Leptospirosis: transmission, diagnosis and treatment of this zoonosis
Leptospirosis is a zoonosis (disease affecting both animals and humans) caused by bacteria of the genus Leptospira
It is typical of several animal species (the main reservoir of leptospires pathogenic to humans are rodents) and is spread in the environment by the microorganisms they release in urine.
Leptospirosis is widespread throughout the world, but mainly affects rural areas in temperate and tropical regions.
How is leptospirosis transmitted?
Infected animals excrete leptospires from their kidneys, releasing them into the environment through urine.
The micro-organisms are able to survive in moist soil with a neutral or moderately alkaline pH, at temperatures that are not particularly cold.
Humans are infected by skin contact (in the presence of wounds, even microscopic ones) or mucous membranes with water where leptospires are present, by direct contact with infected animals or by eating contaminated vegetables.
There are no known cases of person-to-person transmission of the disease.
The incubation period for leptospirosis is seven to fourteen days.
The disease can manifest itself in two phases: initially it presents with high fever, chills, haemorrhagic conjunctivitis and exanthematous manifestations; the second phase, or immune phase, involves the appearance of jaundice, enlargement of the liver and spleen, nephritis, renal failure and widespread neurological involvement, with meningitis and encephalitis.
This second phase is also known as ‘Weil’s disease’.
Depending on the serovar involved in the infection, leptospirosis can also run its course completely asymptomatically.
The lethality rate is low, although it should not be underestimated, especially in elderly patients.
Diagnosis
Leptospirosis is diagnosed by detecting the bacteria in blood, urine and CSF.
There are techniques for detecting leptospire DNA from blood and urine as early as the first week of the disease.
Leptospirosis is treated with antibiotic and supportive therapy
Treatment is based on antibiotics, penicillin G, to which leptospires are very sensitive.
The recovery of cases not treated in time can take several months.
Leptospirosis prophylaxis consists of the control of rodents and other animals carrying leptospires and a ban on bathing in stagnant waters, rivers and canals.
The efficacy of human vaccination is debated because it does not provide protection against all types of leptospires, but it is nevertheless recommended for those who, because of their work, are more exposed to the risk of infection.
Therefore, elementary hygiene rules remain of paramount importance:
- wash hands thoroughly
- pay attention to the hygiene of children (who very easily bring their hands to their mouths)
- wash foods such as vegetables and fruit carefully
- avoid contact with contaminated water.
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