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Leptospirosis

Leptospirosis

Leptospirosis is the most widespread zoonotic disease in the world. It is particularly common in tropical and sub-tropical areas of the world. Human cases are uncommon in Canada. However, there may be an increase of leptospirosis in dogs in North America.

Information for Health Professionals

Leptospirosis is the most widespread zoonotic disease (disease that we acquire from animals) in the world. British Columbians are at low risk of leptospirosis. They are most likely to be exposed to Leptospira when traveling to tropical and sub-tropical countries where the organism is more common. Infections occurring after exposure in BC are believed to be very rare. 

Infected people may show a range of symptoms: they can be asymptomatic (without symptoms) or experience severe illness. Fortunately, most cases are relatively mild, and recovery is complete. A small proportion of people die from leptospirosis in Canada (1-5%), but up to 20% of people die in outbreaks in under-resourced countries.

 

Leptospirosis can cause many symptoms including: 


·         fever

·         chills 

·         headache

·         muscle aches

·         malaise (feeling unwell)

·         conjunctivitis (pink eye)

·         vomiting 


Jaundice (yellow skin or eyes), abdominal pain, and a rash may also occur. Serious consequences are possible, including:


·         kidney and liver failure

·         meningitis 

·         respiratory problems


The infection may start with mild symptoms that become severe over a few days. Symptoms start an average of 10 days (range 2 to 30 days) after exposure to the bacteria and last from a few days to several weeks. Sometimes a person can be infected and have no symptoms. 

 

Leptospirosis is caused by a bacterium called Leptospira.

Leptospirosis occurs when:


·         people with cuts or abraded skin come into contact with              water or soil that is contaminated with infected animal urine (for example, swimming, wading, boating or taking part in other recreational activities in water that may be contaminated with urine of infected animals) 

·         farm workers come into direct contact with the body fluids of infected pregnant animals while aiding in birthing

·         contaminated aerosols are inhaled or contaminated water or fluids come into contact with the eyes or nose

·         the bacteria are ingested through contaminated drinking water or food (for example, drinking untreated water from lakes, streams or rivers)


Animals known to carry or be infected with Leptospira include:


·         rats and other rodents

·         deer 

·         foxes 

·         skunks

·         cattle 

·         dogs 

·         pigs 

·         horses


Leptospirosis is most common in people who work outdoors or with animals, including:


·         livestock farmers

·         farmers working in sugar cane fields

·         sewage workers 

·         veterinary staff 

·         abattoir workers 

·         fish farmers

·         hunters 

·         trappers


Leptospirosis also occurs in adventure racers who swim or wade through contaminated water. 

Dogs and other animals can get leptospirosis through drinking, swimming or walking through contaminated water or coming into contact with infected wildlife. Cats seem less prone to infection.

 

Leptospirosis is not transmitted from person to person.

 

The more serious forms of leptospirosis include meningitis, kidney and liver failure, and miscarriage in pregnant women.

  
Leptospirosis is diagnosed through a blood test; several blood samples may be needed.

If you think you have leptospirosis, see your family doctor immediately for testing, advice and treatment. If you have participated in activities in which you may have been exposed to animal urine or contaminated water, tell your doctor.


Early treatment with antibiotics is important.

‎There is no commercially available vaccine for humans.

 

People who are at very high risk of becoming infected with leptospirosis may discuss the use of antibiotics prior to a known leptospirosis exposure with their physician.  These include:


·         soldiers training in tropical regions 

·         adventure tourists who will have freshwater exposure (especially tropical) 

·         veterinarians who will be working with infected animals

Antibiotic use after exposure may be indicated for persons who have encountered the bacteria and are highly likely to become infected. Antibiotic prophylaxis is NOT routinely offered to protect owners of infected animals because the risk of transmission through normal human contact with infected animals is usually low.

 

Information about how to protect yourself is provided for pet owners, swimmers, farmers and other high risk occupations below:

 

Pet exposure:

 

If your pet is currently healthy


  • Discuss getting your dog vaccinated with your veterinarian
  • Avoid leaving pet food and water outside where it can attract wildlife.
  • Be sure to wash your hands after:
    • Petting or handling your pet
    • cleaning up indoor urine accidents from pets
    • washing your pet
    • cleaning up any bedding that is contaminated with urine
    • if you are bitten, nipped or licked by your pet.
  • Do not let your children crawl or play in areas of the yard where there may be fresh animal urine.
  •  Don't let your pet in areas where food is being prepared or grown, or on your bed

If you think your pet has leptospirosis


  • Immediately take your pet to a veterinarian for diagnosis and treatment. 
  • When cleaning surfaces that may be contaminated or have urine from an infected pet on them, use an antibacterial cleaning solution, detergent or a solution of 1 part household bleach in 10 parts water (Centers for Disease Control and Prevention 2005). 
  • Use gloves to handle its urine, blood, and tissues during its infection. Wash your hands after touching your dog. 
  • Cover cuts and abrasions with waterproof dressings. 
  • It would be prudent for pregnant or breast-feeding women, the elderly and young children to avoid cleaning up animal wastes and contact with sick animals during periods of peak transmissibility (up to 3 weeks after onset of infection in the animal), if possible.

Recreational exposure:


  • Cover skin wounds with waterproof bandages before entering the water.
  • Eco and adventure tourists should be made aware of the risks and take appropriate measures to protect exposed skin (regardless of whether or not it is intact), eyes and mucous membranes as much as possible during primary (e.g. wading, swimming) and secondary (e.g. boating) contact with recreational water in tropical areas. 
  • Eco adventure tourists and others should discuss pre-exposure prophylaxis (see pre-exposure below) with a travel clinic or their health care provider if they will be participating in high-risk activities. 
  • Do not swim, wade or participate in activities in water that may be contaminated with animal urine, for example, where there are streams draining pastureland, especially after a rain storm. 
  • Shower after swimming or being exposed to surface water.

Occupational exposures:


  • If your work activities put you in contact with potentially contaminated water, soil, or animals, wear protective clothing, footwear and gloves to prevent exposure. 
  • Pet shop owners should wear rubber gloves when cleaning up animal waste, especially that of dogs, and especially that of any animal that appears ill. Thorough hand washing after clean-up is encouraged. 
  • Veterinarians may want to consider pre- or post-exposure prophylaxis if they will be working with infected animals or if they have determined that an exposure to infected fluids or tissue has occurred (see below).

Farmers


  • Farmers should prevent contact of livestock with rodents, wild animals and other livestock, which could potentially be infected. 
  • The living quarters of infected livestock should be cleaned, disinfected and dried before exposing healthy animals to those areas. 
  • Farmers should discuss the possibility of vaccination and antibiotic use with their veterinarian to prevent and minimize outbreaks in their livestock. 
  • Farmers should minimize exposure of livestock to contaminated water by avoiding urine drainage into water sources and draining swampy land (Editorial Journal of Veterinary Medicine Association). 
 

References:
Control of Communicable Diseases Manual, Heymann, 2008.
U.S. Centers for Disease Control and Prevention.
Guidugli F, Castro AA, Atallah AN. Antibiotics for preventing leptospirosis. Cochrane Database of Systematic Reviews 2000, Issue 4.
Brown K, Prescott J. Leptospirosis in the family dog: a public health perspective. CMAJ. 2008. 
Extension Beef Cattle Resource Committee. [homepage on the Internet]. [cited 2008 June 20].

Last Updated: March 13, 2012

SOURCE: Leptospirosis ( )
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