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2.  Leptospirosis is a bacterial diseases caused by
Leptospira and transmitted to human being by
urine or through water soil or food contaminated
with urine of infected animal, and most
commonly the animal is a rat.

3.  Leptospirosis affects wild and domestic animals
worldwide especially rodents such as rats, mice
and voles. Most domestic animals including
cattle, sheep, goats, buffalo, pigs and horses may
be infected through grazing in areas
contaminated by the urine of the carrier host.

4.  Leptospirosis is considered to be the most widespread
of the disease transmissible from animal to man. It
has worldwide occurrence except polar regions. It
has high prevalence in warm humid tropical countries.
Out breaks mostly occur as a result of heavy rainfall
and consequent floodings.

5.  The disease is an occupational hazard for rice and
sugarcane fieldworkers, farmers, fish workers miners,
veterinarians, workers in animal husbandry, dairies
and abattoirs, sewer workers, and military troops;
outbreaks occur among those exposed to fresh river,
stream, canal and lake water contaminated by the
urine of domestic and wild animals,

6.  Contact of the skin, especially if abraded, or of mucous
membranes with moist soil, vegetation especially sugarcane
contaminated with the urine of infected animals, or
contaminated water, as in swimming, wading in floodwaters,
accidental immersion or occupational abrasion; direct
contact with urine or tissues of infected animals;
occasionally through drinking of water and ingestion of food
contaminated with urine of infected animals

7.  Common features are fever with sudden onset,
headache, chills, severe myalgia (calves and thighs)
and conjunctival suffusion. Other manifestations that
may be present are diphasic fever, meningitis,
hemolytic anemia, hemorrhage into skin and mucous
membranes

8.  hepatorenal failure, jaundice, mental confusion
and depression, myocarditis and pulmonary
involvement with or without hemorrhage and
hemoptysis. In areas of endemic leptospirosis, a
majority of infections are clinically inapparent
or too mild to be diagnosed definitively.

9.  Clinical illness lasts from a few days to 3 weeks or longer.
Generally, there are two phases in the illness: the
leptospiraemic or febrile stage, lasting 4 to 9 days, followed
by the convalescent or immune phase on the 6 to 12 day.
Recovery of untreated cases can take several months. Deaths
are due predominantly to renal failure, cardiopulmonary
failure and widespread hemorrhage, rarely to liver failure.

10.  The diagnosis is made by isolation of leptospires from
blood during the acute illness and from urine after the
first week.
 Culture takes 1-6 weeks to become positive.
 The IgM ELISA is particularly useful in making an
early diagnosis, as it is positive as early as 2 days.

11.  Leptospirosis is curable by use of antibiotics.
Penicillin is the drug of choice but other
antibiotics (tetracycline or doxycycline) are also
effective. Along with antibiotics symptomatic
treatment is also given such as pain killers and
antipyretics.

12.  (a) VACCINATION : Immunization of farmers and
pets is recommended to prevent disease.
 (b) ENVIRONMENTAL MEASURES : This includes
preventing exposure to potentially contaminated
water, reducing contamination by rodent control and
proper disposal of wastes

13.  (c) HEALTH EDUCATION: Educate the public on modes of
transmission, to avoid swimming or wading in potentially
contaminated waters and to use proper protection when work
requires such exposure.
 (D) PERSONAL PROTECTION: Protect workers in
hazardous occupations by providing boots, gloves and
aprons

14.  CHEMOPROPHYLAXIS- doxycycline (e.g. 200 mg
in one weekly dose for as long as necessary) may be
effective in preventing leptospirosis in exposed
persons in areas of high exposure.
 Other measures include isolation and notification and
early treatment of the patient.

15. By – SURESH KUMAR ( Nursing Tutor )