What are the symptoms of canine leptospirosis. How is leptospirosis diagnosed in dogs. What is the treatment for canine leptospirosis. How can leptospirosis in dogs be prevented.

Understanding Canine Leptospirosis: A Serious Bacterial Infection

Canine leptospirosis is a potentially severe bacterial infection that affects dogs and can also pose risks to humans. Caused by various strains of Leptospira bacteria, this disease requires prompt attention and proper management. Let’s delve into the key aspects of canine leptospirosis to better understand its impact and how to protect our furry companions.

Transmission of Leptospirosis in Dogs: Sources and Risk Factors

Leptospirosis can be found throughout the United States, with some regions facing higher risks than others. The bacteria responsible for this infection thrive in warm, wet environments, particularly during late summer and early fall. These resilient organisms can survive for extended periods, ranging from weeks to months.

How do dogs contract leptospirosis? The most common transmission route is through contact with contaminated water, especially stagnant or slow-moving bodies like puddles, ponds, or lakes. Soil, bedding, or food contaminated with infected urine also pose significant risks. Various animals, including rodents, small mammals, and even some livestock, can spread leptospirosis through their urine.

Can leptospirosis enter a dog’s body through intact skin? No, the bacteria typically enter through ingestion, broken skin, or mucous membranes such as the eyes, nose, or mouth. The incubation period, which is the time between exposure and symptom onset, is approximately one week.

Recognizing the Clinical Signs of Leptospirosis in Dogs

Leptospira bacteria target the cells lining blood vessels, potentially interfering with normal blood clotting. As the infection spreads throughout the body, it primarily affects the liver and kidneys. The severity of symptoms can vary widely, ranging from mild to life-threatening.

• Fever
• Decreased appetite
• Vomiting
• Diarrhea
• Increased thirst and urination
• Lethargy or weakness
• Stiffness and soreness

Additional signs may include dehydration, jaundice (yellowing of the eyes or gums), petechiae (small bleeding under the skin), and uveitis (redness of the eyes). In severe cases, dogs may experience rapid or labored breathing due to pulmonary hemorrhage (bleeding into the lungs).

Diagnosing Leptospirosis: Challenges and Necessary Tests

Accurately diagnosing leptospirosis can be challenging due to its similarity to other diseases and potential uncertainties in vaccination history. To confirm the presence of this infection, veterinarians rely on a combination of tests and clinical observations.

1. Blood work and urine testing
2. PCR test to detect Leptospira DNA
3. Antibody testing
4. Chest x-rays (in cases of suspected pulmonary hemorrhage)

Why is a combination of tests necessary for diagnosing leptospirosis? The use of multiple diagnostic tools helps veterinarians rule out other conditions and confirm the presence of Leptospira bacteria, ensuring accurate diagnosis and appropriate treatment.

Treatment Approaches for Canine Leptospirosis

The primary treatment for leptospirosis involves a course of antibiotics, with doxycycline being the most commonly prescribed medication. Treatment typically lasts for at least two weeks. In many cases, hospitalization is necessary to administer intravenous fluids and manage electrolyte imbalances.

What additional treatments might be necessary for dogs with leptospirosis? Depending on the severity of the infection and its impact on various organs, veterinarians may prescribe medications to protect the gastrointestinal tract, prevent nausea, manage pain, provide nutritional support, and regulate blood pressure.

Prognosis and Potential Complications

While leptospirosis is treatable with antibiotics, and complete recovery is possible, some dogs may experience long-term effects. These can include chronic kidney or liver disease. In severe cases where significant organ damage has occurred or blood clotting is severely impaired, survival may be less likely. Dogs with respiratory complications face a higher risk of mortality.

Zoonotic Potential: Protecting Humans from Leptospirosis

Leptospirosis is classified as a zoonotic disease, meaning it can spread from animals to humans. To minimize the risk of transmission, it’s crucial to take appropriate precautions when handling infected dogs or their bodily fluids.

• Wear gloves when handling urine or potentially contaminated materials
• Wash hands thoroughly after any accidental contact
• Vaccinate dogs to reduce the risk of human exposure

How effective is dog vaccination in preventing human leptospirosis cases? While vaccination significantly reduces the risk of infection in dogs, it also plays a crucial role in minimizing the potential for human exposure, creating a dual layer of protection for both pets and their owners.

Prevention Strategies: Keeping Your Dog Safe from Leptospirosis

Preventing leptospirosis is far simpler and less stressful than treating an active infection. By implementing a few key strategies, you can significantly reduce your dog’s risk of contracting this bacterial disease.

1. Annual vaccination with the leptospirosis vaccine
2. Limiting access to standing water
3. Implementing effective rodent control measures
4. Avoiding contact with wildlife

What is the recommended vaccination schedule for leptospirosis? After the initial vaccine, dogs require a booster shot in 3-4 weeks. Subsequently, annual boosters are necessary to maintain protection against the four most common Leptospira strains.

The Importance of Veterinary Guidance in Leptospirosis Management

When it comes to protecting your dog from leptospirosis, consulting with a veterinarian is crucial. These professionals can assess your dog’s individual risk factors, lifestyle, and overall health to determine the most appropriate prevention strategies.

Why might the leptospirosis vaccine not be suitable for all dogs? While vaccination is generally recommended, certain factors such as age, health conditions, or lifestyle may influence the decision. Your veterinarian can provide personalized advice based on your dog’s specific circumstances.

Staying Informed: Ongoing Research and Developments

As with many areas of veterinary medicine, research into leptospirosis continues to evolve. Staying informed about new developments, improved diagnostic techniques, and emerging treatment options can help pet owners make the best decisions for their furry companions.

How can pet owners stay updated on leptospirosis research? Regularly consulting with your veterinarian, following reputable veterinary organizations online, and participating in educational seminars or webinars can help you stay informed about the latest advancements in leptospirosis prevention and treatment.

Creating a Leptospirosis-Aware Environment: Tips for Dog Owners

Beyond vaccination and veterinary care, there are several steps dog owners can take to create an environment that minimizes the risk of leptospirosis exposure:

• Maintain a clean yard free of standing water and potential wildlife attractants
• Use caution when walking dogs in areas with high wildlife activity
• Clean and disinfect any areas where infected animals may have urinated
• Educate family members about the risks and prevention strategies

How can dog owners balance outdoor activities with leptospirosis prevention? While it’s important to be cautious, dogs shouldn’t be deprived of outdoor experiences. By being aware of high-risk areas, avoiding standing water, and maintaining good hygiene practices, owners can allow their dogs to enjoy nature while minimizing exposure risks.

The Role of Community Awareness in Leptospirosis Prevention

Raising awareness about leptospirosis within your community can contribute to a safer environment for all dogs. By sharing information about the disease, its transmission, and prevention methods, you can help other pet owners protect their animals and reduce the overall prevalence of the infection.

What are some effective ways to raise community awareness about leptospirosis? Organizing informational sessions at local pet stores, collaborating with veterinary clinics for educational events, and sharing reliable resources on social media can all contribute to increased community knowledge and prevention efforts.

Leptospirosis in Different Breeds: Are Some Dogs More Susceptible?

While all dogs can potentially contract leptospirosis, some breeds or types of dogs may face higher risks due to their typical lifestyles or physical characteristics. Understanding these potential differences can help owners and veterinarians tailor prevention strategies more effectively.

Do certain dog breeds have a higher risk of contracting leptospirosis? While the bacteria don’t discriminate between breeds, dogs that spend more time outdoors, particularly in wet environments or areas with high wildlife activity, may face increased exposure risks. This can include hunting dogs, farm dogs, or breeds commonly used for outdoor work or recreation.

Age and Health Considerations in Leptospirosis Risk

A dog’s age and overall health status can influence its susceptibility to leptospirosis and its ability to fight off the infection if exposed. Puppies, senior dogs, and those with compromised immune systems may be at higher risk for severe complications if they contract the disease.

How does a dog’s age affect its leptospirosis risk and vaccination schedule? Puppies typically receive their first leptospirosis vaccine as part of their initial vaccination series, usually around 12 weeks of age. Senior dogs may require more careful consideration due to potential age-related health issues, and your veterinarian can provide guidance on the most appropriate vaccination schedule for older pets.

Global Perspective: Leptospirosis as a Worldwide Concern

While this article focuses on canine leptospirosis in the United States, it’s important to recognize that this disease is a global concern. The prevalence and specific strains of Leptospira can vary by region, influenced by factors such as climate, wildlife populations, and local prevention efforts.

How does the global nature of leptospirosis impact dog owners? For those who travel with their pets or import dogs from other countries, understanding the leptospirosis risk in different regions is crucial. It’s advisable to consult with a veterinarian about additional precautions or vaccination requirements when traveling to areas with different leptospirosis profiles.

International Efforts in Leptospirosis Research and Prevention

Collaborative international research efforts are ongoing to better understand leptospirosis, improve diagnostic methods, and develop more effective treatments and vaccines. These global initiatives contribute to our overall knowledge and ability to manage this potentially serious disease.

What recent advancements have been made in leptospirosis research? Recent studies have focused on developing more accurate and rapid diagnostic tests, exploring new treatment options, and investigating the potential for vaccines that provide broader protection against multiple Leptospira strains.

The Future of Leptospirosis Management: Emerging Trends and Technologies

As veterinary medicine continues to advance, new approaches to managing and preventing leptospirosis are on the horizon. From improved diagnostic tools to novel treatment strategies, these developments hold promise for enhancing our ability to protect dogs from this challenging disease.

What potential future developments might impact leptospirosis management? Emerging technologies such as gene sequencing and advanced immunological techniques may lead to more precise diagnostic methods and tailored treatment approaches. Additionally, ongoing research into vaccine development may result in more comprehensive protection against a wider range of Leptospira strains.

The Role of One Health in Leptospirosis Control

The concept of One Health, which recognizes the interconnectedness of human, animal, and environmental health, is particularly relevant to leptospirosis control. By addressing the disease from multiple angles – including veterinary care, human medicine, and environmental management – we can work towards more effective prevention and control strategies.

How does the One Health approach benefit leptospirosis prevention efforts? By fostering collaboration between veterinarians, physicians, environmental scientists, and public health professionals, the One Health approach can lead to more comprehensive and effective strategies for managing leptospirosis risks across species and ecosystems.

Canine leptospirosis | Cornell University College of Veterinary Medicine

Canine leptospirosis is a bacterial infection that can have serious consequences in dogs and can also affect humans. There are multiple strains of the bacteria called Leptospira that cause leptospirosis. Prevention of leptospirosis includes vaccination, which protects against the four most common strains, and avoiding common sources of contamination.

Transmission

Leptospirosis can be found across the United States, though some regions may be more susceptible than others. The bacteria thrive in warm and wet environments, especially during late summer and into fall, and they can survive for weeks to months. Periods of heavy rainfall can make it easier to spread.

The most common way dogs get leptospirosis is through water contaminated with urine, particularly stagnant or slow-moving water like puddles, ponds or lakes. Another source is from contact with urine-contaminated soil, bedding or food.

Many different animals can spread leptospirosis through their urine, primarily rodents and small mammals like rats and raccoons, and even some livestock. Leptospira enters the body through ingestion, broken skin or mucous membranes (eyes, nose or mouth). The incubation period, or the time between exposure to the organism and the appearance of symptoms, is about one week.

Clinical signs

Leptospira attaches to cells that line blood vessels (endothelial cells) which can make it harder for blood to clot normally. The bacteria spreads throughout the body and affects organs, most notably the liver and kidneys. Signs can range from mild to severe, and sometimes become life-threatening.

These common signs may be seen in varying degrees of severity:

• Fever
• Decreased appetite
• Vomiting
• Diarrhea
• Increased thirst and urination
• Lethargy or weakness
• Stiffness and soreness

Other signs may include dehydration, yellowing of the eyes or gums (jaundice), small bleeding under the skin (petechiae), redness to the eyes (uveitis) and more. In severe cases, rapid or difficulty breathing may be noted from bleeding into the lung (pulmonary hemorrhage).

Diagnosis

Leptospirosis can be difficult to diagnose because the clinical signs may resemble many other diseases, or the vaccine history may be uncertain. Your veterinarian will recommend blood work and urine testing.

Based on these results, additional testing to confirm a diagnosis is needed such as a PCR test, which looks for DNA of the Leptospira organism, and testing for antibodies. Chest x-rays may be needed to check for a pulmonary hemorrhage.

Treatment

Leptospirosis is treated with antibiotics, most commonly doxycycline, for at least two weeks. Hospitalization with IV fluids and management of electrolytes is often necessary initially.

Additional treatments may include medications to protect the gut, prevent nausea and pain, provide nutritional support and manage blood pressure.

Outcome

Leptospirosis is responsive to antibiotics and complete recovery is possible, but some dogs that survive may be left with chronic kidney or liver disease. Some dogs may not survive if the infection has caused significant organ damage or severely affected the ability of blood to form clots.

Dogs with respiratory issues may be less likely to survive.

Zoonosis

Leptospirosis is a zoonotic disease, which means there is the possibility for it to spread from mammals to people. Gloves should be worn if handling any urine. If there is any accidental contact, hands should be thoroughly washed.

Vaccinating your dogs will decrease the risk of human exposure, as well as protecting against infection.

Prevention

Prevention is much simpler than treatment, and your veterinarian can discuss with you if it is an appropriate vaccine for your dog’s lifestyle.

• Vaccinate dogs annually with the leptospirosis vaccine
• Limit access to standing water
• Prevent rodent problems
• Avoid contact with wildlife

After the first vaccine, your dog will need a booster in 3-4 weeks. Your dog should then receive a booster once a year.

Dr. Aly Cohen and her Pomeranian Mishka. Photo provided.

Dr. Aly Cohen is an extension veterinarian for the Cornell Richard P. Riney Canine Health Center and a clinical instructor for Cornell’s Maddie’s Shelter Medicine Program. She also serves as the contract veterinarian for the Ross Park Zoo in Binghamton, New York. Dr. Cohen graduated from the Ross University School of Veterinary Medicine, and her veterinary interests include surgery and emergency medicine. She has two Pomeranians named Mishka and Java.

Leptospirosis – Physiopedia

Original Editors – Shelby Adams & Sarah Huttonfrom Bellarmine University’s Pathophysiology of Complex Patient Problems project.

Top Contributors – Shelby Adams, Sarah Hutton, 127.0.0.1, Elaine Lonnemann, Evan Thomas, WikiSysop, Kim Jackson and Nupur Smit Shah

Contents

• 1 Definition
• 2 Prevalence
• 3 Characteristics/Clinical Presentation/Examination
• 4 Prognosis/Associated Co-morbidities
• 5 Medications
• 6 Diagnostic Tests/Lab Tests/Lab Values
• 7 Etiology/Causes
• 8 Systemic Involvement
• 9 Medical Management (current best evidence)
• 10 Physical Therapy Management (current best evidence)
• 11 Differential Diagnosis
• 12 Case Reports/ Case Studies
• 13 Resources
• 14 References

Definition/DescriptioLeptospirosis is a bacterial disease that affects humans & animals. It is caused by the bacteria genus Leptospira. This bacteria is spread through urine of infected animals, which can get into water or soil and can survive for weeks to months. The most common method of transmission is through direct contact with infected urine or other bodily fluids such as saliva, or contaminated water, soil, or food.^[1] This bacteria can enter the body through skin or mucous membranes (eyes, nose, mouth) especially if skin is broken with cut or scratch.^[1] Outbreaks are most commonly associated with contaminated water such as flood waters. Person to person transmission of this bacteria is rare^[2]. Both wild and domestic animals can be carriers of this bacteria, this includes but is not limited to: cattle, pigs, horses, dogs, rodents, and wild animals. Animals may show no signs or symptoms of the disease. In humans it can cause a wide range of symptoms, which can easily be mistaken for others diseases. Some infected individuals may be asymptomatic. Without treatment, Leptospirosis can lead to serious problems such as: kidney damage, meningitis, liver failure, respiratory distress, or even death. ^[3]

^[4]

It is estimated that 100-200 of human Leptospirosis cases are identified annually in the United States. About 50% of these cases occur in Hawaii. Leptospirosis survives well in warm climates, fresh water, and muddy areas.^[1] The largest recorded U.S. outbreak occurred in 1998, where 775 people were exposed to this disease, with 110 becoming infected. Incidence in the United States is relatively low, however, leptospirosis is considered to be the most widespread zoonotic disease in the world. Significant increases in incidence have been reported from Peru and Ecuador following heavy rainfall and flooding in the spring of 1998. Thailand has also reported a rapid increase in incidence between 1995 and 2000.^[3]

Characteristics/Clinical Presentation/Examination[edit | edit source]

Clinical presentation of leptospirosis is variable depending on the stage of the disease. Time between a person’s exposure to the source and showing these signs and symptoms can be 2 days to 4 weeks. Early state signs and symptoms include high fever, headache, chills, muscle aches, vomiting, jaundice, red eyes, abdominal pain, diarrhea, and rash. The second stage presents with more severe symptoms such as kidney or liver failure, meningitis, hemorrhage, hepatomegaly, pulmonary hemorrhage, and ARDS. This phase is also known as Weil’s disease. Case fatality for leptospirosis is 1-5%.^[3]

^[5]

Pathogenic leptospires are divided in two stages. The first stage of leptospirosis is septicemia or the acute stage. This stage lasts from 3 days to 10 days and presents mostly as headache and myalgia. During this stage leptospires are found in blood in a decreasing number until 15 days after onset of symptoms. Samples must be collected up to 2 days after initiating antibiotherapy to detect leptospires. The second stage or immune stage, usually occurs during the second week after onset of symptoms and lasts 4-30 days. During this stage, the increased antibody titer is correlated to elimination of leptospires from blood.^[6]

Prognosis/Associated Co-morbidities[edit | edit source]

The majority of Leptospirosis cases (over 90%) are considered mild.^[4] Early diagnosis leads to a faster onset of treatment, which can prevent the patient from developing a more severe level of Leptospirosis. If the patient does reach severe levels, it is considered a medical emergency. Patients most often succumb to this disease because of renal failure, acute respiratory distress syndrome, or a massive hemorrhage; pulmonary involvement is the most common.^[4] Patients do survive severe Leptospirosis, especially when there is a quick initiation of supportive therapy and antibiotics.^[1]

Currently, there are no known documented comorbidities that were found in the research. However, it would seem reasonable to suspect those with a compromised or suppressed immune system would be more susceptible to contracting Leptospirosis. There is also a higher risk based on environment and occupation. For example, farmers, pet shop owners, and survivors of natural disasters are at an increased risk to be exposed to leptospirosis.^[3]

If antibiotic treatment is needed it may include the following:

• Doxycycline
• Ampicillin or amoxicillin
• Azithromycin or clarithromycin
• Fluoroquinolone such as ciprofloxacin or levofloxacin^[4]

Antibiotics for leptospirosis requiring hospitalization include the following:

• Intravenous penicillin G
• Intravenous third-generation cephalosporins (cefotaxime and ceftriaxone)
• Intravenous ampicillin or amoxicillin (second-line agents)
• Intravenous erythromycin (in penicillin-allergic pregnant women)^[4]

^[7]

Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]

Laboratory studies used to screen for the diagnosis of leptospirosis include the following:

• Leptospira immunoglobulin M (IgM) ELISA or IgM/immunoglobulin G (IgG) enzyme-linked immunoabsorbent assay (ELISA), including rapid diagnostic kits usable in the field
• Real-time DNA polymerase chain reaction (PCR) of blood, urine, and cerebrospinal fluid (CSF)^[4][1]

Laboratory studies used to confirm the diagnosis of leptospirosis include the following:

• Microscopic agglutination testing (MAT; criterion standard for serologic identification of leptospires, available at reference laboratories)
• Single titer ≥1:200 or 4-fold rise in serum drawn between the first and fourth week of illness is considered diagnostic
• DNA PCR of blood, urine, CSF, tissue
• Culture of leptospires from body fluids or tissue (criterion standard, but requires specific media and several weeks’ incubation, thus usually limited to reference laboratory)^[4][1]

Studies to determine the extent of organ involvement and severity of complications may include the following, depending on the clinical presentation:

• Complete blood cell (CBC) count

^[8]

• Elevated erythrocyte sedimentation rates and peripheral leukocytosis with left shift noted
• Anemia due to hemorrhages
• Lowered platelet count
• Blood urea nitrogen and serum creatinine may be elevated
• Serum Creatine Kinase levels elevated in patients with muscular involvement
• Increased coagulation times
• Increased Serum bilirubin levels due to obstructive disease due to capillaritis in liver
• CSF analysis:

         – To exclude causes of bacterial meningitis

         -Polymorphonuclear leukocytes in early leptospirosis

         -Monocytes in later

         -Protein may be normal or elevated

• Chest radiography
• Biliary tract ultrasonography
• Electrocardiography (ECG)

         -Congestive Heart Failure

         -Cardiogenic Shock

• Urinalysis may show:

         -Protein

         -Erythrocytes

         -Hyaline casts

         -Granular casts^[4][1]

Leptospires are from a group of bacteria called spirochetes. There are two families of leptospiraceae: leptospira and leptonema. Leptospira have over 200 known pathogenic serologic variants, and 21 species of identified.^[3] 13 of these 21 species have been detected in human cases. The appearance and motility of leptospires varies with the nature of the medium in which they are grown.^[2] Certain geographic regions contain specific leptospiral serovars and species, the serologic characterization of an isolate is not an absolute predictor of its species designation. Leptospires are long, thin, motile spirochetes. They may be free-living or associated with animal hosts and survive well in fresh water, soil, and mud in tropical areas.^[3] Despite the different types of leptospires, there is no documentation of different presentations.
Once the leptospire enters the host, the pathogen reproduces. The survival rate of the leptospires depend on the immune system of the host, a suppressed immune system means the leptospires are more likely to survive and infect the host. ^[9] Once they survive initial contact, they need to spread throughout the body. So, they migrate to the bloodstream and lymphatic system to spread quickly.^[9] Once in the bloodstream and lymphatic system, the bacteria continues to spread and affect the other systems of the body.

 ^[10]

After infection, common systems affected by Leptospirosis are: kidney, nervous, hepatic, musculoskeletal, visual, cardiopulmonary, and integumentary. Common systemic issues that are associated with Leptospirosis in early stages include: myalgia, red eye, abdominal pain, and in some cases skin rash. In later stages it has systemic issues such as: liver damage, causing jaundice, kidney failure, meningitis, encephalitis, and bleeding in the lungs.^[3]

Medical Management (current best evidence)[edit | edit source]

Antibiotic therapy should be given early in the course of disease.^[3] Some sources state that in mild cases, it is typically unnecessary to treat with antibiotics since it is self-limited and can resolve without medical attention. However oral antibiotics can shorten the course of illness and can reduce and shorten urinary excretion of leptospirosis thereby decreasing chance of further spreading the infection.^[4] In persons with more severe symptoms IV antibiotics may be needed. There is an incubation period of 7 days, with a range of 2-29 days.^[3] In cases of widespread epidemics Prophylaxis can be used.^[4] Patients with severe cases of leptospirosis also require additional therapy and careful management of renal, hepatic, hematologic, and central nervous system complications. If renal failure begins, starting early hemodialysis or peritoneal dialysis may reduce mortality by nearly two-thirds. Other supportive care can include inotropic agents, diuretics, or ophthalmic drops.^[4]

Physical Therapy Management (current best evidence)[edit | edit source]

At this time there is no physical therapy management for Leptospirosis. If a Physical Therapist suspects signs and symptoms of Leptospirosis refer to a physician immediately for testing. However, once the patient gets proper treatment/medication, and they are in the recovery phases, a physical therapist can help with the associated sequelae. For example, common complications of Leptospirosis include kidney damage/failure, meningitis, liver failure, and respiratory distress.^[11] These conditions come with complications that physical therapists can help treat. For instance, meningitis can cause stiffness of the trunk and neck. Physical therapists can intervene to help maintain mobility in the neck/trunk. It is important to understand that while physical therapists cannot affect the bacteria infection itself, they can affect the associated sequelae.

There are many other diagnoses that present in a similar manner to Leptospirosis, especially in the early phases. The early phases present with flu-like symptoms; such as muscle aches, fever, and chills. In more severe cases, Leptospirosis may be misdiagnosed as meningitis, sepsis, or dengue.^[4] This is why patient history is crucial; as a clinician, it is important to ask about travel history and exposure to animals. These two points can provide information needed to get Leptospirosis on the radar.
The following conditions may also present like Leptospirosis^[3]:

• Brucellosis
• Chikungunya
• Enteroviral Infections
• Hantavirus Pulmonary Syndrome
• Hepatitis A
• Malaria
• Q Fever
• Rickettsial Infection
• Viral Hemorrhagic Fevers
• Measles
• Rubella

Case Reports/ Case Studies[edit | edit source]

Predictors of the development of myocarditis or acute renal failure in patients with leptospirosis: An observational study^[11][11]

Severe leptospirosis: treatment with intravenous corticosteroids and supportive care^[12][12]

^{Combined involvement of muscle, nerve, and myoneural junction following Leptospira infection[6][6]}

Centers for Disease Control and Prevention

World Health Organization

1. ↑ ^{1.01. 11.21.31.41.51.6} World Health Organization [Internet]. [Place unknown]: WHO; Prepared for World Day 2001 [ cited 2016 March 31]. Available from: http://www.who.int/water_sanitation_health/diseases/leptospirosis/en/
2. ↑ ^2.02.1 NSW Government Health [Internet]. [Place unknown]: NSW Ministry of Health; [last updated 2012 July 01: cited 2016 March 31]. Available from: http://www.health.nsw.gov.au/Infectious/controlguideline/Pages/leptospirosis.aspx
3. ↑ ^{3.03.13.23.33.43.53.63.73.83.9} “Leptospirosis.” Centers for Disease Control and Prevention [Internet]. [Place unknown]: Centers for Disease Control and Prevention; 18 Nov. 2014 [last updated 2015 June 9; cited 2016 March 31]. Available from: http://www.cdc.gov/leptospirosis/
4. ↑ ^{4.004.014.024. 034.044.054.064.074.084.094.104.11} Villarreal MR. File:Indian6.jpg [Internet]. File:Indian6.jpg. Unknown; [cited 2016Apr4]. Retrieved from: https://en.wikipedia.org/wiki/file:indian6.jpg)
5. ↑ GT. Leptospirosis : Treatment and Symptoms : New kit the cost per test will only be Rs. 50 [Internet]. YouTube. YouTube; 2015 [cited 2016Apr4]. Retrieved from: https://www.youtube.com/watch?v=r0bvwsiub5s)
6. ↑ ^6.06.1 Cruz LS. Leptospirosis: A Worldwide Resurgent Zoonosis and Important Cause of Acute Renal Failure and Death in Developing Nations. Ethnicity & Disease. Spring 2009: Volume 19: Pages 37-41.
7. ↑ epS. File:Medical Drugs for Pharmacy Health Shop of Medicine.png [Internet]. WikiMedia Commons. 2012 [cited 2016Apr10]. Retrieved from: https://commons.wikimedia.org/wiki/file:medical_drugs_for_pharmacy_health_shop_of_medicine.png#filelinks
8. ↑ E. File:Complete blood count CBC diagram. png [Internet]. Wikimedia Commons. 2012 [cited 2016Apr10]. Retrieved from: https://commons.wikimedia.org/wiki/file:complete_blood_count_cbc_diagram.png
9. ↑ ^9.09.1 Leptospirosis Information Center [Internet]. [Place unknown]: WordPress; 2011 December [ cited 2016 March 31]. Available from: http://www.leptospirosis.org/life-cycle-of-pathogenic-leptospires/
10. ↑ Ewing DEP. Public Domain Images [Internet]. Public Domain Images. Unknown; [cited 2016Apr4]. Retrieved from: http://www.public-domain-image.com/free-images/science/microscopy-images/leptospirosis-leptospira-spp/leptospira-bacteria-are-visible-at-right-dieterle-silver-stain
11. ↑ ^11.011.1 Right Diagnosis [Internet]. [Place unknown]: HealthGrades Inc.; [last updated 2015 August 13: cited 2016 April 04]. Available from: http://www.rightdiagnosis.com/l/leptospirosis/complic.htm
12. ↑ Minor, K. Mohan, A. Proquest [Internet]. United States: Elsevier Limited; 2013 [date of last update 2014 March 09: cited 2016 April 04]. Available from: http://search.proquest.com.libproxy.bellarmine.edu/docview/1287984663/21B15BB1F3314C12PQ/5?accountid=6741

GBUZ SK Novoaleksandrovskaya RB – Prevention of leptospirosis

Prevention of leptospirosis

Leptospirosis is a natural focal zoonotic infectious disease characterized by liver damage, as well as damage to the kidneys and nervous system against the background of general intoxication. Often accompanied by hemorrhagic symptoms and jaundice. The causative agent of leptospirosis can enter the body through mucous membranes or injured skin. From infection to the first clinical manifestations of leptospirosis can take from several days to a month. In the early diagnosis of leptospirosis, the microscopic detection of leptospira in a blood preparation plays an important role; the results of bacterial culture are often retrospective.

Leptospirosis usually has a favorable prognosis, deaths are mainly associated with insufficient or untimely medical care and a weakened state of the body. Currently, mortality from leptospirosis does not exceed 1-2%. An increase in this indicator to 15-20% is possible during periods of mass epidemics.

Prevention of leptospirosis primarily means control over the incidence of farm animals, as well as limiting the reproduction of rodents (disinfestation of urban facilities, rural farms). Sanitary and hygienic measures include monitoring the state of water sources (both places of water intake for the needs of the population and public beaches), agricultural land.

Specific vaccination measures involve the administration of a killed leptospirosis vaccine to persons working with animals or to citizens who are in an epidemic focus during outbreaks of leptospirosis.
The source of infection is primarily rodents, hedgehogs, as well as farm animals (pigs, cattle), dogs. Leptospira are excreted with animal waste products, polluting water, soil, vegetables, and plants. It is impossible to catch leptospirosis from a sick person.
The disease has many mechanisms of transmission:

Alimentary – infection occurs when drinking water from open reservoirs, as well as food contaminated with the urine of a sick animal;

Contact – infection occurs when damaged skin, mucous membranes come into contact with contaminated water, soil. information_items_118

A person is at risk of getting leptospirosis when swimming in stagnant water. Water can be contaminated with urine, faeces of sick animals. Thus, Listeria is able to penetrate not only through damaged skin, but also through the mucous membrane of the mouth, nose, and also through the conjunctiva of the eyes. You can get leptospirosis even when walking barefoot on contaminated soil.

People who work on livestock farms, meat processing plants, and also carry out their work in wetlands are at high risk of the likelihood of the disease. Do not discount veterinarians, animal shelter workers, public utilities, who can become infected from sick dogs.

Human susceptibility to infection is very high . So, when bathing in a pond, a person can get sick even if there is a small area of ​​damaged skin and a small amount of bacteria in the water.

To prevent the disease, avoid swimming in low-flowing water bodies, as well as drinking water from open water bodies. It is important to prevent the appearance of rodents in places where vegetables are stored (warehouses, cellars).

Groups of people at high risk of infection (veterinarians, animal breeders, workers in meat processing plants, disinfectors) must wear protective clothing when performing work duties. In addition, these people are subject to vaccination with a killed leptospirosis vaccine, which is administered subcutaneously in 2 ml twice, with an interval of ten days. A year later, revaccination should be carried out. After a suspected infection, doxycycline may be given as emergency prophylaxis.

Leptospirosis: symptoms, diagnosis, treatment, prevention

Allergist

Bykov

Sergey Anatolyevich

Experience 19 years

Allergist (immunologist), Candidate of Medical Sciences, member of the Russian Association of Allergologists and Clinical Immunologists, member of the European Academy of Allergology and Clinical Immunology (EAACI).

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Leptospirosis is a disease of an infectious nature and an acute course. Its causative agent is the bacteria Leptospira, and the main points of “impact” are the muscles, central nervous system, capillaries, kidneys and liver. You may know this disease by the name of water fever.

It is distributed throughout the world, and most pathogens are found in swampy areas and very humid regions. The causative agent of leptospirosis is most often carried by rodents, pigs, horses, dogs, and also representatives of cattle. Among animals, mortality from this disease can reach 90%. It also affects a person very seriously, so most often it requires immediate hospitalization.

Infection, incubation period, stages

Usually, the infection enters the body through mucous membranes, wounds, the gastrointestinal tract and the genitourinary system – it passes from contaminated water, food, soil. The incubation period most often takes from four days to two weeks, but in some cases stretches to a month. Most cases of the disease occur at the end of summer and the beginning of autumn. At risk are agricultural workers, veterinarians.

In the first stage, leptospirosis is accompanied by high fever, chills, weakness, and nausea. The infection attacks the surfaces of cells. The second stage is characterized by the penetration of infection into the capillaries, their defeat. The liver, adrenal glands, kidneys, brain membrane, central nervous system suffer. Pain in the muscles, headaches are added to the general signs of malaise and intoxication.

At the third stage, antibodies to the pathogen appear in the blood, the main signs of the disease begin to become dull. The fourth stage is associated with the formation of an immune response to infection and recovery.

Since there are several types of pathogen, immunity is formed only for a specific one – in the future, infection with other variants of leptospira is possible.

Signs of disease

The first symptoms of the disease include a sharp increase in temperature up to 39-40 degrees, chills, headaches, weakness, redness of the eyes.

The main symptoms of leptospirosis (other than those mentioned) look like this:

• muscle pain – most often in the calves, thighs, in the lumbar region. Sometimes the skin can hurt;
• swollen lymph nodes, as well as some organs, such as the spleen or liver;
• rapid weight loss;
• problems with sleep and psychological state: insomnia, anxiety, irritability;
• redness of the throat, usually slight;
• cardiac arrhythmia, decreased pressure;
• swelling in the face.

A rash with leptospirosis refers to additional signs – it does not always appear. The same goes for symptoms such as jaundice, anemia, nausea or vomiting.

Risk of disease and complications

Diagnosis of leptospirosis is extremely important in the initial stages of the disease, since it can lead to a host of serious complications, among them:

• internal bleeding;
• acute renal or hepatic failure;
• heart problems;
• pneumonia;
• meningitis;
• pancreatitis;
• paralysis and paresis of various kinds;
• toxic shock;
• and even death.

An infected person is in dire need of medical attention.

Types of disease

There are several classifications of leptospirosis, to name a few of them. By type, the disease is distinguished with and without jaundice, and by the leading syndrome – 4 variants of the disease. There are cases when the kidneys are more affected, or the kidneys and liver at the same time, as well as the meninges. The variant with increased bleeding is also highlighted separately.

According to the severity of the disease, mild, moderate and severe degrees are distinguished. In the first case, the level of intoxication is mild, the internal organs are not affected. In moderate course, there are all signs of leptospirosis and severe intoxication, and in severe cases, internal organs are already affected.

Also, the disease can proceed without complications and with complications, give or not give relapses.

Diagnostics

To make a diagnosis, not only visual and other signs of leptospirosis are taken into account. It is extremely important to conduct a number of studies:

• to study the general and biochemical analysis of blood, the general analysis of urine;
• perform PCR or RT-PCR tests, as well as diagnostics of RNHA and HCR;
• make a coagulogram, ultrasound, lumbar puncture (if necessary).

Clinical guidelines for leptospirosis suggest differentiation (separation) of the disease from diseases that manifest themselves in a similar way. In this case, these are hepatitis of different types.

Treatment

To effectively treat leptospirosis, the patient is first taken to the hospital – this is a prerequisite, since the disease can lead to deadly complications.

Further, patients are prescribed medication, which includes at least four groups of drugs, each of which is responsible for its own tasks. It is necessary to introduce a vaccine against the pathogen, remove local symptoms, remove the effects of intoxication, etc. Depending on the condition of the patient, complex procedures on special equipment can also be used, for example, support for the kidneys if they do not cope with their functions.

Additionally, a diet is provided. If we are talking about kidney damage, then this is diet No. 7, with liver damage – No. 5.

Prophylaxis

An important point is the prevention of leptospirosis, which allows you to avoid the disease or significantly reduce the risk of infection. Preventive measures include the following:

• vaccination against leptospirosis. Vaccination is carried out from the age of seven. In adulthood, it is shown to people working in the agricultural sector, veterinary medicine;
• careful observance of the rules of personal hygiene;
• refusal to swim in places where it is prohibited or simply not allowed. Avoid any untested bodies of water;
• work with animals only in compliance with personal safety measures. If possible, animals should be vaccinated with a special serum;
• timely treatment of any damage to the skin and mucous membranes with special means.