What is leptospira?                                

• It is a bacterial disease, caused by bacteria leptospira, spread through the urine of infected animals
• Most commonly spread through rodents like rats, mice
• Most common in warm climates
• In developing country like India-most commonly affects farmers
• Transmitted by water /soil contaminated by urine of infected animals coming in contact with  breaks in skin, eyes, mouth, nose

What are the presenting symptoms?

• Incubation period i.e  the time from infection to symptom onset   is: 7-12 days
• some infected people may have no symptoms
• disease may occur in 2 phases
• wide range of symptoms from mild to severe
• high fever,headache,chills,muscle aches,vomiting,jaundice,abdominal pain,diarrhea, rash
• after the first phase of above mentioned symptoms –the  patient may recover for a time and become ill again
• if second phase occurs-it is more severe, may cause –kidney failure, liver failure or meningitits, and lung hemorrhages

How can one get infected?

• Rats, mice, and moles are important primary hosts
• A wide range of other mammals including dogs, deer, rabbits, hedgehogs, cows, sheep, swine, raccoons, and certain marine mammals carry and transmit the disease as secondary hosts
• Transmitted through contact with water, food, or soil that contains urine from infected animals
• Through  swallowing of contaminated food or water
• Can also get transmitted through the skin, mucosal contact

What are the various tests that can be done?

• For the first 7 days, bacteria is detected in Blood & CSF
• After 7-10 days of bacteria detected in Urine
• Diagnosis is confirmed with tests such as enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR)
• MAT (microscopic agglutination test) is considered the gold standard in diagnosing leptospirosis
• kidney function tests and liver function tests may also be deranged

What conditions can mimic leptospirosis?

• dengue fever and other hemorrhagic fevers
• hepatitis of various causes
• viral meningitis
• malaria
• typhoid fever
• mild forms should be distinguished from influenza and other related viral diseases

What are the preventive measures?

• Effective rat control
• Avoidance of urine contaminated water sources
• During outbreaks in endemic regions-prophylaxis with Doxycycline once a week, with  doctors advise is used to minimize the risk of infection

What are available medical therapy?

• Effective antibiotics include
• doxycycline or penicillin
• For more severe cases: cefotaxime or ceftriaxone are preferred antibiotics
• In cases with kidney damage-dialysis may be required
• corticosteroids in gradually reduced doses is recommended by some specialists in cases of severe hemorrhagic effects.
• Administration of organ-specific care and treatment are essential in cases of kidney, liver, or heart involvement.
• other supportive symptomatic  treatment  is given as required