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    Leptospirosis: Symptoms, Causes, Treatment And Prevention

    Leptospirosis is a type of infection caused by Leptospira bacteria [1] . The corkscrew-shaped bacteria that cause the rare type of bacterial infection is spread to human beings through animals, especially rodents. The bacteria pass from animals to human beings, when one comes in contact with the animal urine. One can contract the infection through any cut or opening in the skin.

    The infection can be caused by several species of the Leptospira genus. It is not limited to human beings but can also affect animals. Although comparatively rare, leptospirosis is one of the most common infections transmitted by animals to humans[2] . The infection can also be transmitted when the animal urine comes in contact with the mucous membrane or the eyes.

    leptospirosis

    The water-borne bacterial disease can be transmitted by both domestic and wild animals. Studies have revealed that leptospirosis is commonly found in underdeveloped or developing countries. And the infection is reported among farmers and low-income communities [3] . In the case of developed countries, leptospirosis is found in individuals who are engaged in outdoor activities. The infection does not spread from one individual to the other, although there have been very few reports on the bacteria spreading from one person to another. It is considered to be weakly contagious[4] .

    In some cases, the bacterial infection can elevate to severe levels - resulting in the development of Weil's disease. It is the severe form of leptospirosis and can be fatal [5] .

    Symptoms Of Leptospirosis

    The signs of bacterial infection usually appear suddenly. It appears within a period of 5 to 14 days after you contract the Leptospira bacteria. However, it can develop within anywhere between 2 to 30 days after the infection. In some cases, the infection can be mild, whereas in others it can be severe. And, the symptoms of both the severe and mild condition vary[6] .

    In the case of mild leptospirosis, the symptoms include [7]

    • fever and chills,
    • jaundice,
    • coughing,
    • red and irritated eyes,
    • headache,
    • muscle pain, particularly on the lower back and calves,
    • rashes, and
    • diarrhoea, vomiting, or both.

    The symptoms of mild leptospirosis usually disappear within a period of seven days, without any treatment. However, about 10% of the cases elevate to severe leptospirosis.

    Severe leptospirosis develops within a few days after the symptoms of mild leptospirosis have subsided or disappeared. The symptoms are dependent on the internal organs involved. The symptoms can result in respiratory distress, liver or kidney failure and even meningitis.

    If the leptospirosis affects the heart, kidneys and the liver, the symptoms will be [8]  [9]

    • muscle pain,
    • nosebleeds,
    • chest pain,
    • fatigue,
    • unexplained weight loss,
    • poor appetite,
    • irregular, often fast, heartbeat,
    • swelling of the hands, feet, or ankles,
    • nausea,
    • jaundice, seen in a yellowing of the whites of the eyes, tongue, and skin, and
    • panting.

    When left untreated, the symptoms can lead to kidney failure[10] .

    If leptospirosis affects the brain or the spinal cord, it can cause meningitis or encephalitis. The symptoms include[11]

    • vomiting,
    • stiff neck,
    • aggressive or unusual behaviour,
    • high fever,
    • confusion or disorientation,
    • drowsiness,
    • fits or seizures,
    • problems with physical movements,
    • nausea,
    • photophobia or sensitivity to light, and
    • inability to speak.

    If the infection affects the lungs, the symptoms will include [12]

    • high fever,
    • panting,
    • difficulty breathing, and
    • coughing up blood.

    Causes Of Leptospirosis

    One gets affected by the bacterial infection on coming in contact with water, vegetation or wet soil that has been contaminated by the urine of the affected animals. The common carries of the Leptospira bacteria are rodents (mice and rats), pigs, cattle, dogs and horses [13] .

    The infection spreads through bacteria, transmission (drinking contaminated water, unhealed cuts, eyes or nose etc.) and at-risk occupations [14] such as farmers, sewer maintenance workers, veterinarians, slaughterhouse workers, sailors on rivers, waste disposal facility workers etc.

    Diagnosis Of Leptospirosis

    It is difficult to examine and understand leptospirosis in the initial or mild stage as the symptoms are similar to that of the flu or infections. The mild leptospirosis will cure by itself in a period of seven days. If the doctor suspects severe leptospirosis, you will be required to undergo some tests [15] .

    Blood tests will be carried out to detect the presence of antibodies for the bacteria. The other tests include

    • Enzyme-linked immunosorbent assay (ELISA)
    • MAT (microscopic agglutination test) which is a serological test, and is considered the gold standard in diagnosing leptospirosis
    • Polymerase chain reaction (PCR)

    Apart from the tests, the doctor will ask you certain questions to examine and understand whether the condition is really leptospirosis.

    The doctor will ask if you have[16]

    • had any contact with activities that occurred in a slaughterhouse, or relating to animal care,
    • been swimming in a lake, pond, canal, or river,
    • had any contact with animal urine or blood.

    Apart from these, urine tests will also be done [17] .

    Treatment For Leptospirosis

    In order to manage the signs and symptoms of the condition, effective antibiotic therapy can be applied as the treatment method. The medicines used for leptospirosis are ampicillin, azithromycin, ceftriaxone, doxycycline, and penicillin[18] .

    Individuals suffering from severe leptospirosis will have to get admitted in the hospital to get further treatment, as the symptoms can elevate to conditions such as kidney failure, meningitis or encephalitis [19]  [20] .

    Complications Of Leptospirosis

    If left untreated, the bacterial infection can result in the development of life-threatening conditions [21] .

    • It can lead to kidney failure, liver failure, or heart failure.
    • In some extreme cases, the condition has resulted in death.
    • It can lead to Weil's disease.

    Prevention Of Leptospirosis

    You can always adopt the following measures to limit the onset of the infection [22] [23] .

    • Washing and cleaning wounds.
    • Wearing protective clothing such as boots, gloves, spectacles, aprons, masks etc. 
    • Consuming clean drinking water. 
    • Covering skin lesions such as cuts or wounds with waterproof dressings.
    • Avoiding wading or swimming in potentially contaminated water bodies. 
    • Washing or showering after exposure to contaminated urine or contaminated soil or water.
    • Avoiding touching ill or dead animals, or assisting animals in giving birth.
    • Strictly maintaining hygienic measures during care or handling animals.
    • Disinfecting contaminated areas such as scrubbing floors in stables, butcheries, abattoirs, etc.
    • Controlling pests such as rodents.
    • Ensuring that dogs have a vaccination against leptospirosis.
    View Article References
    1. [1] Faine, Solomon.Leptospira and leptospirosis. CRC Press Inc., 1994.
    2. [2] Bharti, A. R., Nally, J. E., Ricaldi, J. N., Matthias, M. A., Diaz, M. M., Lovett, M. A., ... & Vinetz, J. M. (2003). Leptospirosis: a zoonotic disease of global importance.The Lancet infectious diseases,3(12), 757-771.
    3. [3] Adler, B., & de la Peña Moctezuma, A. (2010). Leptospira and leptospirosis.Veterinary microbiology,140(3-4), 287-296.
    4. [4] Ko, A. I., Reis, M. G., Dourado, C. M. R., Johnson Jr, W. D., Riley, L. W., & Salvador Leptospirosis Study Group. (1999). Urban epidemic of severe leptospirosis in Brazil.The Lancet,354(9181), 820-825.
    5. [5] Vinetz, J. M., Glass, G. E., Flexner, C. E., Mueller, P., & Kaslow, D. C. (1996). Sporadic urban leptospirosis.Annals of internal medicine,125(10), 794-798.
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    15. [15] Yang, C. W., Pan, M. J., Wu, M. S., Chen, Y. M., Tsen, Y. T., Lin, C. L., ... & Huang, C. C. (1997). Leptospirosis: an ignored cause of acute renal failure in Taiwan.American Journal of kidney diseases,30(6), 840-845.
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