Leptospirosis - Symptom, Treatment And Causes

Pathogenic spirochetes belonging to the genus Leptospira cause an infectious ailment in animals and humans, known as leptospirosis. It is believed to be the commonest zoonosis of the world and is linked to rodents in poor sanitation settings, agricultural occupations and recently with adventure sports involving mud, fresh water or soil.

The life cycle of leptospirosis can be described as follows:

• Stage 1: the bacterium enters the body of the host through damaged skin, conjunctival membranes, and lungs. This bacterium is very capable of penetrating through the skin. Once the bacterium reaches within the host then it can reproduce as they can do it in body temperatures. The survival bacterium depends on the lack of an adequate immune response from the body of the host.
• Stage 2: After surviving in the host body it migrates towards the lymphatic system and the bloodstream. It spreads throughout the body of the host within no time.
• Stage 3: One or more species can maintain the bacteria in a conducive environment. Through the urinary shedding. They have a very short lifespan so they cannot get clinically ill. The best example of this can be a reservoir.
• Stage 4: It can survive in several environments for an extended time which can last for months or years. This leads to the reinfection of the animal host.
  • It appears within 1 to 2 weeks of the infection.
  • It can sometimes be fatal in some cases.
  • Through the urinary shedding.

For the survival of leptospirosis in the environment, moisture is an important factor.

• If a person suffers from the condition of leptospirosis then it is the result of the indirect or direct exposure to the urine of the infected animal.
• The other modes of transmission can be inclusive of infected animal tissue and consuming food and water that is contaminated.
• The bacteria can also enter the body of the human through the abrasions and the cuts as well on the skin.
• In some of the rare cases, it might also enter the body of the person by inhaling the droplets of urine.
• As the person gets infected it appears in the blood and invades all the organs and the tissues. This bacterium mostly settles in the convoluted tubes of the kidney. It is passed in the urine for a period ranging from some months to several years. They can be transmitted from one human to another, but happens very rarely.

There is a sudden appearance of signs and symptoms of leptospirosis. It appears within 1 to 2 weeks of the infection. Although the incubation period varies from 2 to 30 days. Signs and symptoms with which a person might suffer from are:

• A person might experience fever and chills.
• There may be coughing on the part of the person.
• A person might experience severe headaches.
• A person may develop jaundice.
• There may red and irritated eyes along with a rash on the skin.
• There may be muscle pain specifically in the calves and the lower back.

The majority of the people recover within a week without receiving any treatment, however, only 10 percent develop the condition of severe leptospirosis.

The condition of leptospirosis is caused by a bacterium known by the name of Leptospira interrogans. It is an organism that is carried by several animals and it lives in their kidneys. It can be found in the soil and water through the urine of the animals. Thus, if a person is around any water or soil wherein an infected animal had urinated then it is highly possible that the bacteria can infect the body of the person by invading through the skin from the open wounds and scratches.

A person can also get infected if the bacterium enters through the genitals or mouth, and nose. It is difficult to get it from other humans however, it can be passed while having sex. A person is at an increased risk of this condition if he/she is surrounded by the animals most of the time.

Treatment begins in patients with compatible symptoms. The standard for serologically identifying leptospires is only done by reference laboratories. Convalescent serum and paired acute specimens might give a delayed confirmation in the diagnosis. Oral doxycycline shows decrease in the fever’s duration and major symptoms in simple infections which don’t need hospitalization. Patients undergoing hospitalization for leptospirosis respond best with penicillin G doses. Supportive therapy along with supervised management of hematological, renal, hepatic and CNS (central nervous system) involvements, is require for those affected with a serious leptospirosis form (Weil disease).

Antibiotic therapy for treating mild leptospirosis is generally not required as it is usually self-limiting and resolves in most cases without requiring medical attention. Orally taken antibiotics reduce the duration of illness and most importantly shorten and reduce the excretion of leptospires through urine. Prophylactics can be used for an epidemic setting. If used, antibiotics might be needed and the treatment might include:

• Doxycycline
• Amoxicillin or ampicillin
• Clarithromycin or azithromycin
• Fluoroquinolones like levofloxacin or ciprofloxacin

Patients having severe leptospirosis may need careful management for hepatic, renal, CNS and hematological complications and also supportive therapy. In case of renal failure, early start of peritoneal dialysis or hemodialysis might decrease mortality rates by almost two thirds. Inotropic agents, ophthalmic drops or diuretics are all included in extra supportive care.

The majority of the people who develop this infection in the severe form require hospitalization. It can sometimes be fatal in some cases. The process of recovery from the condition of leptospirosis can be very slow. A person suffering from this condition would experience chronic fatigue like illness which can last for several months. Some people might experience persistent headaches or experience depression. In some of the rare cases, there may be an infection in the eye as well as leading to chronic inflammation of the eye.

A person can prevent himself from getting infected with leptospirosis by doing the following things:

• If a person is living in a developing country then drink the water only if you are sure that it is clean. As the bacterium which causes this condition can enter through the body openings, a person should avoid swimming and waterskiing and fishing.
• The main carriers of the bacterium are the rodents. In western countries, nearly twenty percent of the rats carry it. It can also be carried by the farm animals as well.
• A person should be aware of the surroundings while traveling as this condition is most prevalent in the countries where sanitation is a problem.
• A person should use disinfectant for cleaning up as bleach, iodine, Lysol, and acid solutions are very effective in killing the bacterium.