Causative Agent Incubation Period Mode of Transmission Clinical Manifestations Diagnosis and Treatment Nursing Management

Also called as Weils Disease, Mud Fever, Trench Fever,

Flood Fever, Spiroketal Jaundice, Japanese Seven Days Fever It is a worldwide zoonotic disease caused by bacteria leptospires. Rat is the main host to leptospirosis although pigs, cattles, rabbits, hare, skunk and other wild animals serve as reservoir hosts. It is an occupational disease affecting veterinarians, miners, farmers, sewer workers, etc.

 1. Leptospiremic phase- leptospires are present in the

blood and Cerebro Spinal Fluid (CSF). Onset of signs and symptoms are abrupt with fever, headache, myalgia, nausea, vomiting, cough and chest pain.
2. Immune phase- correlates with the appearance of

circulation IgM.

 Leptospira interrogans gram negative, fine spiral

bacteria 0.1um in diameter and 6-20 um in length. Locomotion is achieved in a fluid medium by a whirling motion around the longitudinal axis and by a serpentine or corkscrew motion in a semisolid medium.

 Ranges from 7-19 days, with average of 10 days.

 Entry of the leptospira bacteria

through wounds when in contact with flood waters, vegetation, moist soil contaminated with the urine of infected animals, especially rats.

 Fever

Non-specific symptoms of muscle pain, headache

Severe cases result to liver involvement, kidney failure

or brain involvement. Thus some cases may have yellowish body discoloration, dark-colored urine and light stools, low urine output, severe headache.

 By presenting clinical manifestations

Culture
Blood and CSF examination during the first week Urine examination on the 10th day

 Antibiotics duly prescribed by a physician.

Penicillins and other B- lactam antibiotics (PCN at 2M

units q6H IM/IV) Tetracycline (Doxycycline at 100mg q12H PO) Erythromycin (500mg q12H PO) if allergic to Penicillin
Early recognition and treatment within two days of

illness to prevent complications of leptospirosis, so early consultation is advised.

 Provide education to clients telling them to avoid

swimming or wading in potentially contaminated water or flood water. Use of proper protection like boots and gloves when work requires exposure to contaminated water. Drain potentially contaminated water when possible.

 Control rats in the household by using rat traps or rat

poison, maintaining cleanliness in the house. Isolate the patient and concurrent disinfection of soiled articles. Report all cases of leptospirosis. Chemoprophylaxis can be done in a group of high risk infected hosts.