Leptospirosis

 

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Definition

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. This bacteria can enter the body through skin or mucous membranes (eyes, nose, mouth) especially if skin is broken with cut or scratch. Outbreaks are most commonly associated with contaminated water such as flood waters. Person to person transmission of this bacteria is rare. 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. (8)

Prevalence

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. 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. ⁽⁸⁾

Characteristics/Clinical Presentation

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%. ⁽⁸⁾

Associated Co-morbidities

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Medications

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Diagnostic Tests/Lab Tests/Lab Values

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Etiology/Causes

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Systemic Involvement

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Medical Management (current best evidence)

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Physical Therapy Management (current best evidence)

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Differential Diagnosis

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Case Reports/ Case Studies

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Resources

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Recent Related Research (from Pubmed)

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References

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