First ever case of leptospirosis reported in-1886
•Re
emerging infectious disease
Leptospirosis
History
•1886:The first ever case of leptospirosis
was reported by Adolf Weil. Weil’s
disease
•1914:Causative organism was isolated for the first
time by Japanese scientists Inada and Ido
•1931:The first case in India reported from
Andaman & Nicobar Islands
•1994:The first case from Gujarat reported from Valsad
District
Major Zoonosis
ØAnthrax
ØPlague
ØBovine
TB
ØGlanders
ØNipha virus
ØZika Virus
ØCCHF
ØLeptospirosis
Leptospirosis is a disease of zoonotic group.
Leptospirosis characterized as...
ØZoonotic disease.
ØOccupational disease. (People engaged with Agriculture
& Animal Husbandry)
ØSeasonal disease. (during monsoon... June-October)
ØMulti organ Involvement
ØHigh Mortality can be prevented by early precautionary measures.
How is the
disease caused?
A Zoonosis
Man is an accidental host
Sites Of
Entry
Enters in the human body through cracks & wounds of
soles and hands, abraided mucus membrane and
conjunctiva.
High Risk Group
Disease mainly affecting poor farm labourers and cattle handlers.
High Risk Group
•High Mortality amongst productive age
group.
•Human being having low immunity for Zoonotic disease.
Factors responsible for
disease prevalence
Agent
Host Environment
Factors catalyzing disease
prevalence
•Natural calamities like:-
Heavy Rain/ Floods Earthquakes Cyclones
Recommended
clinical case definition of leptospirosis :
Every fever case will be
classified in 3 categories
•Fever case
•Presumptive
case of Leptospirosis
•Suspected
clinical case
•Confirmed
case
a.)Fever Case
b.)Presumptive Case of Leptospirosis
Fever case with any one of the following
1. Bilateral conjunctival suffusion
2. Frontal Headache
c.)Suspected Case: Fever
case with any one of the following
•Severe Myalgia (Calf, Back & Abdomen muscles)
•Oliguria/Anuria
•Yellowish discoloration of urine/eyes
•Meningism
•Blood in cough/vomiting
•Gabharaman
•Breathlessness
•Cold extremities
•Irregular pulse
d.)
Confirmed Case: A suspected case with
positive laboratory test.
Signs
& Symptoms
In Humans
•Fever
•Bilateral Conjunctival Suffusion
•Frontal Headache
•Severe Myalgia
•Oliguria/Anuria
•Yellowish discoloration of urine/eyes
•Meningism
•Blood in cough/vomiting
•Gabharaman /
Breathlessness
•Cold extremities
•Irregular pulse
In Animals
•Fever
•Weakness
•Anorexia
•Mastitis
•Missed abortions
Clinical
Types
ANICTERIC
LEPTOSPIROSIS
•Fever
•Headache
•Myalgia
•Conjunctival
suffusion
Conjunctival Suffusion
ICTERIC
LEPTOSPIROSIS
•Weil’s Syndrome: Liver & Kidney
•Multi organ dysfunction: Heart, Lungs, Blood, Brain, Eyes
RENAL MANIFESTATIONS
Some Renal Involvement is Invariable
ØCLINICAL FEATURES:
Wide
spectrum:
§ Asymptomatic Urinary Abnormality
§ Acute renal failure
ØInvestigations:
Urine: Decreased amount, albumin, cast, cells
Blood: Urea,
serum creatinine-
increased
U.S.G.: Increased kidney size-nonspecific
HEPATIC INVOLVEMENT
CLINICAL FEATURES
•Jaundice/Hepatomegaly
•Hepatic
encephalopathy, death due to hepatic failure – rare
INVESTIGATIONS :
Increased
serum bilirubin
SGPT/SGOT
normal or mildly elevated
Conjunctival Suffusion and Icterus
Pulmonary
Alveolar Haemorhage
The
Commonest Cause Of Death Due To
Leptospirosis In
India.Accounts
for more than 95% deaths.
Pulmonary
Alveolar Haemorhage
CLINICAL
FEATURES
Symptoms
§ Cough
§ Haemoptysis
§ Dyspnoea
Signs
§Tachypnea
§Basal creps
Spreading
upwards
§Hypoxemia
Respiratory failure
Pathology: Alveolar haemorrhage
Lung-Post
Mortem
Treatment
Antibiotics
•Penicillin/Doxycycline
•Ceftriaxone
•No evidence of resistance to any of these
drugs
Organ
Specific Supportive Care
ØRenal:
Haemodialysis
ØHepatic:
General measures
ØCardiac:
I/V fluids,Dopamine,Dobutamine
Arrhythmias
ØHaematological:
Platelet concentrates
Treatment
of Pulmonary haemorrhage
•Mechanical
ventilation with PEEP Initial non invasive vetilation
•Platelet transfusions
•Correction of coagulation abnormalities
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