Leptospirosis is a bacterial infection that affects both people and animals. When an unhealed skin breach comes into touch with water or soil containing animal urine, it can spread from animals to people.
Leptospirosis is caused by bacteria belonging to the Leptospira genus. It can lead to life-threatening illnesses like Weil’s disease or meningitis.
Normally, the condition does not spread from one individual to another.
Open wounds, eyes, and mucous membranes are all places where germs can enter the body. Rats, skunks, opossums, foxes, and raccoons are among the animals that may spread the infection to people.
Leptospirosis is more frequent in tropical areas, where it affects 10 or more people in every 100,000 each year. according to the World Health Organization (WHO).
It affects between 0.1 and 1 per 100,000 people in temperate regions. It can impact 100 or more people per 100,000 in an outbreak.
Traveling to tropical locations puts you at a higher risk of becoming sick.
Causes
Raccoons, bats, sheep, dogs, mice, rats, horses, cattle, buffaloes, and pigs can all carry the Leptospira bacteria.
The bacteria live in the kidneys of the animals and are expelled through urine, contaminating the soil and water supplies.
The bacteria may live for months in the soil or water.
Symptoms
Leptospirosis signs and symptoms generally occur rapidly, 5 to 14 days after infection. According to the CDC, the incubation period can last anywhere from 2 to 30 days.
Leptospirosis (mild)
Mild leptospirosis has the following signs and symptoms:
- a fever and chills
- a rash
- red and irritated eyes
- jaundice
- coughing
- diarrhea, vomiting, or both
- headache
- muscle pain, particularly lower back and calves
The majority of people recover without therapy within a week, but around 10% develop severe leptospirosis.
Severe leptospirosis
After moderate leptospirosis symptoms have faded, signs and symptoms of severe leptospirosis will develop.
The symptoms differ depending on whether crucial organs are affected. Kidney or liver failure, respiratory distress, and meningitis are all possible outcomes. These are potentially lethal.
The heart, liver, and kidneys
If the heart, liver, or kidneys are affected by leptospirosis, the person will suffer the following symptoms:
- panting
- poor appetite
- swelling of the hands, feet, or ankles
- unexplained weight loss
- jaundice, seen in a yellowing of the whites of the eyes, tongue, and skin
- fatigue
- irregular, often fast, heartbeat
- muscle pains
- nausea
- nosebleeds
- pain in the chest
This can progress to life-threatening kidney failure if not treated.
The brain
Meningitis, encephalitis, or both may occur if it affects the brain or spinal cord.
Meningitis is an infection of the membrane that surrounds the brain and spinal cord, while encephalitis is an infection of the brain tissue. The indications and symptoms of both conditions are identical.
These may include the following:
- stiff neck
- inability to speak
- vomiting
- aggressive or unusual behavior
- confusion or disorientation
- drowsiness
- fits or seizures
- high fever
- nausea
- photophobia, or sensitivity to light
- problems with physical movements
Meningitis or encephalitis that goes untreated can cause catastrophic brain damage and even death.
The lungs
If the lungs are affected, the person will be unable to breathe.
The following are some of the signs and symptoms:
- coughing up blood
- panting
- high fever
There may be so much blood that the victim suffocates in severe cases.
Types
Leptospirosis is divided into two types.
Mild leptospirosis is the most common kind of leptospirosis, accounting for 90% of cases. Muscle pain, chills, and even a headache are some of the symptoms.
Severe leptospirosis: Severe leptospirosis can develop in between 5% and 15% of patients. If the bacteria affects the liver, kidneys, or other important organs, it can cause organ failure, internal bleeding, and death.
According to the Centers for Disease Control and Prevention (CDC), persons suffering from serious sickness have a death rate of 5 to 15%.
Leptospirosis is less likely to develop severe if it is treated well and promptly.
Those who are already unwell, such as with pneumonia, children under the age of five, and those who are older are more prone to acquire severe leptospirosis.
Who is in danger?
Leptospirosis is more frequent in tropical climates, however it may also be found in impoverished regions of big cities in developing parts that are not tropical.
According to the WHO, the danger is increased during periods of heavy rain and flooding.
The bacteria thrives in hot, humid environments. It tends to be sporadic rather than constantly present.
Leptospirosis is more common in the following people:
- the Andes and tropical Latin America
- East Sub-Saharan Africa
- South and Southeast Asia
- Australia
- the Caribbean and Central America
New Zealand, Australia, Hawaii, and Barbados are among tourist areas where leptospirosis can be found.
Flooding makes an outbreak more likely. Leptospirosis may become more widespread if climate change causes more flooding around the world.
Leptospirosis in the United States
According to the CDC, 100 to 150 cases occur in the United States each year, with the majority occurring in Puerto Rico and Hawaii. In 1998, 775 people were exposed, which was the highest number of instances.
Those most at risk in countries with developed infrastructure, such as the United States, are:
- abattoir workers and meat handlers
- those involved in recreational water sports, such as sailing or canoeing
- military personnel
- sewage workers
- farm and agricultural workers who have regular contact with animals or infected water or soil
- pet shop employees and veterinarians
Because of good health care, death rates in wealthy countries are substantially lower than in poorer countries.
Treatment
Antibiotics, such as doxycycline or penicillin, may be prescribed in moderate cases.
Patients with severe leptospirosis will require hospitalization. Antibiotics will be administered intravenously.
Depending on which organs are affected by leptospirosis, the patient may require a ventilator to assist them breathe.
Dialysis may be required if it damages the kidneys.
Intravenous fluids can help with hydration and nutrition.
Hospital stays might last anything from a few weeks to months. This is mostly determined by the patient’s response to antibiotic treatment and the extent to which the infection has damaged their organs.
The fetus can be affected by leptospirosis during pregnancy. Anyone who contracts the infection while pregnant will need to stay in the hospital for observation.
Diagnosis
Early-stage, mild leptospirosis is difficult to identify since the symptoms are similar to those of the flu and other common illnesses.
If a doctor detects severe leptospirosis, the patient may be subjected to additional testing.
There are a variety of tests to choose from. Tests may need to be repeated in some circumstances to validate the findings.
Any recent travel, particularly to locations where leptospirosis is common, will be brought up by the doctor.
They might inquire if the individual:
- may have had contact with animal urine or blood
- has had contact with any activities that occurred in a slaughterhouse, on a farm, or relating to animal care
- has been swimming in a lake, pond, canal, or river
Leptospirosis can be confirmed or ruled out using a variety of blood and urine tests.
Leptospirosis is a disease that must be reported in the United States. If a person’s diagnosis confirms an infection, the doctor must notify the appropriate health authorities.
Prevention
Several methods can help lower the risk of contracting leptospirosis, particularly for people whose leisure or job activities put them at risk.
Water sports: In non-tropical, industrialized countries like the United States, the risk of leptospirosis is quite low, thus most people don’t need to avoid them.
Those who participate in watersports as part of a vacation adventure or who swim in freshwater on a regular basis, however, should exercise caution.
One thing to remember is to cover any skin cuts with a waterproof dressing.
This can help prevent you from infectionslike hepatitis A and giardiasis.
It is a good idea to shower properly after swimming in fresh water.
Working with animals or potentially contaminated water or soil requires protective apparel and adherence to local and national rules and regulations.
Gloves, masks, boots, and goggles may be required.
People traveling to places where leptospirosis is common should take the following precautions:
- Clean and cover any skin wounds with a waterproof dressing.
- Drink only water that is boiled or from a sealed bottle.
- Avoid swimming in fresh water.
Disaster response: Antibiotics may be used as a preventive measure for emergency workers or military personnel in disaster zones.
Other suggestions
Other ways to avoid contracting leptospirosis include:
- avoiding wading, swimming, or other contact with rivers, streams, and lake water, especially after flooding, or shower at once after exposure
- avoid contact with or consuming anything that has been in contact with flood water
- avoiding drinking water from rivers and lakes unless it has been boiled or chemically treated
- ensuring that dogs have a vaccination against leptospirosis
- controlling pests, especially rodents
- washing hands with soap and water after handling animals and animal products
- avoiding touching dead animals with bare hands
- cleaning all wounds as soon as possible and covering them with waterproof dressings
- wearing protective clothing at work, if appropriate
Transmission
People can occur as a result of:
- the eyes, nose, or mouth coming into contact with contaminated water or soil
- less commonly, contact with the blood of an infected animal
- drinking contaminated water
- unhealed cuts or wounds that come into contact with contaminated water or soil
Infection is rarely transmitted between humans, however it can happen during sexual intercourse or breastfeeding.
Sources:
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574773/
- https://www.cdc.gov/leptospirosis/health_care_workers/index.html
- http://www.who.int/zoonoses/diseases/lerg/en/index1.html
- https://www.medicalnewstoday.com/articles/246829
- http://www.who.int/zoonoses/diseases/lerg/en/index2.html
- https://www.cdc.gov/leptospirosis/health_care_workers/
- https://www.cdc.gov/features/leptospirosis/index.html
- http://www.who.int/zoonoses/diseases/lerg/en/index2.html
