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Monday, July 2, 2012

Health Talk: Leptospirosis

The Department of Health (DoH) here has advised the public to watch out for the common diseases during wet season as the rainy season has officially started in the country. Dr. Lyndon Lee-Suy, program manager for Emerging and Re-emerging Diseases of the DoH, said the common diseases during rainy days include influenza, cough and colds, skin irritation, dengue and leptospirosis.
Lee Suy encouraged the public to boost their immune system by staying healthy, having regular exercises, enough time of sleep, eating the right foods, having a balanced diet, dealing with stress and living a healthy lifestyle.
On prevention of the spread of the diseases, Lee Suy noted the usual practice - cough etiquette or the proper way of coughing (covering their face when coughing), proper washing of hands regardless of season.

What is leptospirosis?

Leptospirosis is an infectious disease caused by a type of bacteria called a spirochete. Leptospirosis can be transmitted by many animals such as rats, skunks, opossums, raccoons, foxes, and other vermin. It is transmitted though contact with infected soil or water. The soil or water is contaminated with the waste products of an infected animal. People contract the disease by either ingesting contaminated food or water or by broken skin and mucous membrane (eyes, nose, sinuses, mouth) contact with the contaminated water or soil.
Leptospirosis occurs worldwide, but it is most commonly acquired in the tropics. The U.S. Centers for Disease Control and Prevention states 100-200 cases of leptospirosis are reported each year in the United States, with about 50% of cases occurring in Hawaii. Although the incidence in the United States is relatively low, leptospirosis is considered the most widespread disease that is transmitted by animals in the world.
A 2010 outbreak in Michigan caused serious illness in numerous pets, raising concern for the local human population. In 2009, typhoons hit the Philippines, causing a leptospirosis outbreak. The Philippines Department of Health then reported 1,887 cases of leptospirosis, which resulted in 138 deaths.

What are leptospirosis symptoms and signs?

Leptospirosis symptoms begin from two to 25 days after initial direct exposure to the urine or tissue of an infected animal. This can even occur via contaminated soil or water. Veterinarians, pet shop owners, sewage workers, and farm employees are at particularly high risk. People participating in outdoor sporting activities like canoeing, rafting, hiking, and camping can also come into contact with contaminated water or soil.
The illness typically progresses through two phases:
  • The first phase of nonspecific flu-like symptoms includes headaches, muscle aches, eye pain with bright lights, followed by chills and fever. Watering and redness of the eyes occurs and symptoms seem to improve by the fifth to ninth day.
  • The second phase begins after a few days of feeling well. The initial symptoms recur with fever and aching with stiffness of the neck. Some patients develop serious inflammation of the nerves to the eyes, brain, spinal column (meningitis), or other nerves. Right upper area abdominal pain may occur. Less common symptoms relate to disease of the liver, lungs, kidneys, and heart.
Leptospirosis associated with liver and kidney disease is called Weil's syndrome and is characterized by yellowing of the eyes (jaundice). Patients with Weil's syndrome can also develop kidney disease and have more serious involvement of the organs affected.

How is leptospirosis diagnosed?

The diagnosis of leptospirosis is made by culture of the bacterial organismLeptospira from infected blood, spinal fluid, or urine. However, many doctors must rely upon rising Leptospira antibody levels in the blood in order to make the diagnosis, as the technique required to perform the culturing is delicate and difficult.

How is the treatment for leptospirosis? What is the prognosis for leptospirosis?

The treatment of leptospirosis involves high doses of antibiotics. Antibiotic treatment (doxycycline [Vibramycin, Oracea, Adoxa, Atridox], penicillin) is most effective when initiated early in the course of the illness. Severely ill patients may need hospitalization for IV fluid and antibiotic treatment. Severe liver and kidney manifestations of the infection may require intensive medical care and sometimes dialysis treatment. However, even in severe cases, liver and kidney function often does return after recovery from the illness.


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