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LEPTOSPIROSIS

Leptospira are found in the urine between 10 20 days after onset.


SOURCES OF INFECTIONS
Contaminated food and water, and infected wild life and domestic animals especially
rodents.

RATS ( L. leterohemoragaie) the Weil;s disease frequently observed among miners,


sewer, and abattoir workers.
DOGS ( L. canicola) observed in veteranians, breeders, and owners of the dogs.
MICE ( L. grippotyphosa) attacks farmers and flax workers.
RATS ( L. bataviae) attacks rice field worker.

MODE OF TRANSMISSION
It can be accuired through ingestionor contact with the skin and mucous membrane such
as eyes, nose, mouth or through a break on skin with the infected urine or carcasses of wild and
domestic animals. Leptospira enters the blood to cause damge therafter, the kidneys, the liver,
meniges and conjuctivae. It is contagious as long as it is still moist. Although rats, mice and
voles are important primary host, a wide range of other mammals including deer, rabbits,
hedgehog, cows, sheep, raccoons, possums, skunks, and even certain marine mammals are also
able to carry and transmit the disease as secondary hosts.
Dogs may lick the urine of an infected animal off the grass or soil, or drik from an
infected puddle. There have been reports of house dogs contracting leptospirosis apparently
from licking the urine of infected mice that entered the house. The type of habitats most likely to
carry infective bacteria are muddy riverbanks, ditches, gulleys and muddy livestock rearing areas
where there is a regular passage of either wld or farm mammals.
There is a direct corellation between the amount of rainfall and the incidence of
leptospirosis, amking it seasonal in emperate climates and year round in tropical climates. It is
also transmitted by the semen of infected animals. Workers can contract the disease through
contact with infected blood or body fluids.
The leptospires are thin, coiled, gram-negative, aerobic organisms 6-20 m in length.
They are motile, with hooked ends and paired axial flagella (one on each end), enabling them to
burrow into tissue. Motion is marked by continual spinning on the long axis. They are unique
among the spirochetes in that they can be isolated on artificial media.
Leptospires belong to the order Spirochaetales and the family Leptospiraceae.
Traditionally, the organisms are classified based on antigenic differences in the
lipopolysaccharide envelopes that surround the cell wall. Serologic detection of these
differences, therefore, is based on identifying serovars within each species. Based on this system,
the genus Leptospira contains two speciesthe pathogenic Leptospira interrogans, with at least

218 serovars, and the nonpathogenic, free-living, saprophytic Leptospira biflexa, which has at
least 60 serovars.
Although not fully understood, leptospires are believed to enter the host through
abrasions in healthy skin, through sodden and waterlogged skin, directly through intact mucus
membranes or conjunctiva, through the nasal mucosa and cribriform plate, through the lungs
(after inhalation of aerosolized body fluid), or through the placenta during pregnancy. Virulent
organisms in a susceptible host gain rapid access to the bloodstream through the lymphatics,
resulting in leptospiremia and spread to all organs. The incubation period is usually 5-14 days
but has been described from 72 hours to a month or more.
If the host survives the acute infection, septicemia and multiplication of the organism
persist until the development of opsonizing immunoglobulin in the plasma, followed by rapid
immune clearance. However, after clearance from the blood, leptospires remain in
immunologically privileged sites, including the renal tubules, brain, and anterior chamber of the
eye, for weeks to months. In humans, leptospires in the renal tubules and resulting leptospiruria
rarely persist longer than 60 days.