Published in IJCP August 2019
From the Desk of Group Editor in Chief
Beware of Leptospirosis in Areas of Floods
August 16, 2019 | KK Aggarwal
     


Many parts of the country are reeling under floods. Heavy rains have caused devastating floods, which have claimed lives and destroyed homes. Not only this, floods increase the risk of transmission of many infectious diseases such as typhoid, cholera, hepatitis A and mosquito-borne diseases such as malaria, dengue.

Leptospirosis is another infectious disease, which spreads via contaminated flood waters.

10 key facts on Leptospirosis

  1. Leptospirosis is a zoonosis with protean manifestations caused by pathogenic spirochetes of the genus Leptospira.
  2. The organism infects a variety of wild and domestic mammals, especially rodents, cattle, swine, dogs, horses, sheep and goats. Animals can be asymptomatic or develop clinical infection, which can be fatal.
  3. Reservoir animals may shed the organism in their urine intermittently or continuously throughout life, resulting in contamination of the environment, particularly water.
  4. Humans most often become infected after exposure to environmental sources, such as animal urine, contaminated water or soil, or infected animal tissue through cuts or abraded skin, mucous membranes or conjunctiva.
  5. The clinical course is variable. It may manifest as a subclinical illness followed by seroconversion, a self-limited systemic infection or a severe, potentially fatal illness accompanied by multiorgan failure.
  6. Leptospirosis presents with the abrupt onset of fever, rigors, myalgias and headache in 75-100% of patients.
  7. Conjunctival suffusion in a patient with a nonspecific febrile illness should raise suspicion for the diagnosis of leptospirosis.
  8. Most cases are mild-to-moderate. However, the course may be complicated by renal failure, uveitis, hemorrhage, acute respiratory distress syndrome with pulmonary hemorrhage, myocarditis and rhabdomyolysis.
  9. A high index of suspicion is required.
  10. In the absence of a definitive laboratory diagnosis, administration of empiric treatment is appropriate. Oral doxycycline or oral azithromycin are the antibiotics of choice.