Leptospirosis- Know How to Guard Against it and Stay Healthy

Introduction-

Leptospirosis is a water-borne disease that occurs in the rainy season.
It is caused by an organism called Leptospira, which is shed by rats, dogs, cattle, etc., through their urine. These animals are the carriers of this organism and they harbor it in their urinary system without getting affected.
When their urine gets diluted in the water puddles during the rains, they can infect human beings by direct entry through the intact skin.
Leptospirosis is prevalent worldwide with India, some African and South American countries leading with a large number of cases yearly.
Shown below is the distribution map the disease worldwide-

What is leptospirosis?

In my last two blogs on Infectious disease, I had discussed Malaria and Dengue.
Both are transmitted by mosquitoes. Whereas Malaria is caused by a parasite called Plasmodium, Dengue by the Dengue virus, Leptospirosis is caused by a spiral bacteria called the Leptospira.
As per the WHO definition, it is:-

I will now show some pictures below which will explain the disease in detail with signs, symptoms, and complications.

What is Leptospira look like?

This is a spiral bacteria called Leptospira interrogans.
It is found mostly in the urine of rats, dogs, and cattle.

How is this disease spread?

The figure below shows the different ways on how we get leptospirosis:-

Having known its transmission, you can see how it can be prevented by taking a few precautions in the rainy season[discussed at the end]

What are its Signs and Symptoms of Leptospirosis?

Signs and symptoms vary in different people. The picture below shows the symptoms mostly found in patients suffering from leptospirosis.
It shows that the disease as 2 phases, namely the Acute phase and the Immune phase.

1. The acute phase is the one where the patient is sick but can be treated successfully.
2. The immune phase is the one where complications as shown in the picture occur and mostly lead to complications which requires hospitalization. 
   

A rash appears on the skin sometimes as shown below-

How many types of Leptospirosis are there?

There are 2 types of leptospirosis:-

In the first type, there is no jaundice. That is why it is termed Anicteric. They may have all other symptoms like headache, body ache, skin rash, and other features as shown in the picture of signs and symptoms above.
In the Icteric type, the patient has severe jaundice and other parts of the body get involved. There is internal hemorrhage[bleeding] within organs like stomach, eyes, kidney, etc. This ultimately leads to multi-organ failure and death.

Weil’s Disease-

Weil’s disease is a major and fatal complication of leptospirosis and is as described below-

If you are having any of the above symptoms, you should contact your family physician.

Shown below is a picture of the effect of a severe form of leptospirosis wherein the platelet count of the patient low and internal bleeding occurs.

The eyes show seepage of blood in the sclera[white part of the eye] and is called conjunctival suffusion.

What laboratory investigations your doctor may advise?

If your doctor is suspecting that you are suffering from leptospirosis, he/she may order the following tests:-

Treatment-

1. Patients should have plenty of fluids, soups, etc. along with medicines prescribed by your doctor.
2. Paracetamol- to reduce fever.
3. Antibiotics:-Doxycycline 100 mg twice daily for a week to 10 days;
4. Antiemetics[anti-vomiting]-like domperidone to prevent vomiting;
5. Anti-inflammatory pain killers like diclofenac, ibuprofen,nimesulide
6. Glucose powder- for severe fatigue.
7. Intravenous Dextrose saline to correct dehydration.

You may also be suggested by your family physician regarding the prevention of the disease in other family members by prescribing some medicine like doxycycline once a day for 2 weeks.
Kindly do not treat yourself – this disease can be fatal. Weil`s disease is a serious condition that needs hospitalization.

Prevention Of Leptospirosis-

Having said all this, you can prevent this disease by

1. Avoiding barefoot walking in water flooded on roads in the rainy season,
2. Use good rubber or all-season shoes,
3. Try to avoid wetting your feet in the muddy waters during the rainy season.

Some precautionary measures for the prevention of leptospirosis as suggested by the WHO is as shown below:-

Let’s have a quick recap of what we have learned today-

Conclusion-

I hope I have explained all the details of this deadly disease. You can very well prevent leptospirosis if you follow all the precautions I have mentioned above.
Contaminated water in the rainy season is the main source of infection. Here again, wearing rubber gloves and shoes can go a long way in preventing the disease.
For more on Leptospirosis, Click Here.
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