Leptospirosis or Weils disease is an animal infection caused by a group of bacteria called as “spirocheates”. Rodents and rats are the major reservoirs of the disease and human infections occurs when they come in contact with these infected animals. Human leptospirosis manifests in many forms are widely varied ranging from mild fever to severe disease affecting multiple organs like liver and kidneys that could prove fatal if left untreated.
Transmission
Leptospira Interrogans, the causative bacteria in the “Spirocheates” group enters the human body through breakages in the skin or through intact mucous membranes (like gums, eyes) by direct contact with urine or other tissues of the infected animals.
Another major route of infection is through indirect contact of broken skin with water, soil or other environmental agents contaminated with the urine and faeces of infected animals.
The bacteria shed in the urine and faeces of the infected animals remains in the environmental agents like soil, water for several weeks.
Droplets from infected animals have also been reported as potential infecting agents.
Other examples of animals which can get infected includes domestic dogs, cattle, pigs, buffaloes, goats etc.
Man to man infection is uncommon.
Who are at Risk of Leptospirosis?
People living in warm, humid tropical countries are at higher risk of developing this dangerous disease. They are at increased risk particularly in rainy seasons.
Infection of humans occurs when they come in contact with the urine of infected animals. This can happen in several occupations like agriculture farmers, field workers, underground sewers, veterinarians, meat handlers etc.
In developed countries, persons who are engaged in outdoor activities like trekking, swimming, fishing are the ones who becomes infected the most.
In developing countries where there are no proper waste disposal systems, no adequate drainage systems, the chances of infection are very high.
Symptoms and Signs
Some infected person may have no symptoms at all.
Fever, sever myalgia (muscle pain), sever headache, redness in the conjunctiva, abdominal pain, rashes (occasional) are some of the common symptoms which makes it hard to diagnose clinically. In most of the cases, the disease disappears with these symptoms.
In some persons, the disease can progress to affect the brain, lungs and can produce symptoms like vomiting, high-grade fever, neck stiffness.
Leptospirosis is called as Weils disease when it affects the liver and kidneys. This results in jaundice, fatigue, bleeding manifestations. Other major organs which can be affected in severe leptospirosis are the heart and brain.
Weils disease is a dangerous condition and is associated with high mortality rates. Death usually occurs due to kidney failure and lung involvement.
Diagnosis
Laboratory diagnosis of Leptospirosis is mainly by identifying the bacteria under “dark field” microscopy of the patient’s blood.
Serological tests to detect the bacteria includes the Indirect Haemagglutination Test, Immunoflouroscent antibody tests and the very popular ELISA test (very helpful in early diagnosis)
Microscopic Agglutination Test (MAT) is the gold standard for diagnosing leptospirosis.
Kidney function and Liver function tests have to be done to identify the extent of organ damages.
Treatment
Antibiotics like Penicillin and Cephalosporins are the drug of choice in Leptospirosis. Tetracycline or Doxycyclines are also effective in treating the disease.
Early diagnosis and organ specific medical care is absolutely essential to prevent mortality. Severe cases of kidney failure may need dialysis.
Prevention
Some of the main preventive measures include :
- Rodent control
- Taking steps to prevent occupational exposure to contaminated soil and water.
- Doxycycline given once a week for persons working and living in high risk areas. We distribute Doxycycline to farmers and manual labourers before the onset of monsoon in India as a prophylaxis.
- Doxycycline can be given to travellers who are planning to visit the high risk areas to prevent the deadly disease.
- Proper waste disposal systems can play a valuable role in preventing the disease.
- Educating those persons who are at higher risk of getting infected about the dangers of working with wounds or injuries has been very effective in rural areas.
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Image Credit – CDC Global
