LEPTOSPIROSIS

(Weils Disease/Canicola Fever/Hemorrhagic Jaundice/Mud Fever/Swine Herd

Disease)

A common zoonotic disease

Caused by Leptospira (L.interrogans)
Rats common hosts
Organism shed in the urine
Enters the body-skin/mucous membrane
Organs affected-kidney, liver, meninges, brain

CLINICAL FEATURES

Age group of 10-20 years;males

Malaise, body pain, non specific features of viral fever initially

Conjunctival suffusion, tendernes in calf and lumbar regions

Headache, chills, anorexia and jaundice

Epigastric pain, tenderness and vomiting

INCUBATION PEERIOD

The incubation period varies from six to fifteen days.

PERIOD OF COMMUNICABILITY

Leptospira is found in the urine between 10-20 days afetr disease onset.

SOURCE OF INFECTION

Infection comes from contaminated food and water and infected wildlife and domestic
animals, especially rodents.
MODE OF TRANSMISSION

Direct contact with urine or tissue of infected animal

Indirect contact

Droplet infection

RISK FACTORS

Occupational exposure

Farmers Rice, Sugarcane, Vegetables, Cattle, Pigs

Sewerage workers; Abattoirs, Butchers

Vetenarians, Lab staff, Miners, Soldiers

Fishermen Inland (not on the sea)

Recreational activities

Swimming, Sailing, Marathon runners, Gardening

OTHER MANIFESTATIONS

Renal failure

Meningeal irritation

Petechial haemorrhages from skin, mucous membrane

Myocarditis

Hyptotension

Multi organ failure

 TYPES OF LEPTOSPIROSIS

Anicteric Icteric(Weils Syndrome)

Milder form Severe form

Fever, Myalgia, Headache, Jaundice + involvement of other organs

Conjunctival suffusion Oliguria, anuria, proteinuria

90% patients present with this form 5-10% have this type

Weils Syndrome

It can be defined as severe leptospirosis with jaundice accompanied by azotemia,

haemorrhage, anemia, disturbance in consciousness and continued fever.

Hepato renal syndrome

COMPLICATIONS

Meningitis

Respiratory distress

Renal interstitial tubular necrosis that results in renal failure

Cardiovascular problems
PATHOPHYSIOLOGY

LABORATORY DIAGNOSIS

BUN and Creatinine

ELISA

Liver function test:

AST

ALT

GGT

Leptospira antigen-antibody test

Leptospira antibody test

MEDICAL MANAGEMENT

A. Suppresing the causative agent

 B. Fighting possible complications

Aetiotropic drugs (penicillin, ampicillin, amoxicillin)

For prophylaxis, doxycycline

Peritoneal dialysis

Administration of fluids and electrolytes and blood as indicated

NURSING MANAGEMENT

Isolate the patient; urine must be properly disposed of.

Darken the patients room because the light is irritating to the patients eyes.

Observe meticulous skin care to ease pruritus.

Keep patient close under surveillance.

Keep homes clean. Regularly replace water in pools, vaces, aquaria, etc. to prevent
stagnation.

Eradicate rats and rodents.

Provide health education on the modes of transmission of the disease.

Encourage oral fluid intake.

NURSING DIAGNOSIS

Body Image Disturbance

High risk for injury

Anxiety

Altered nutrition lessthan body requirements

Impaired skin integrity

PREVENTION AND CONTROL

Sanitation in homes, workplaces and farms is a must.

There is a need for proper drainage system and control of rodents.

Animals must be vaccinated.

Infected humans and pets should be treated.

Information dissemination campaign must be conducted effectively.