Leptospirosis Weil's Disease - Treatment, Diagnosis, Prevention

Leptospirosis Weil's Disease - Treatment, Diagnosis, Prevention

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Leptospirosis is an acute infection, primarily of rodents but can be acquired by man.

It has a worldwide distribution and is common in swimmers who swim in contaminated waters. The contamination takes place due to the urine of infected rodents or domestic and wild animals. It is an occupational hazard for rice field workers, sugarcane field workers, sewer workers, farmers, miners, veterinarians and military troops stationed in old barracks.

The causative organism of this infection belongs to the leptospiro group of organisms. There are many serotypes and more than eighteen of these can cause the disease in rodents and man. Leptospirosis spreads through farm animals, cats, dogs, pigs, wild animals like foxes, skunks, deer, raccoons, as also reptiles and frogs. The urine of infected animals carries the organisms and this can contaminate water used by man. The germ gains entry through abraided injured skin or mucous membrane.

The incubation period for the germ causing leptospirosis varies from three days to three weeks.

In milder forms this infection may resemble the common flu or influenza. In more severe forms its onset is sudden with an abrupt rise of temperature, rigors, severe headache, muscular pains, nausea, vomiting, gastro-intestinal disturbances and worst of all jaundice. The fatalities which occur are more often in the jaundice cases. The kidneys may get involved giving rise to haematuria (blood in urine).

Minor cases recover within two to three weeks whereas severe cases take longer. In cases where meningitis occurs, the mortality rate is fifteen per cent. Jaundice carries the same risk. Rare cases may have cardiac involvement or myocarditis.

Routine investigations for fever will show a very high white cell count; anaemia of a severe degree is detected. The platelet count falls. Urine analysis shows protein in urine.

The diagnosis is based on culture of the organism from blood or the cerebrospinal fluid and in later stages from urine. A specific ELISA test is also diagnostic.

A number of antimicrobial drugs are used. Penicillin, streptomycin, tetracycline, chloramphenicol and erythromycin have been used with varying degrees of success.

Doxycycline given early in the course of the disease shortens its course and is also highly successful as a preventive treatment in endemic areas.

Those who suffer liver or kidney failure have to be specifically looked after for adequate water and electrolyte balance. In liver damage exchange transfusion has been used to combat the high bilirubin levels and in kidney failure, dialysis.

(Drugs mentioned above to be taken on medical prescription only.)

• Rodent control in human habitation and in warehouses and farms during the harvest season.

• Segregation of domestic animals and prevention of contamination of living, working and recreational areas of man from the urine of infected animals.

• Vaccination of farm and pet animals.

• Swimming-pools must be checked for contamination.

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