TRANSMISSION


Urine and blood from a leptospirosis infected person or animal can contain a sufficient amount of bacteria to spread the disease. A common transmission route for humans is getting urine or blood from an infected animal on damaged skin. Even a tiny skin abrasion can be enough for the bacteria to get into the body. Leptospira bacteria can also enter the body through mucous membranes, e.g. those found in the eyes, nose, mouth and genitals.


When infected blood or urine gets into water or soil, the bacteria can survive there for several months. Contract with contaminated water or soil can be enough to catch leptospirosis, e.g. if you have a small abrasion on your skin or get water/ soil onto a mucous membrane. Also, keep in mind that water and soil can contaminate food and food can also be directly contaminated by urine and blood.


Many different animals can carry and transmit leptospirosis, including dogs, rodents, cattle, horses and pigs. An infected animal is often symptom free and can continue to excrete bacteria into the environment year after year.


The incubation time for leptospirosis in humans is usually one to two weeks but anywhere from 48 hours to more than a month has been reported.


SYMPTOMS


Examples of symptoms from the eyes


• Eye inflammation can occur, with reddening of the eyes and increased sensitivity to light.


• If leptospirosis bacteria causes liver inflammation with poor liver function as a result, one noticeable symptom can be the yellowing of the sclera. The sclera is the white part of the


66 | The Report • June 2017 • Issue 80


eye; the part that surrounds the iris. When the liver isn’t working properly, the sclera becomes yellow due to increased levels of bilirubin in the body. In some cases, the sclera can even look greenish. Always check your eyes before you put in your contact lenses if you wear coloured lenses. If you do not you risk not seeing the symptoms of leptospirosis, liver damage and a long list of different diseases.


Examples of symptoms from the skin


• Skin rash


• If leptospirosis bacteria causes liver inflammation with poor liver function as a result, symptoms can include the yellowing of the skin due to increased levels of bilirubin. In such situations, itchy skin is also common. In severe cases, the skin can look greenish rather than yellowish.


Examples of symptoms from the digestive system


• Stomach ache • Diarrhea • Vomiting


• If leptospirosis bacteria causes liver inflammation with poor liver function as a result, symptoms can include pale feces and dark urine.


Examples of symptoms from the respiratory system


• Coughing up blood (caused by lung bleeding)


Examples of other symptoms


• High fever • Chills • Headache • Muscle ache • Edema


Illness that develops within 12 hours of the exposure event would not be leptospiral in origin. Often infections that involve contaminated water can show illness very rapidly, caused by the effects of other unrelated bacteria and viruses in the water (such as


TREATMENT


Leptospira bacteria are sensitive to several different antibiotics, including well-known ones such as Penicillin and Doxycycline.


If the infection is diagnosed early and symptoms are mild, oral antibiotics are often sufficient. In more severe cases, intravenous treatment with antibiotics may be necessary. Each individual symptom can also require specific treatment. If kidney function is impaired, dialysis can be carried out.


When an MD has good reason to suspect leptospirosis in a patient, antibiotic treatment is typically started right away, without waiting for test results.


HOW QUICKLY CAN AN ILLNESS DEVELOP?


Human leptospirosis takes a while to incubate, and the normal range between exposure and illness is 3 to 14 days, although it can take up to 21 days. It’s considered extremely unlikely that the illness would show earlier than 24 hours after exposure, even if the patient was otherwise unwell. In rare cases the incubation time can be very long (several weeks), but it is normally assumed that if there is no illness after 30 days then infection is either not present, or was subclinical.


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