Leptospirosis is a zoonotic disease, caused by the bacteria genus Leptospira, that can cause a variety of symptoms and which, untreated, may lead to meningitis, kidney damage, or even death (“Leptospirosis”). Leptospires, bacteria of the genus Leptospira, appear as tightly coiled spirals and achieve optimal growth at 28-30°C, thriving in warm and humid regions. However, because most tropical, humid countries are also developing counties, chances of exposure are greater in those areas (Levett). Prevalent in Ecuador, New Guinea, and Guyana (see Figure 1), each with over 100 cases per 100,000 people, leptospirosis is a growing afflication in many Latin American, African, and Asian countries. (Greenwood). While no governmental organizations exist to monitor leptospirosis exclusively, there are many programs and prevention protocols in place to monitor its progress and protect nation’ citizens. II. Disease: description, symptoms, diagnosis and treatment The bacteria that causes leptospirosis resides in many animal reservoirs that often come in close contact with humans, including cattle, pigs, horses, dogs, rodents, and other wild animals (“Infection”). However, when infected, the animals may prove asymptomatic, and thereby continue to infect water, soil, and food with without rousing notice. Humans contract leptospirosis through contact with the urine or other bodily fluids (except saliva) of infected animals or through contact with water, soil, or food that has been contaminated with the animals’ urine. Despite the large number of ways the disease can be transmitted, most cases of leptospirosis are through contaminated water and the bacteria rarely spread from person to person (“Infection”). In addition to its large number of animal hosts, leptospirosis can cause a wide variety of symptoms or may cause no symptoms at all.
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Illness can occur anywhere from 2 days to 4 weeks after exposure and begins with a fever, often accompanied by other symptoms, which may include chills, headache, muscle aches, vomiting, or diarrhea. This constitutes the first phase of the illness, after which the infected individual will recover. However, after this reprise from symptoms, the individual may enter phase two of the sickness, also called Weil’s disease, characterized by jaundice, abdominal pain, rashes, red eyes, kidney failure, liver failure, or meningitis (“Signs and Symptoms”). In addition to these symptoms, leptospirosis in this stage may also cause haemorrhages, myocarditis with arrhythmias, and pulmonary haemorrhages with subsequent respiratory failure (“Human Leptospirosis: Guidance” 17). The total duration of the illness may span up to 3 weeks, but, without treatment, recovery may take months (“Signs and Symptoms”). Due to the wide variety of symptoms and increased prevalence in developing countries with limited access to modern medical care, leptospirosis is often challenging for physicians to diagnose, especially in cases where symptoms include cough, nausea, vomiting, or a skin rash because of its similarity to other prevalent illnesses (“Human Leptospirosis: Guidance” 18). Therefore, laboratory tests are needed in order to confirm the diagnosis of leptospirosis. The laboratory detects antibodies from urine, blood, or tissue-cultured bacteria and utilizes fluorescent markers to identify the leptospires (“Human Leptospirosis: Guidance” 21). The laboratory specialists test for Leptospira antibodies through the the microscopic agglutination test (MAT), which works by combining the patient’s blood with various dilutions of live or dead leptospires. The antibodies present in the serum causes the leptospires to clump together and the clumps are compared to the regional requirements for the cut-off points for a positive diagnosis, ranging from 1:100 to 1:800 (“Human Leptospirosis: Guidance” 21-24). Although the test is time consuming and near impossible to standardize, the MAT has a high specificity, making it extremely reliable (“Human Leptospirosis: Guidance” 24). Physicians treat leptospirosis with a variety of antibiotics, the strength of which depends on the severity of the disease. …show more content…
Less severe cases require oral antibiotics, such as penicillin and ampicillin, while more severe cases require high doses of intravenous penicillin. However, all treatment should begin before day five of the illness due to the controversy surrounding the effectiveness of treatment after that day (“Human Leptospirosis: Guidance” 19). When hospitalization becomes necessary, especially following renal care, studies show that supportive care, attention to fluid and electrolyte balance, and dialysis, can reduce the illness’ mortality (“Human Leptospirosis: Guidance” 19). III. Impact on individuals, communities and countries Despite
Illness can occur anywhere from 2 days to 4 weeks after exposure and begins with a fever, often accompanied by other symptoms, which may include chills, headache, muscle aches, vomiting, or diarrhea. This constitutes the first phase of the illness, after which the infected individual will recover. However, after this reprise from symptoms, the individual may enter phase two of the sickness, also called Weil’s disease, characterized by jaundice, abdominal pain, rashes, red eyes, kidney failure, liver failure, or meningitis (“Signs and Symptoms”). In addition to these symptoms, leptospirosis in this stage may also cause haemorrhages, myocarditis with arrhythmias, and pulmonary haemorrhages with subsequent respiratory failure (“Human Leptospirosis: Guidance” 17). The total duration of the illness may span up to 3 weeks, but, without treatment, recovery may take months (“Signs and Symptoms”). Due to the wide variety of symptoms and increased prevalence in developing countries with limited access to modern medical care, leptospirosis is often challenging for physicians to diagnose, especially in cases where symptoms include cough, nausea, vomiting, or a skin rash because of its similarity to other prevalent illnesses (“Human Leptospirosis: Guidance” 18). Therefore, laboratory tests are needed in order to confirm the diagnosis of leptospirosis. The laboratory detects antibodies from urine, blood, or tissue-cultured bacteria and utilizes fluorescent markers to identify the leptospires (“Human Leptospirosis: Guidance” 21). The laboratory specialists test for Leptospira antibodies through the the microscopic agglutination test (MAT), which works by combining the patient’s blood with various dilutions of live or dead leptospires. The antibodies present in the serum causes the leptospires to clump together and the clumps are compared to the regional requirements for the cut-off points for a positive diagnosis, ranging from 1:100 to 1:800 (“Human Leptospirosis: Guidance” 21-24). Although the test is time consuming and near impossible to standardize, the MAT has a high specificity, making it extremely reliable (“Human Leptospirosis: Guidance” 24). Physicians treat leptospirosis with a variety of antibiotics, the strength of which depends on the severity of the disease. …show more content…
Less severe cases require oral antibiotics, such as penicillin and ampicillin, while more severe cases require high doses of intravenous penicillin. However, all treatment should begin before day five of the illness due to the controversy surrounding the effectiveness of treatment after that day (“Human Leptospirosis: Guidance” 19). When hospitalization becomes necessary, especially following renal care, studies show that supportive care, attention to fluid and electrolyte balance, and dialysis, can reduce the illness’ mortality (“Human Leptospirosis: Guidance” 19). III. Impact on individuals, communities and countries Despite