical professionals
• It was also reported among troops at Gallipoli and other
battles of World War I,
The following areas and/or countries/continents are known to have the highest
incidences of leptospirosis:
South East Asia, and Southern Russia.
Cases of infection are also reported in the following tourist hotspots: New Zealand,
Australia, Hawaii, and Barbados.
After flooding, large outbreaks of leptospirosis may occur.
According to WHO (World Health Organization), approximately 10 million people
are thought to come down with leptospirosis annually.
• By infected urine of animals
• Transmitted by infected blood and body fluid
in slaughter home worker
• Human can get infected by water ,food or soil
containing urine by infected animal
• Leptospirosis is common among water-sport
enthusiasts in specific areas as prolonged
immersion in water promotes the entry of the
Occupation at risk
Occupations at risk include
sewer maintenance workers,
waste disposal facility workers,
And people who work on derelict buildings.
Survivors of natural disasters (e.g., flooding)
people engaging in recreational water sports (swimming, etc)
• Rodent-first recognized carriers of leptospirosis and
are considered the primary source of infection to
• Cattle, buffaloes, horses, sheep, goat, pigs and dogs
are also considered common reservoirs of the
bacteria that causes leptospirosis.
• Leptospirosis is a BIPHASIC DISEASE begins
with flu like syndrome (Fever,chills, Intense
• first phase resolves, and the patient is briefly
asymptomatic until the second phase begins
• Red eyes,Diarrohea,Rash
• Pulmonary symptoms
Symptoms-Severe Form( Heart, kidney ,liver affected)
Irregular heartbeat, often accelerated heartbeat
Muscle pains Nausea
Pain in the chest
The hands, feet or ankles swell
Unexplained weight loss
Yellowing of the whites of the eyes, tongue and
Symptoms-Severe Form with
• blotchy rash appears on the skin. When a glass is
pressed against it, it does not change color or fade
• Confusion or disorientation Drowsiness
• Fits (seizures)
• High fever, Nausea
• Photophobia (sensitivity to light) Problems with
• Stiff neck
• The patient is unable to speak
• Aggressiveness, or unusual behavior
• Microbiologic identification :
• Blood or CSF first 10 days Urine second
week (Fletcher’s, EMJH Medium)
• Serology: screening
• detection of IgM (ELISA)
• Leptospirosis can be treated with antibiotics that should be
given as early in the course of illness as possible.
• If you have symptoms of leptospirosis and have been
exposed to water potentially contaminated with urine of
infected animals, consult a doctor.
• If leptospirosis is suspected, appropriate antibiotics will be
• Treatment is most effective when started as soon as
• Clinicians should never wait for the results of laboratory
tests before starting treatment with antibiotics.
• In uncomplicated cases the oral Doxycycline is
• In hospitalized patient the Penicillin G is the
drug of choice
• In sever form the third-generation
cephalosporin are as effective as penicillin G
• Doxycycline is the drug
of choice for above cause
• Wearing protective clothing (boots, gloves, spectacles, aprons, masks).
• Covering skin lesions with waterproof dressings.
• Preventing access to, or giving adequate warning about water bodies
known or suspected to be contaminated (pools, ponds, rivers). Try to
avoid wading or swimming in potentially contaminated water.
• Washing or showering after exposure to urine splashes or contaminated
soil or water.
• Washing and cleaning wounds.
• Avoiding or preventing urine splashes and aerosols, avoiding touching ill
or dead animals, or assisting animals in giving birth.
• Strictly maintaining hygienic measures during care or handling all
• Where feasible, disinfecting contaminated areas (scrubbing floors in
stables, butcheries, abattoirs, etc.).
• Consuming clean drinking-water.
Take home message
• RODENT Control
• Avoid stagnant water
• Use of PPE
• "an ounce of prevention is worth a pound of