Leptospirosis is a potentially serious condition triggered by the Leptospira bacteria. The condition occurs in several wild and domestic animals including dogs and rats. Some animals serve as carriers and pass on the bacteria in their urine. Humans acquire these infections directly from infected animals or indirectly via soil or water contaminated by urine from an infected animal.
This is considered as an occupation condition affecting farmers and those who work in slaughterhouses and sewers. Nevertheless, some are infected while engaging in outdoor activities when they come in contact with contaminated water or soil especially while swimming.
Indications of leptospirosis
In most cases of infected individuals, the symptoms of leptospirosis are not serious. A small percentage of cases might affect several organs. This is a potentially deadly form of leptospirosis called as Weil syndrome.
The condition typically occurs in 2 phases:
- Initial phase – about 2-20 days after infection occurs, symptoms such as headache, fever, sore throat, chills and severe muscle aches in the back and calves abruptly occur. The eyes can become reddened on the 3rd or 4th day. Some might cough, occasionally bringing up blood along with chest pain. Many usually recover within a week.
- Second (immune) phase – in some individuals, the symptoms recur after a few days. This is due to inflammation triggered by the immune system as it eliminates the bacteria from the body. The fever returns while the tissues that cover the brain and the spinal cord are often inflamed. This inflammation triggers headache and stiff neck.
In case leptospirosis develops during the early phase of pregnancy, the risk for miscarriage is heightened.
What is Weil syndrome?
This form can develop during the second phase. It results to jaundice, bleeding tendency and kidney failure. The individual might have nosebleed or cough up blood or bleeding can occur within tissues in the lungs, skin and even the digestive tract.
Anemia might even develop. Various organs such as the lungs, heart and the kidney might cease to function.
Those who do not develop jaundice can recover. Approximately 5-10% of cases with jaundice or those over the age of 60 are at risk for death. The risk for death is high if changes in mental function, respiratory failure, kidney failure and internal bleeding occur.
Prevention
The antibiotic doxycycline is used to prevent leptospirosis. It is usually given orally once a week to those who are likely to be exposed to the bacteria particularly those who live in or travel to an area where an outbreak is occurring.
Management
The mild infections are managed using antibiotics such as doxycycline or amoxicillin that are taken orally. As for severe infections, antibiotics such as ampicillin or penicillin are administered intravenously. Fluids that contain salt might also be given.
Those who have the infection do not require isolation but proper care must be taken while handling and disposing of the urine. Those who have Weil syndrome might require blood transfusions and hemodialysis.