Leptospirosis: Causes, Phases, Transmission, Symptoms, Risk Factors, Diagnosis, Treatment, Complications and Prevention

Leptospirosis is a rare bacterial infection we can acquire from animals. It is transmitted via the urine of animals, particularly dogs, rats, and farm animals. They could have been suffering from the condition but do not exhibit any symptoms.

Leptospirosis, like the flu, usually causes discomfort but poses little danger to life. The duration is at most a week. However, patients with a severe form of leptospirosis will occasionally recover and then will get sick again. This condition is referred to as Weil's disease, and it can result in much more severe issues like chest pain, arm, and limb edema. It's common to be needed to be hospitalized when suffering from leptospirosis.

Causes Of Leptospirosis

The bacteria Leptospira interrogans is responsible for leptospirosis. Many animals carry the organism, which resides in the kidneys of those animals. Through their urine, it finds its way into the land and water.

The bacteria can enter the body through holes in the skin, including scratches, open wounds, or dry patches, if you come into contact with dirt or water that has been urinated on by an infected animal. The nose, mouth, or genitalia are other entry points. 

If you spend a lot of time outdoors or near animals, you have the risk of becoming ill. If you work one of these jobs, you'll probably encounter it more frequently:

• Farmer
• Veterinarian
• Working underground (in a mine or a sewer)
• Worker in a slaughterhouse
• Military personnel
• Additionally, the disease can be acquired if you camp, swim, or float close to infected lakes and rivers.

Warm climates are where leptospirosis is more prevalent. The bacteria is widespread around the planet, but it is particularly prevalent in Australia, Africa, Southeast Asia, Central and South America, and the Caribbean.

What Are The Phases Of Leptospirosis?

There are two phases of leptospirosis: the leptospiremic (acute) phase and the immune (delayed) phase. You might just have a few minor symptoms or none at all during the leptospiremic phase. Some people report having serious symptoms during the immunological phase.

Leptospiremic phase

When in the leptospirosis phase, also known as the septicemic phase, you may suddenly experience flu-like symptoms. After a Leptospira infection, this often starts two to fourteen days later. It covers a period of time between three and ten days.

To reach your organs at this stage, bacteria must travel through your circulation. Blood testing can identify the signs of an infection.

Immune phase

The immunological phase allowed Leptospira bacteria to travel from the blood to organs. The majority of the bacteria is in the kidneys, which also create urine. So the blood will have anti-Leptospira antibodies, and a urine test will show signs of the presence of the bacterium.

Few Weil's syndrome patients will experience significant illness at this time. internal bleeding, renal damage, and severe jaundice (yellowing of the skin and eyes) are all symptoms of Weil's syndrome.

How Is Leptospirosis Transmitted?

Usually, the bacteria Leptospira found in animal poop is what causes leptospirosis in humans. Leptospirosis can affect nearly any creature, including rats, dogs, horses, pigs, and cows. They could exhibit minimal or no symptoms of a disease.

Leptospirosis-infected animals can contaminate water or soil, which distributes the bacterium to other animals or people. Leptospirosis can be transmitted by:

• Direct contact with the feces or other bodily fluids of an animal that has leptospirosis.
• Getting contaminated water or soil in your eyes, nose, mouth, or through a skin break.
• Following significant rainfall and flooding, a large number of people may suddenly develop leptospirosis (an outbreak). Floodwaters carry germs with them as they wash into rivers, lakes, and canals.

Rarely may one individual transmit leptospirosis to another.

Symptoms Of Leptospirosis

Leptospirosis symptoms can vary in nature and intensity.

Mild leptospirosis could result in:

• Fever
• Coughing
• Headache
• Musculoskeletal pain, particularly in the calves and lower back
• A rash without itching that mostly affects the shins and can cause rhabdomyolysis
• Diarrhea
• Vomiting
• Chills
• Reddish coloration of the eye
• Abdominal pain

Severe leptospirosis symptoms include:

• Jaundice 
• Renal failure
• Liver failure
• Bleeding
• Respiratory problems
• Heart arrhythmia
• Myocarditis with aseptic meningitis

The person with the illness typically takes between one and two weeks to start exhibiting symptoms, but it could take up to a month.

Risk Factors For Leptospirosis

Risk factors of leptospirosis include:

• Reside in temperate or tropical regions, respectively.
• Work with animals, such as dairy farmers or veterinarians, work outside, like mine or sewer employees, kayak or swim in polluted bodies of water, camp outside, or partake in outdoor activities
• Have a garden or otherwise deal with potentially polluted soil issues, reside in areas with flooding or low sanitation

Diagnosis Of Leptospirosis

Diagnosis of  leptospirosis can be done by  using the methods listed below:

• Past Medical History- This will help your doctor evaluate your risk and rule out other illnesses.
• By Using Blood Tests- Your doctor can suggest blood tests to screen for leptospirosis antibodies, your kidney and liver function, and your total blood count.
• Microscopic Agglutination Test. This test is the most reliable method of determining leptospirosis. In your blood serum, leptospirosis antibodies are analyzed.
• Lumbar Puncture-  Your cerebral spinal fluid is tested during a lumbar puncture to look for meningitis symptoms.

Treatment Of Leptospirosis

The appropriate course of action is dependent on the severity. Options include

• Management of fluid intake and fever.
• Being well-hydrated
• Obtaining sleep 
• Utilizing over-the-counter painkillers

Antibiotics

Drugs called antibiotics are made to kill dangerous microorganisms. For leptospirosis treatment, the following antibiotics are used:

• Doxycycline
• Azithromycin
• Penicillin (for severe cases) in addition to amoxicillin
• Ceftriaxone (For serious conditions) 

Antibiotics may be injected intravenously in cases of severe leptospirosis.

Other medical procedures

You will need to be admitted to the hospital if your leptospirosis is severe. This is due to the fact that severe instances damage many organs.

You might need additional medical interventions at the hospital, depending on your clinical state and its severity, like:

vasopressors (medications to support blood pressure), mechanical breathing during dialysis.

Complications Of Leptospirosis

With treatment, leptospirosis can become milder. But if unattended, it could have negative effects such as:

• Liver failure and meningitis
• Kidney damage
• Breathing difficulties
• A shock caused by the hemodynamic collapse
• Fetal death in expectant Mothers
• In extreme cases, it might even cause death.

Prevention Of Leptospirosis

Avoiding exposure to the bacterium is the best strategy to prevent leptospirosis. Here are some tips for preventing the illness:

To avoid getting leptospirosis, follow  the following advice:

• Avoid swimming in freshwater bodies of water, such as rivers or streams, that may contain animal feces.
• When there has been a lot of rain or floods, stay out of the water.
• Do not enter floodwater or swim there.
• Boiling water first will treat hazardous water.
• Control the population of mice and rats.
• When working with contaminated soil or water, put on protection gear or wear shoes.
• Wear protective attire or footwear if you work with animals.

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