What are the clinical signs 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 Comprehensive Guide

Canine leptospirosis is a bacterial infection that poses significant health risks to dogs and can potentially affect humans. Caused by multiple strains of the Leptospira bacteria, this disease thrives in warm, wet environments and can have severe consequences if left untreated. Understanding the nature of this infection, its transmission, symptoms, and prevention methods is crucial for dog owners and veterinary professionals alike.

The Transmission of Leptospirosis in Dogs

Leptospirosis can be found throughout the United States, with some regions being more susceptible than others. The bacteria responsible for this disease can survive for extended periods in the environment, particularly in warm and wet conditions.

Common Sources of Infection

• Contaminated water sources (puddles, ponds, lakes)
• Urine-contaminated soil
• Infected bedding or food
• Contact with urine from infected animals (rodents, raccoons, livestock)

The bacteria typically enter a dog’s body through ingestion, broken skin, or mucous membranes such as the eyes, nose, or mouth. The incubation period for leptospirosis is approximately one week, meaning symptoms may not appear immediately after exposure.

Recognizing the Clinical Signs of Canine Leptospirosis

Leptospirosis can manifest with a wide range of symptoms, varying from mild to severe. In some cases, the infection can become life-threatening. Dog owners should be aware of the following common signs:

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

In more severe cases, additional symptoms may include:

• Dehydration
• Jaundice (yellowing of the eyes or gums)
• Petechiae (small bleeding under the skin)
• Uveitis (redness of the eyes)
• Difficulty breathing due to pulmonary hemorrhage

Diagnosing Leptospirosis in Canines

Diagnosing leptospirosis can be challenging due to the similarity of its symptoms to other diseases and potential uncertainty regarding a dog’s vaccination history. Veterinarians typically employ a combination of diagnostic tools to confirm the presence of the infection:

1. Blood work and urine testing
2. PCR testing to detect Leptospira DNA
3. Antibody testing
4. Chest X-rays to check for pulmonary hemorrhage

These diagnostic methods help veterinarians distinguish leptospirosis from other conditions and determine the most appropriate course of treatment.

Treatment Options for Canine Leptospirosis

Once diagnosed, leptospirosis is primarily treated with antibiotics, with doxycycline being the most commonly prescribed medication. The treatment typically lasts for at least two weeks. In many cases, hospitalization is necessary to provide additional supportive care:

• IV fluid therapy
• Electrolyte management
• Medications to protect the gastrointestinal tract
• Anti-nausea medications
• Pain management
• Nutritional support
• Blood pressure management

Can dogs fully recover from leptospirosis? While complete recovery is possible with prompt and appropriate treatment, some dogs may experience long-term effects such as chronic kidney or liver disease. In severe cases, where significant organ damage has occurred or blood clotting is severely impaired, the prognosis may be poor.

The Zoonotic Potential of Leptospirosis

Leptospirosis is a zoonotic disease, meaning it can be transmitted from animals to humans. This characteristic underscores the importance of proper hygiene and preventive measures when dealing with infected dogs or potentially contaminated environments.

Precautions for Dog Owners and Veterinary Staff

• Wear gloves when handling urine or potentially contaminated materials
• Thoroughly wash hands after any contact with an infected dog
• Vaccinate dogs to reduce the risk of human exposure
• Follow proper sanitation protocols in veterinary clinics and kennels

By taking these precautions, the risk of human infection can be significantly reduced while still providing necessary care for infected animals.

Preventing Leptospirosis in Dogs

Prevention is key when it comes to leptospirosis, and there are several strategies that dog owners can employ to protect their pets:

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

How often should dogs be vaccinated against leptospirosis? After the initial vaccine, a booster should be administered 3-4 weeks later. Subsequently, annual boosters are recommended to maintain protection against the four most common strains of Leptospira.

The Impact of Climate and Environment on Leptospirosis Risk

Understanding the environmental factors that contribute to the prevalence of leptospirosis can help dog owners and veterinarians assess the risk more accurately. The bacteria thrive in specific conditions:

• Warm temperatures
• High humidity
• Abundant rainfall
• Standing water

These conditions are often found in tropical and subtropical regions, but climate change has led to an expansion of suitable habitats for Leptospira bacteria. As a result, areas previously considered low-risk may now face increased incidence of the disease.

Seasonal Variations in Leptospirosis Cases

While leptospirosis can occur year-round, there is often a seasonal pattern to its prevalence. In many regions, cases tend to spike during late summer and early fall, coinciding with periods of increased rainfall and outdoor activities. Dog owners should be particularly vigilant during these times, especially if their pets have access to potentially contaminated water sources.

Leptospirosis in Urban vs. Rural Settings

The risk of leptospirosis is not limited to rural or wilderness areas. Urban environments can also harbor the bacteria, albeit through different vectors:

Urban Risk Factors

• Rat infestations in city parks or alleys
• Contaminated urban water sources (puddles, fountains)
• Contact with infected stray animals

Rural Risk Factors

• Exposure to livestock urine
• Access to ponds, streams, or other natural water bodies
• Increased contact with wildlife

Understanding these distinctions can help tailor prevention strategies to specific living environments.

The Role of Veterinary Professionals in Leptospirosis Management

Veterinarians play a crucial role in the prevention, diagnosis, and treatment of canine leptospirosis. Their responsibilities extend beyond clinical care to include:

• Educating pet owners about the risks and prevention of leptospirosis
• Recommending appropriate vaccination schedules based on individual risk factors
• Conducting thorough diagnostic procedures for suspected cases
• Implementing proper isolation and treatment protocols for infected animals
• Reporting confirmed cases to relevant health authorities

By fulfilling these roles, veterinary professionals contribute significantly to controlling the spread of leptospirosis and protecting both animal and human health.

Emerging Research and Future Prospects in Leptospirosis Management

The field of leptospirosis research is dynamic, with ongoing studies aimed at improving prevention, diagnosis, and treatment methods. Some areas of current interest include:

• Development of more effective and broad-spectrum vaccines
• Improvement of rapid diagnostic tests for field use
• Investigation of novel antibiotic treatments
• Understanding the long-term effects of leptospirosis on organ function
• Studying the impact of climate change on disease prevalence

These research efforts hold promise for enhancing our ability to combat leptospirosis in the future, potentially reducing its impact on both canine and human populations.

The Economic Impact of Canine Leptospirosis

Beyond its health implications, leptospirosis can have significant economic consequences for dog owners and the veterinary industry:

Costs Associated with Leptospirosis

• Diagnostic testing expenses
• Hospitalization and treatment costs
• Long-term management of chronic complications
• Preventive measures (vaccination, environmental modifications)
• Potential lost work time for owners caring for sick pets

Understanding these economic factors can help emphasize the importance of prevention and early detection to both pet owners and policymakers.

Global Perspectives on Canine Leptospirosis

While this article primarily focuses on leptospirosis in the context of the United States, it’s important to recognize that the disease is a global concern. Different regions face unique challenges in managing leptospirosis:

Variations in Global Prevalence

• Higher incidence in tropical and subtropical regions
• Emerging cases in previously unaffected areas due to climate change
• Differences in predominant Leptospira serovars across geographic regions

International Control Efforts

• Collaborative research initiatives
• Standardization of diagnostic and reporting procedures
• Global surveillance networks

Understanding these global perspectives can inform more comprehensive and adaptable strategies for managing canine leptospirosis worldwide.

The Psychological Impact of Leptospirosis on Pet Owners

The diagnosis and treatment of leptospirosis can have significant psychological effects on pet owners. These may include:

• Anxiety about the pet’s prognosis and potential for recovery
• Guilt, especially if the infection could have been prevented
• Stress related to the financial burden of treatment
• Fear of zoonotic transmission to family members

Veterinary professionals should be prepared to address these psychological aspects, offering support and resources to help owners cope with the challenges of managing a pet with leptospirosis.

Leptospirosis in Other Domestic Animals

While this article focuses on canine leptospirosis, it’s worth noting that the disease can affect other domestic animals as well. Understanding the broader impact of leptospirosis can provide valuable context for dog owners and veterinary professionals:

Leptospirosis in Other Species

• Cats: Generally less susceptible but can be infected
• Horses: Can develop severe symptoms, including abortion in pregnant mares
• Cattle: A significant economic concern in the livestock industry
• Pigs: Can act as asymptomatic carriers, posing risks to other animals and humans

The interconnected nature of leptospirosis across species underscores the importance of a One Health approach in managing this zoonotic disease.

Legal and Ethical Considerations in Leptospirosis Management

The management of leptospirosis involves several legal and ethical considerations that veterinary professionals and pet owners should be aware of:

Legal Aspects

• Mandatory reporting requirements for confirmed cases
• Liability issues related to zoonotic transmission
• Regulations governing vaccine administration and record-keeping

Ethical Considerations

• Balancing individual animal welfare with public health concerns
• Addressing potential conflicts between client confidentiality and public health reporting
• Ensuring informed consent for vaccination and treatment procedures

Navigating these legal and ethical aspects requires careful consideration and often collaboration between veterinary professionals, public health officials, and legal experts.

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.