LEPTOSPIROSIS

I. DESCRIPTION
Leptospirosis is an infectious disease of humans and animals that is caused spirochetes
of the genus Leptospira. Leptospirosis, the most widespread zoonosis, is emerging as a major
public health problem. The clinical manifestations of human leptospirosis are diverse, ranging
from mild, flu-like illness to a severe disease form known as Weils syndrome. Severe disease is
characterized by jaundice, acute renal and hepatic failure, pulmonary distress and hemorrhage,
which can lead to death.

Leptospirosis is found throughout the world, including Europe, but is most common in
tropical and subtropical areas. This is because the leptospira bacteria are able to survive
longest in hot and humid conditions.

Leptospirosis is acquired through direct or indirect contact with the urine of an infected
animal. The spirochete most commonly enters through abrasions in the skin or through
the conjunctiva.

The principal source of infection in humans is the rat, although other sources include
dogs, livestock, rodents, and other wild animals.

The incubation period is usually 7 to 13 days but can range from 2 to 26 days

Two syndromes occur: anicteric leptospirosis, which is typically self-limiting and

consists of a septicemic phase and an immune phase, and icteric leptospirosis (Weil
disease), which is characterized by severe jaundice, liver failure, and renal failure and
may be fatal, with mortality rates ranging from 5% to 40%

Disease onset is abrupt, and the anicteric illness is typically biphasic, with an acute
leptospiremic phase followed by an immune-mediated leptospiruric phase.

Neonatal infections can occur.

Causative agent: Leptospira Interrogans (most common). It is a spirochete (coiled, helicalshaped), gram-negative, aerobic bacteria with a thin body, hooked ends and paired axial
flagella. The hooks are used for attachment to the infected tissue. The antigenic differences

in the lipopolysaccharide envelopes that surround their cell walls are used to classify the
different serotypes of the bacteria. Other subgroups: L. icterohemorrhagia, L. canicola.
Reservoir: wild and domestic animals such as rats, swine, cattle and dogs.
Mode of Transmission: contact of the skin and mucus membrane, especially if abraided
with water contaminated with urine of infected animals.
Incubation Period: Ranges from 7-19 days, with an average of 10 days.
Period of Communicability: as long as 11 months after an acute illness
Pathognomonic Sign: Orange eyes/ orange sclera
Categories:
1. a mild, influenza-like illness;
2. Weils syndrome characterized by jaundice, renal failure, hemorrhage
and myocarditis with arrhythmias
3. meningitis/meningoencephalitis;
4. pulmonary hemorrhage with respiratory failure