LEPTOSPIROSIS (Weils disease, Mud Fever, Trench Fever, Flood

Fever, Spiroketal Jaundice, Japanese Seven Days Fever)

Leptospirosis is a worldwide zoonotic disease caused by bacteria called

leptospires, Leptospira interrogans.

Rat is the main host to leptospirosis although pigs, cattles, rabbit, hare,
skunk and other wild animals can also severe as reservoir hosts.
It affects veterinarians, miners, farmers, sewer workers, abbatoir workers,
etc.

Etiologic agent:
Leptospira interrogans – fine spiral bacteria 0.1 urn in diameter and 6-20 urn
in length. Appears straight with 1 or both ends hooked. Locomotion is
achieved in a fluid medium by a whirling motion around the longitudinal axis
and by a serpentine or corkscrew motion in semisolid medium.

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

Mode of Transmission: through contact of the skin, esp. open wounds with
water, moist soil or vegetation contaminated with urine of infected host.

Signs and Symptoms

Clinical manifestations are variable with different degrees of severity. It has
two
Clinical Phases:
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 circulating IgM

Diagnosis
The diagnosis of leptospirosis is made by culture of the bacterial organism
Leptospira from infected blood, spinal fluid, or urine. However, many doctors
must rely upon rising Leptospira antibody levels in the blood in order to
make the diagnosis, as the technique required to perform the culturing is
delicate and difficult.

Treatment
The treatment of leptospirosis involves high doses of antibiotics. Antibiotic
treatment (doxycycline, penicillin) is most effective when initiated early in
the course of the illness. Severely ill patients may need hospitalization for IV
fluid and antibiotic treatment. Severe liver and kidney manifestations of the
infection may require intensive medical care and sometimes dialysis
treatment. However, even in severe cases, liver and kidney function often
does return after recovery from the illness.
Mortality rates for severe illness with leptospirosis can range from 5%-40%,
depending on the severity of organ dysfunction and the patient's general
health prior to infection. Most previously healthy patients will make a full
recovery.
A vaccine for leptospirosis is available and used in Europe and Asia. It must
be given every year like a flu shot. It is not currently available in the United
States. Travelers who are going to an area where leptospirosis is common
and who will be engaged in activities that increase likelihood of exposure,
can take 200 mg of doxycyline per week by mouth starting before and during
the time period of potential exposure.
Leptospirosis was a reportable disease in the United States, but it was
removed from the national CDC list of reportable diseases. It is, however, still
reportable in some states, most notably Hawaii.

INFLUENZA

Etiologic Agent: Influenza Virus A, B, C,

Source of Infection: Discharges from the mouth and nose of infected persons

Description
Acute highly communicable disease characterized by abrupt onset with fever
which last 1 day to 6 days, chilly sensation or chills, aches or pains in the
back and limbs with prostrations. Respiratory symptoms include coryza, sore
throat and cough.

Mode of Transmission
By direct contact, through droplet infection, or by articles freshly soiled with
discharge of nose and throat of infected person, Airborne.

Incubation Period: Short, usually 24-72 hours.

Period of Communicability: Probably limited to 3 days from clinical onset.

Susceptibility, Resistance and Occurrence

• Universal but of varying degrees as shown by frequent unapparent and
typical infection during epidemics.
• Occurrence is variable, in pandemics, in local epidemics and as
sporadic cases, often unrecognized by reason of indefinite clinical
symptoms.
• Infection produces immunity of unknown duration to the type and
subtype of infecting virus.

Methods of Prevention and Control

• Education of the public as to sanitary hazard from spitting, sneezing
and coughing.
• Avoid use of common towels, glasses and eating utensils.
• Active immunization with influenza vaccine provided prevailing strain
of virus matches antigenic component of vaccine.

Public Health Nursing Responsibilties

•