Leptospirosis (Weil’s disease) Symptoms, Causes, Diagnosis, Treatment and Prevention

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Leptospirosis or Weils Disease or Weils Syndrome is a disease caused by a spirochaete called Leptospira interrogans. It is a disease with symptoms and signs caused by inflammation of the blood vessels in the affected and it is mainly treated using Doxycycline or Penicillin G. this disease occurs worldwide as it is transmitted by rodents such as coming in contact with infected rat urine.

What is Leptospirosis?

Leptospirosis is a zoonosis (animal disease that can be transmitted to humans) that causes generalized inflammation of the vessels (vasculitis)

Leptospirosis Causes

  1. Leptospira icterohemorrhagiae (the commonest serotype in Weils disease)
  2. Leptospira canicola
  3. Leptospira Pomona
  4. Leptospira australis
  5. Leptospira grippotyphosa
  6. Leptospira hyos
  7. Leptospira sejroe

Leptospirosis is caused by the different serotypes of Leptospira interrogans especially Leptospira icterohemorrhagiae.

Leptospirosis Risk Factors

  1. Engaging in recreational activities in rural areas such as picnics
  2. Farm workers
  3. Zoo workers
  4. Sewage workers

Leptospirosis Epidemiology

Leptospirosis occurs worldwide and it is a disease that mainly affects animals (Zoonosis) such as Pigs, Dogs and Cattle. Only about 30 cases of leptospirosis are reported per year in England and Wales even though some cases be undiagnosed; in Hawaii, there is annual incidence of about 130 per 100, 000.

Leptospirosis Transmission

Leptospirosis is transmitted by contact with infected rat urine through breaks in the skin or mucous membranes such as that of the nose or eyes and this could occur in people working in canals or rivers or sewers where rats can easily be found.

Leptospirosis incubation period

Incubation period of leptospirosis is 7 to 12 days with average of 10 days after which the first symptom occurs.

Leptospirosis Pathophysiology

Leptospira interrogans penetrates the skin or mucous membrane and gain entry into the blood where it disseminates and cause inflammation of the blood vessels (generalized vasculitis) in various organs of the body including the brain (CNS) giving a clinical scenario of sepsis this stage is called the septic stage and it is followed after 3 to 7 days by a stage called the Immune stage; the immune stage last for about 4 to 30 days. There are two clinical types of Leptospirosis: Anicteric leptospirosis and Icteric Leptospirosis. The anicteric leptospirosis is milder and shows no jaundice (the immune stage of this form of leptospirosis clinically manifests with mild aseptic meningitis) while the icteric form of leptospirosis is the severe form and it is what is called Weils disease. Icteric leptospirosis (Weils disease) can cause liver and kidney dysfunction, cardiovascular disruptions, and Hemorrhages in the immune stage.

Leptospirosis Symptoms and Signs

  1. Fever
  2. Headache
  3. Vomiting
  4. Anorexia
  5. Muscle pains (Myalgia)
  6. Diarrhea
  7. Hemorrhagic rash
  8. Conjunctival reddening (red eyes)
  9. Jaundice
  10. Renal failure.

Leptospirosis Diagnosis

The diagnostic test of choice is identification of antibody against leptospira spp in a lysis-agglutination reaction but the organism can also be grown in culture of urine, CSF or blood.

Leptospirosis Treatment

Weils disease ( Leptospirosis) is treated using doxycycline or Penicillin G. There is also need for supportive care and hemodialysis when there is renal failure. Prophylactic treatment can be given to people who fall into waterways that are contaminated with leptospires also with penicillin or doxycycline.

Leptospirosis Prevention

  1. Keep rats away from home by clearing bushes and keeping the home clean
  2. Proper environmental and household hygiene to keep rats away
  3. Proper sewage disposal
  4. There is no commercially available vaccine

Leptospirosis Complications

  1. Pneumonia
  2. Meningitis
  3. Myocarditis
  4. Renal failure
  5. Hemorrhagic conjunctivitis
  6. Hepatitis