LEPTOSPIROSIS IN ENGLISH

                                            

                                LEPTOSPIROSIS IN ENGLISH

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LEPTOSPIROSIS-

}  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.

}  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.

}  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.

}  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,

MODE OF TRANSMISSION-

}  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

SIGN AND SYMPTOMS-

}  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

}  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.

}  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.

DIAGNOSTIC INVESTIGATIONS-

}  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.

TREATMENT-

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

PREVENTION-

}  (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

}  (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

}  (E) 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.


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