Leptospirosis Treatment

What is Leptospirosis?

It is an illness that is caused by an infection with the bacteria Leptospira through cuts or abrasions on the skin or the eyes, nose or mouth. The Leptospirosis disease is zoonotic, which means that it can be transmitted to humans from animals and vice versa, and requires immediate treatment. An individual can be infected through any of the following:

• Eating or drinking contaminated food or water
• Contact with contaminated soil or water
• Direct contact with diseased animals’ urine or reproductive secretions. 

In some cases, leptospira causes mild flu-like symptoms, or it may cause no symptoms at all. It can also lead to severe complications like meningitis and can be fatal.

What are the types of leptospirosis?

There are two types of leptospirosis, they can also be referred to as phases, and they include:

• Anicteric syndrome – This is the first phase of the disease. It is a mild, flu-like illness that accounts for about 90% of the cases.
• Icteric syndrome – If an individual gets better but then gets sick again, they will enter the second phase of leptospirosis. This is referred to as the icteric syndrome or Weil’s disease, and it is more severe. This type typically lasts several weeks and is less common than the first phase of leptospirosis.

What are the symptoms of leptospirosis in people?

The symptoms seen differ in type and severity of the infection. Leptospirosis can cause no symptoms in some people. Mild leptospirosis causes the following:

• Fever
• Coughing
• Vomiting
• Rashes that can lead to rhabdomyolysis
• Chills
• Stomach pain
• Muscle pain, especially in the calves and lower back
• Diarrhea
• Headache
• Red eyes

Symptoms seen in severe leptospirosis include:

• Jaundice
• Kidney failure
• Hemorrhage
• Myocarditis
• Aseptic meningitis
• Liver failure
• Heart arrhythmia
• Respiratory problems

It can take between 1 to 2 weeks for the person with the condition to begin to show any symptoms, but it can take up to a month.

How does leptospirosis spread?

It is rare for leptospirosis to spread between humans. However, the spread can occur during pregnancy via the placenta. This poses a miscarriage risk. The disease is also widespread among animals; including the wild, the farm and the domesticated animals. It is quite common in dogs but rare in cats. An animal that has the disease may show no overt symptoms. They are also capable of releasing the bacteria to the environment for months or years. Dogs can be vaccinated against the disease, and it provides up to 12 months of protection from the disease. So it may be necessary for a yearly vaccination schedule. There are no leptospirosis vaccines for cats. The disease can be spread to humans through contact with the urine of infected animals and rarely through bites.

Who are at risk for leptospirosis?

The disease is more likely to affect the following people:

• Those who garden or handle potentially contaminated soil
• Those who live in areas with improper sanitation or flooding
• Those who work with animals, like veterinarians or farmers
• Those living in tropical or temperate regions
• Those who swim in contaminated bodies of water
• Those who work outdoors, like sewer or mine workers
• Those who camp outside or participate in outdoor sports

How is leptospirosis diagnosed?

The disease can be diagnosed using the following methods:

• Medical history – This can help narrow it down and rule out other conditions.
• Blood tests – This is done to measure the patient’s complete blood count and kidney and liver function and check for leptospirosis antibodies.
• Microscopic agglutination test – This test is the gold standard for diagnosing leptospirosis. It checks the blood serum for the antibodies to leptospirosis.
• Lumbar puncture – This test checks the cerebral spinal fluids for any signs of meningitis.

How is leptospirosis treated?

The treatment adopted would depend on the severity of the infection. In mild cases of leptospirosis, the individual may be treated with simple remedies like:

• Drinking a lot of fluids
• Getting plenty rest
• Taking common pain relief medication

Antibiotics are medications that are designed to destroy bacteria. The following antibiotics can be used to treat leptospirosis:

• Doxycycline
• Amoxicillin
• Azithromycin
• Penicillin (used in severe cases)
• Ceftriaxone (used in severe cases)

They may be given intravenously in severe cases of the disease.

Other medical treatments

In severe cases of leptospirosis, the patient would have to be admitted to a hospital. This is because several of their organs are usually affected. Depending on the severity and clinical condition, the patient may require additional medical interventions like:

• Dialysis
• Mechanical ventilation
• Medication that helps to support blood pressure (vasopressor)

How can the disease be prevented?

Avoiding bacteria exposure is the greatest approach to avoiding the sickness. Some of the ways to avoid it in people include:

• Swimming in freshwater (rivers, streams) because they may contain animal urine. 
• Treat unsafe water by boiling it first
• If an individual is working with animals, they should wear protective clothing or shoes
• Control the rats and mice population in their vicinity
• Avoid touching or swimming in floodwater
• Avoid swimming in bodies of water after heavy rain or flooding. 
• Wear protective clothing or shoes when handling contaminated water or soil.

If an individual’s pet is infected, some guidelines on how they can protect themselves include:

• Clean any urine from the pet immediately
• Wash hands after contact with the pet
• Avoid touching the pet’s urine
• Make sure the pet does not pee into any body of water or places that people may touch
• Administer prescribed antibiotics as instructed by the veterinarian

To prevent pets from contracting the disease, an individual may do the following:

• Keep the pets away from rodents, animal carcasses and wild animals
• Make sure that the pets only drink clean water
• Keep the pets away from other animals’ urine
• Keep the pets out of contaminated water, especially after heavy rainfall and flooding
• Enquire about the need for a leptospirosis vaccine for a pet

When to see a doctor

Contact a doctor whenever there is exposure to animal urine, contaminated soil or water. Some other signs that may prompt contacting a doctor include:

• Red eyes
• Jaundice
• Neck stiffness
• Headaches
• Persistent fevers
• Unexplained vomiting and diarrhoea
• Unexplained stomach or muscle pain