By Nabil Asyran Norsyafikah

HISTORICAL PERSPECTIVE  A syndrome of severe multisystem disease presenting as profound jaundice and renal function impairment was described by Weil in Heidelberg in 1886  First visualized in autopsy specimens in a case thought to be Yellow Fever  Simultaneously isolated in Japan and Germany  Many researchers died of the disease

LEPTOSPIROSIS…  An infectious disease that affects humans and animals.  Also known as canicola fever, hemorrhagic jaundice, mud fever, caver’s flu  It is caused by pathogenic spiral bacteria that belong to the genus Leptospira 11,12  The organism enters the body when mucous membranes or wounded skin come in contact with contaminated environmental sources

1.Tightly coiled thin flexible 2.One end appears bent forms a hook 3.Active motile

TRANSMISSION  Rodens (rats) are the most common host -harbour leptospires in kidneys  Humans -direct contact with urine of infected animals -urine-contaminated surface water, soil and plants -swallowing contaminated food

PATHOGENESIS 1. Leptospires peneterate mucous membrane or abraded skin and multiply rapidly upon entering blood stream(cause fever) 2. Spread to kidney, liver, spleen, CNS, eyes and genital tract 3. Initial body responds clears most organs except kidneys(can remain and shed for weeks and months) 4. Produce hemorrhage and necrosis in the tissue and initiates dysfunction of the organ

SIGN AND SYMPTOMPS  1. The incubation period ranges from 2 to 26 days (approximately 10 days).  2. Begins with fever, chills, myalgias, and headache.  3. Dry cough  4. Nausea, vomiting and diarrhea, joint pain, bone pain, sore throat and abdominal pain are less common symptoms.  5. Inflammation of the lining of the eye.  6. May experience muscle pain, enlarged spleen or liver, swollen lymph glands, sore throat, muscle rigidity, noise in LUNG or rash

Weil’s syndrome  Severe form of leptospirosis that causes continous fever, stupor, and reduction in the blood’s ability to clot, which leads to bleeding within tissues.  Blood test reveal anaemia  By the third to sixth days, sign of kidney damage and liver injury appear  Kidney abnormality may cause blood in the urine and painful urination  Liver injury tends to be mild and usually heals completely

RISK FACTOR  OCCUPATION -farm workers, veterinarians, pet shop owners, field agricultural workers, butcher, plumbers etc  RECREATION ACTIVITY -canoeing, hiking, kayaking, fishing, windsurfing, swimming, waterskiing, tourist  ENVIRONMENT -rainy season and flood -temperate and tropical climate

LEPTOSPIROSIS CAN BE A SERIOUS HEALTH PROBLEM  It is an infectious disease with a wide global distribution, has been by and large neglected as a serious health problem till recently.  mimic many other diseases (dengue fever, hepatitis and other haemorrhagic disease) so not recognize as presenting feature leptospirosis  The increasing reports of outbreaks and clusters of cases, particularly from southeast asia, has brought attention to the public health problem posed by this spirocheatal infection

TREATMENT 1. Acetaminophen 2. Doxycycline 3. Tetracycline 4. Ciprofloxacin 5. Fusemide 6. Injection crystalline pecilline for treting weils disease 7. ampicillin

PREVENTION  Elemination of carrier  Vaccination of animals  Rodens control measures  Protective clothing and footware for wooker  Avoid exposure to urine and tissue of animals  Avoid eating uncooked water and drink directly from tap water

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