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Leptospirosis

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WHAT IS LEPTOSPIROSIS?

Abstract

VOL: 100, ISSUE: 25, PAGE NO: 33

 

WHAT IS LEPTOSPIROSIS?
- Leptospirosis is a disease caused by leptospira bacteria that can be transmitted to humans by contact with the urine of rats, cattle, foxes, rodents, and other wild animals.

 

 

- Leptospirosis is common in tropical regions but is also found in temperate areas, including the UK.

 

 

- There are two main types of leptospirosis in the UK:

 

 

- Weil’s disease - a serious and sometimes fatal infection that is transmitted by contact with the urine of infected rats;

 

 

- The Hardjo form of leptospirosis that is transmitted by cattle.

 

 

- Infection with leptospirosis is usually through contact with water, food, or soil that contains urine from infected animals. This contact can either be through ingestion or contact with the skin, especially the mucosal surfaces.

 

 

WHO IS AT RISK?
- People exposed to rats, rat or cattle urine, or to foetal fluids from cattle.

 

 

- Farmers are a major risk group.

 

 

- Other at-risk groups include vets, meat inspectors, butchers, abattoir and sewer workers.

 

 

- People in contact with canals, lakes, and rivers through work or leisure activities are also at risk.

 

 

SYMPTOMS AND DIAGNOSIS
- The incubation period is between two days and four weeks, and illness can last from a few days to three weeks or longer.

 

 

- Without treatment, recovery may take several months.

 

 

- Leptospirosis causes a wide range of symptoms, although some patients may be asymptomatic.

 

 

- Symptoms include:

 

 

- High fever;

 

 

- Arthralgia;

 

 

- Splenomegaly;

 

 

- Severe headache;

 

 

- Sore throat;

 

 

- Chills;

 

 

- Muscle aches;

 

 

- Vomiting;

 

 

- Jaundice;

 

 

- Red eyes;

 

 

- Abdominal pain;

 

 

- Diarrhoea;

 

 

- Mental disturbance;

 

 

- Rash.

 

 

- If untreated, it can lead to kidney damage, meningitis, liver failure, and respiratory distress. In rare cases the disease is fatal.

 

 

- Diagnosis is made by clinical suspicion and history of exposure, and is confirmed by laboratory testing of a blood or urine sample.

 

 

- Leptospirosis is a notifiable disease.

 

 

PREVENTION AND TREATMENT
- Leptospirosis is treated with antibiotics, such as doxycycline or penicillin, which should be given early in the course of the disease.

 

 

- People with severe symptoms may need IV antibiotics.

 

 

- No effective human vaccine is available in the UK.

 

 

- The risk of infection can be reduced by avoiding swimming or wading in water that may be contaminated with animal urine.

 

 

- Protective clothing or footwear should be worn by those exposed to contaminated water or soil because of their job or recreational activities.

 

 

- Hands should be washed after handling animals or contaminated clothing or other materials, and always before eating, drinking or smoking.

 

 

- Doxycycline (200mg weekly) can be effective for people who may be at high risk for short periods, especially through their occupation.

 

 

- General preventative advice includes taking measures to reduce rodent populations, such as clearing rubbish and preventing rodent access into buildings.

 

 

- Existing cuts or abrasions should be covered with waterproof dressings before possible exposure.

 

 

- Any cuts or abrasions received during activities should be thoroughly cleaned.

 

 

- Showering as soon as possible after immersion in surface waters is recommended.

 

 

WEBSITE
NHS Direct: www.nhsdirect.nhs.uk

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