LEPTOSPIROSIS

LEPTOSPIROSIS

What is it?
This is bacterial illness which affects humans as well as animals, caused by bacteria of the genus “Leptospira”, a spirochete (helical-shaped organism)

How do people get it?
The offending microorganism is spread through the urine or body fluids (but not the saliva) of infected animals, which usually include cattle, pigs, dogs horses, rodents and even other wild animals, which occasionally may become sick themselves. Infected animals may continue to excrete the bacteria into the environment continuously or intermittently for a few months, even years. The bacteria can enter the body through the skin (particularly if broken by a small cut or scratch) or the mucous membranes of the mouth, nose or eyes. Drinking contaminated water can also cause the infection. Outbreaks are common after exposure to contaminated water after flooding. The microorganism is capable of surviving for weeks to months in the soil or contaminated water. Person to person transmission is rare.

Where is it found?
It occurs worldwide but more commonly in temperate or tropical climates. It can be an occupational hazard to many people who work outdoors with animals and has also affected campers, swimmers and those engaged in whitewater rafting in contaminated waters.

How long between exposure and appearance of symptoms?
This interval is known as the “incubation period” and can vary from 2 to as many as 28 (but usually 7-14) days.

What are the symptoms?
It may as well as may not cause symptoms. It usually occurs in two distinct phases or stage: in its first phase, it usually begins abruptly with fever, chills, headaches plus muscle pains. Conjunctival vascular injection (bloodshot eyes) usually occurs during the 3rd. or 4th. day). The fever is spiking and lasts 4-10 days and then falls. The second phase usually occurs between the 6th-12th days, with a reappearance of the fever and chills. Liver or kidney involvement and meningitis may complicate the picture and even lead to death. If liver involvement occurs, jaundice usually develops (caused by the destruction of red cells in the blood vessels), in which case the disease is also known as “Weil’s disease”, which may well be complicated by kidney failure.

How is it diagnosed?
Seek medical help as soon as possible. A discussion of diagnostic methods is beyond the purpose of this publication.

What is the treatment?
Patients with this condition must seek competent medical attention as soon as suspected, for even though it can be treated with either oral or IV antibiotics (doxycycline or ampicillin), its management is outside the realm of public or a “friendly pharmacist’s knowledge”.

How long does it last?
Anywhere from 3 to 21 days or a bit longer, depending on complications, if any. Without treatment, it may take months to fully recover from it.

How dangerous is it?
Chances of a full recovery are good if no jaundice develops. Once it does (Weil’s disease), the mortality goes up to 5-10%, higher if the patient is over 60 and/or has other complicating medical issues.

Is there a way to prevent this?
There are measures one can observe to avoid or minimize exposure, like:

- washing all cans before consuming the contents.
- avoid walking or wading barefoot into flood waters.
- avoid swimming in suspect or flood waters.
- wear protective rubber gloves or footwear if handling suspicious material or having to go into flooded areas.
- avoid contact with pet’s urine.

Hope this helps someone.

Rafael G. Belliard, MD