LEPTOSPIROSIS

Weil’s Disease/ Canicola Fever/ Hemorrhagic Jaudice/ Mud Fever/ Swine Herd Disease

LEPTOSPIROSIS

It is a zoonotic infectious bacteria disease carried by animals, both domestic and wild.

Infected urine contaminates water or food, which causes disease when ingested or inoculated through the skin

It is an occupational disease affecting veterinarians, miners, farmers, sewer workers and abattoir workers. Etc.

ETIOLOGIC AGENT

A spirochete of the genus Leptospira (Leptospira interrogans)

These are chiefly saprophytic aquatic organism which are found in the river and lake waters, sewage, and in the sea.

There are 150 serotypes divided among 18 serogroups; some species are pathogenic to man and animals

Weil’s disease is specifically caused by the serovar icterohaemorrhagiae.

RESERVOIR HOSTS

Rats – main host of leptospirosis Pigs Cattles Rabbits Hare Skunk

INCUBATION PERIODThe incubation period varies from six to fifteen days.

PERIOD OF COMMUNICABILITYLeptospira is found in the urine between 10-20 days after disease onset.

SOURCE OF INFECTION

Contaminated food and water Infected wildlife and domestic animals,

especially rodents Rats (L. icterohaemorrhagiae) are the source of

weil’s disease frequently observed among mine, sewer and abattoir workers.Rats (L. bataviae) are also the source of infection that attacks ricefield workers.

Dogs (L. Canicola) can also be the source of infection among veterinarians, breeders and owners of dogs.

Mice (L. grippotyphosa) may also be a source of infection that affects farmers and flax workers.

MODE OF TRANSMISSION

Leptospirosis is transmitted through ingestion or contact with the skin or mucous membranes of infected urine or carcasses of either wild or domestic animals

The disease can be transmitted through the mucous membranes of the eyes, nose and mouth, and though breaks in the skin.

Leptospira enters the blood to cause damage, and thereafter, in the kidneys, the liver, meninges and conjunctivae.

MODE OF TRANSMISSION

Leptospirosis can also be transmitted by the semen of infected animals.

Leptospirosis is common among watersport enthusiast in certain areas such as prolonged immersion in water is known to promote entry of bacteria.

Occupations at risk include veterinarians, slaughter house workers, farmers, and sewer workers.

Human-to-human transmission is rare.

CLINICAL MANIFESTATION

The symptoms range in severity from asymptomatic to fatal.

Clinical course is generally biphasic and the majority of cases are inicteric.

Three septic stages can be recognizeda. Septic stageb. Immune or toxic stagec. convalescence

a. Septic stage

This stage is marked by febrile lasting from 4-7 days. There is an abrupt onset of remittent fever, chills, headache, anorexia, abdominal pain and severe prostration. There is also respiratory distress. Fever subsides with lysis.

b. Immune or toxic stage

This stage can be with or without jaundice, and lasts for 4 – 30 days. Iritis, headache, meningeal manifestations

like disorientation, and convulsion, with CSF findings of aseptic meningitis.

Oliguria and anuria with progressive renal failure.

Shock, coma, and congetive heart failure are also seen in severe cases. Death may occur between the 9th and 16th days.

c. Convalescence stage

At this stage, relapse may occur during the 4th and 5th weeks.

Pathogenesis

Cattle, swine, and other livestock

Rodents and wild animals

Dogs

Contact with contaminated water and soil. Entry through the eyes, mouth and broken skin

MAN

PathophysiologyLeptospir

aEnters the mouths, eyes, or broken skin

Multiplies in the bloodstream

Invades the liver Enters the kidneyInvades the eyes Affect the muscle

Jaundice conjuctivitis

Presence of organismcauses inflammation

of the nephrons and tubular necrosis

Renal failure

Pain and sometimes edema

LABORATORY DIAGNOSIS

BUN and creatinine Enzyme-linked immunosorbent assay

( ELISA) Liver function test

AST ALT GGT

Leptospira antigen-antibody test (LAAT) Lesptospira antibody test (LAT)

COMPLICATIONS

Meningitis Respiratory distress Renal interstistial tubular necrosis that

results in renal failure (Weil’s disease) Cardiovascular problem

MANAGEMENT

MEDICAL MANAGEMENT

Treatment of leptospirosis is geared toward: Suppressing the causative agent Fighting possible complications

Aetiotropic drugs – penicillin, doxycycline, ampicillin, amoxicillinFor prophylaxis, doxycycline 100mg p.o. every 12 hours for 1 week

Peritoneal dialysis Administration of fluid and electrolytes

and blood, as indicated.

NURSING MANAGEMENT

Isolate the patient; urine must be properly disposed of.

Darken the patient’s room because light is irritating to the patient’s eyes.

Observe meticulous skin care to ease pruritis.

Keep clients under close surveillance.

NURSING MANAGEMENT

Keep homes clean. Regularly replace water in pools, aquaria, etc. to prevent stagnation.

Eradicate rats and rodents Provide health education

on the modes of transmission of the disease.

Encourage oral fluid intake.

PREVENTION AND CONTROL

Sanitation in homes, workplaces and farms is a must.

There is a need for proper drainage system and control of rodents ( 40-60% infected)

Animals (cattle, dogs, cats and pigs) must be vaccinated.

Infected humans and pets should be treated.

Information dissemination campaign must be conducted effectively.

THE END

Thank you!

God

bless! Have A nice day!

Prepared by:A.S.G., SN4