Leptospirosis

"Rat fever" redirects here. For the 2011 Brazilian film, see Rat Fever.

Leptospirosis
Other namesRat fever,[1] field fever,[2] rat catcher's yellows,[3] pretibial fever[4]
Leptospira magnified 200-fold with a dark-field microscope
SpecialtyInfectious disease
SymptomsNone, headaches, muscle pains, fevers[5]
ComplicationsBleeding from the lungs, meningitis, kidney failure[5][6]
Usual onsetOne to two weeks[7]
CausesLeptospira typically spread by rodents[8]
Risk factorsExposure to infected animals, especially their urine, or fresh water or damp soil contaminated with infectious urine[8]
Diagnostic methodTesting blood for antibodies against the bacterium or its DNA[5]
Differential diagnosisMalaria, enteric fever, rickettsiosis, dengue[9]
PreventionPersonal protective equipment, hygiene measures, doxycycline[7]
TreatmentDoxycycline, penicillin, ceftriaxone[8]
PrognosisRisk of death ~7.5%[10]
FrequencyOne million people per year[7][11]
Deaths58,900 per year[11]

Leptospirosis is a blood infection caused by the bacteria Leptospira[8] that can infect humans, dogs, rodents and many other wild and domesticated animals.[8] Signs and symptoms can range from none to mild (headaches, muscle pains, and fevers) to severe (bleeding in the lungs or meningitis).[5] Weil's disease (/ˈvaɪlz/ VILES),[12] the acute, severe form of leptospirosis, causes the infected individual to become jaundiced (skin and eyes become yellow), develop kidney failure, and bleed.[6] Bleeding from the lungs associated with leptospirosis is known as severe pulmonary haemorrhage syndrome.[5]

More than ten genetic types of Leptospira cause disease in humans.[13] Both wild and domestic animals can spread the disease, most commonly rodents.[8] The bacteria are spread to humans through animal urine or feces, or water or soil contaminated with animal urine and feces, coming into contact with the eyes, mouth, nose or breaks in the skin.[8] In developing countries, the disease occurs most commonly in pest control, farmers and low-income people who live in areas with poor sanitation.[5] In developed countries, it occurs during heavy downpours and is a risk to pest controllers, sewage workers[14] and those involved in outdoor activities in warm and wet areas.[5] Diagnosis is typically by testing for antibodies against the bacteria or finding bacterial DNA in the blood.[5]

Efforts to prevent the disease include protective equipment to block contact when working with potentially infected animals, washing after contact, and reducing rodents in areas where people live and work.[7] The antibiotic doxycycline is effective in preventing leptospirosis infection.[7] Human vaccines are of limited usefulness;[15] vaccines for other animals are more widely available.[16] Treatment when infected is with antibiotics such as doxycycline, penicillin, or ceftriaxone.[8] The overall risk of death is 5–10%.[10] However, when the lungs are involved, the risk of death increases to the range of 50–70%.[8]

It is estimated that one million severe cases of leptospirosis in humans occur every year, causing about 58,900 deaths.[11] The disease is most common in tropical areas of the world but may occur anywhere.[7] Outbreaks may arise after heavy rainfall.[7] The disease was first described by physician Adolf Weil in 1886 in Germany.[17][18] Infected animals may have no, mild or severe symptoms.[19] These may vary by the type of animal.[16][19] In some animals Leptospira live in the reproductive tract, leading to transmission during mating.[16]

  1. ^ Berger S (2018). Leptospirosis: Global Status. GIDEON Informatics Inc. p. 7. ISBN 978-1-4988-2031-8.
  2. ^ Mosby's Medical Dictionary (9 ed.). Elsevier Health Sciences. 2013. p. 697. ISBN 978-0-323-11258-1. Archived from the original on 8 September 2017. Retrieved 21 February 2016.
  3. ^ McKay JE (2001). Comprehensive Health Care for Dogs. Minnetonka, MN.: Creative Pub. International. p. 97. ISBN 978-1-55971-783-0.
  4. ^ James WD, Elston DM, Berger TG, Andrews GC (2006). Andrews' Diseases of the Skin: Clinical Dermatology. Saunders Elsevier. ISBN 978-0-7216-2921-6.: 290 
  5. ^ a b c d e f g h Soo ZM, Khan NA, Siddiqui R (January 2020). "Leptospirosis: Increasing importance in developing countries". Acta Tropica. 201: 105183. doi:10.1016/j.actatropica.2019.105183. PMID 31542372.
  6. ^ a b McBride AJ, Athanazio DA, Reis MG, Ko AI (October 2005). "Leptospirosis". Current Opinion in Infectious Diseases. 18 (5): 376–86. doi:10.1097/01.qco.0000178824.05715.2c. PMID 16148523. S2CID 220576544.
  7. ^ a b c d e f g Karpagam KB, Ganesh B (January 2020). "Leptospirosis: a neglected tropical zoonotic infection of public health importance-an updated review". European Journal of Clinical Microbiology & Infectious Diseases. 39 (5): 835–846. doi:10.1007/s10096-019-03797-4. PMID 31898795. S2CID 209669669.
  8. ^ a b c d e f g h i Cite error: The named reference Lane 2016 was invoked but never defined (see the help page).
  9. ^ Farrar J, Hotez P, Junghanss T, Kang G, Lalloo D, White NJ (2013). Manson's Tropical Diseases E-Book. Elsevier Health Sciences. p. 438. ISBN 978-0-7020-5306-1. Archived from the original on 8 September 2017. Retrieved 2 September 2017.
  10. ^ a b Cite error: The named reference Evangelista2010 was invoked but never defined (see the help page).
  11. ^ a b c Costa F, Hagan JE, Calcagno J, Kane M, Torgerson P, Martinez-Silveira MS, et al. (2015). "Global Morbidity and Mortality of Leptospirosis: A Systematic Review". PLOS Neglected Tropical Diseases. 9 (9): e0003898. doi:10.1371/journal.pntd.0003898. PMC 4574773. PMID 26379143.
  12. ^ "Rats / RHS Gardening". www.rhs.org.uk.
  13. ^ Picardeau M (May 2017). "Virulence of the zoonotic agent of leptospirosis: still terra incognita?". Nature Reviews. Microbiology. 15 (5): 297–307. doi:10.1038/nrmicro.2017.5. PMID 28260786. S2CID 11626842.
  14. ^ Chan, O. Y.; Chia, S. E.; Nadarajah, N.; Sng, E. H. (16 October 1987). "Leptospirosis Risk in Public Cleansing and Sewer Workers". Annals of the Academy of Medicine, Singapore. 16 (4): 586–90. PMID 3446001.
  15. ^ Cite error: The named reference Teixeira2019 was invoked but never defined (see the help page).
  16. ^ a b c Ellis WA (2015). "Animal Leptospirosis". Leptospira and Leptospirosis. Current Topics in Microbiology and Immunology. Vol. 387. pp. 99–137. doi:10.1007/978-3-662-45059-8_6. ISBN 978-3-662-45058-1. PMID 25388134.
  17. ^ Slack A (July 2010). "Leptospirosis". Australian Family Physician. 39 (7): 495–8. PMID 20628664.
  18. ^ Weil A (1886). "Über eine eigenthümliche, mit Milztumor, Icterus und Nephritis einhergehende, acute Infektionskrankheit" [On a strange, acute infectious disease, accompanied by swelling of the spleen, icterus, and nephritis]. Deutsches Archiv für Klinische Medizin (in German). 39: 209–232. OCLC 1040554855.
  19. ^ a b "Leptospirosis" (PDF). The Center for Food Security and Public Health. October 2013. Archived (PDF) from the original on 24 November 2014. Retrieved 8 November 2014.