Leptospirosis
Leptospirosis is an acute zoonotic natural focal infectious disease that occurs with damage to the kidneys and liver, nervous system, with general intoxication and hemorrhagic syndrome, and jaundice. Synonyms – Vasiliev-Weil’s disease, infectious jaundice, Japanese fever, canine fever.
ETIOLOGY
The causative agent of leptospirosis is the hydrophilic bacterium Leptospira (there are 230 serovars), it is widespread everywhere. The disease is of a professional nature, most often animal breeders, deratizers, veterinarians get sick. Workers of meat processing plants. Leptospirosis has a summer-autumn seasonality. The incubation period is 4 days – 1 month, after recovery, type–specific immunity develops. The source of leptospirosis is wild and domestic animals. The mechanism of transmission is fecal-oral, pathways are aquatic, alimentary, food. For people, a sick person is not dangerous.
Leptospira destroys red blood cells. It is well resistant in water – in open reservoirs for 30 days, in moist soil for 90 days, however, it is quickly inactivated.
symptoms
Human infection occurs in the presence of a damaged area of the skin and contact with contaminated water with animal excrement, the use of such water for food.
Weil’s cider is the development of anemia, jaundice on the background of prolonged fever with subsequent disturbance of consciousness. There are several periods during leptospirosis:
The initial period is 1 week. Acute onset with the development of intoxication, thirst. The patient suffers from tremendous chills and severe pain in the calf muscles. Patients cry out in pain, cannot walk, stand, acute pain when touching the calves. The face and neck are hyperemic, the conjunctiva is injected. Jaundice syndrome of the skin and mucous membranes develops, yellow urine, hemorrhagic syndrome – petechial rash occurs on the body at injection sites, nosebleeds.
The peak period is characterized by a critical decrease in body temperature, then rises again. On palpation, Pasternatsky’s symptom is positive. Kidney function is impaired (oliguria, anuria). Life–threatening conditions of the patient develop – gastric, intestinal, uterine bleeding. Lethality in this period is 20%.
COMPLICATIONS
of ITSH
Acute renal failure
Acute liver failure
Bleeding
Myocarditis
Leptospirosis meningitis
Pneumonia, polyneuritis
Otitis media, mumps
LABORATORY DIAGNOSTICS
Leptospirosis must be differentiated from influenza and acute respiratory infections.
Blood biochemistry – elevated bilirubin, urea, creatinine. ALT is normal, sulemic and thymolic are normal.
Microscopic method
Blood serology
Biological method
treatment
All patients must be admitted to the hospital. Penicillin and tetracycline antibiotics are prescribed as soon as possible. The outcome of the disease depends on the beginning of qualified care. The patient is assigned strict bed rest for the entire period of fever. Anti-leptospirosis immunoglobulin and glucocorticosteroids are necessarily administered. A diet No. 7 is prescribed with a restriction of the use of salt, liquid up to 1.5 liters per day – kidney sparing. With severe pain in the calves, hot water bottles are applied.
MEDICAL EXAMINATION
After recovery, patients are observed by an optometrist, neurologist for 6 months
PREVENTION
Specific – killed leptospirosis vaccine subcutaneously 0.5 ml for all risk groups and for epidemiological indications
Emergency – all contact Doxycycline 5 days 0.1 g
Non–specific – protection of reservoirs from rodents, a ban on the construction of livestock buildings near open reservoirs, swimming upstream (if there are buildings), proper operation of reservoirs, sanitary and educational work among workers with animals.
