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Leptospirosis: Important Facts

THE Department of Health recently announced an outbreak of Leptospirosis in the region
, with confirmed 5 mortality and more than 200 cases diagnosed.

The people are in a panic mode, and who wouldn’t be? I remember receiving text messages and calls at odd hours, patients and acquaintances asking for referrals to be admitted.

Fear is compounded by the lack of correct information regarding the disease. A family member told me, that he heard over the radio, that, one can get the disease through smelling contaminated air! Of course, we know that isn’t so.
Leptospirosis is caused by a spirochete and is transmitted by rats, cattle, pigs, horses and even our very own pets: dogs and cats. That is, if they acquired the bacterium through contact with infected soil or water. Man in turn gets the illness by wading through contaminated water, which happens during flooding!

It is important to note that even with kayaking and other outdoor sports, one may get infected when water or soil is contaminated. The bacterium gets into contact with the body when one has a break in the skin, or through mucous membranes like the eyes, the nose and the mouth!

Ingesting contaminated water and food is another route by which the disease is transmitted. It is worth mentioning too, that, there is no person to person transmission!

It takes 2 to 28 days after the initial contact with the contaminated water or food, when the signs and symptoms start to appear.

Leptospirosis is Biphasic: the first phase, where the patient presents with FLU Like manifestations: fever, headache, muscle aches. Thus, sometimes, unless a history of wading in a flooded area is elicited, this is sometimes misdiagnosed as another viral illness.

The patient gets well, and few days later, may enter the second phase: recurrence of fever, this time accompanied with aching or stiffness of the neck, abdominal pain, yellowing of the sclerae or skin, tea -colored urine. It is when the kidneys and liver are involved that the patient’s condition may worsen!

However, when treatment is instituted early on, recovery is the rule rather than the exception. However, there are individuals who may have the bacterium and yet remain asymptomatic.

The initial health status of the patient prior to contracting the disease will have an impact in terms of recovery.
Diagnosing leptospirosis may be done through culture. Though this is not routinely done as it will take time before the result may be out.

These days, using serological testing for antibodies is commonly done. The gold standard still is the MAT (microscopic Agglutination test).

Treatment may be done on an out patient service, unless the patient is in the second stage with known possible complications like meningitis or possible liver and kidney failure, which will require hospitalization.

The mainstay treatment for uncomplicated cases is the administration of antibiotics. Taking the medication prior to the start of symptoms or what we call as Prophylactic treatment is acceptable. For now, there is no known drug resistance as yet. Prevention, I should say, is everybody’s business!