Leptospirosis: History of animal contact essential for diagnosis – InSight+

After floods and mouse infestations, GPs are advised to consider leptospirosis in patients with fever, severe headache, muscle aches, chills, vomiting and red eyes, experts say.

The key to establishing a diagnosis of leptospirosis in the face of multiple differential diagnoses, such as influenza, lies in a history of contact with suspect animals.

Professor Emeritus Ben Adler, a microbiologist with 40 years of experience, including with the Victorian Infection and Immunity Network and the Department of Microbiology at Monash University, told InSight+ that the first symptoms of leptospirosis were largely “non-specific”.

“But if there is no history of contact with… [relevant] animals, it won’t be lepto,’ he said.

Leptospirosis is caused by the leptospira bacteria, of which there are many strains. It can be found in the urine from mice, rats, cattle, pigs and dogs† The first symptoms appear 5-14 days after infection and last from a few days to 3 weeks. If left untreated, serious illness, depending on the species, can lead to: pulmonary hemorrhage, acute renal failure and acute liver failuremeningitis and even death.

People can pick up leptospira from contaminated flood water, mud and soil, from cuts and abrasions and mucous membranes in the nose, mouth and eyes. Human-to-human transmission is rare.

Of mouse pests in the eastern states and western australia, as well as flooding in queensland and new south wales this year, leptospirosis is on the rise.

A spokesman for the federal health ministry said the number of cases of the notifiable disease in humans had increased over the past year. She said there have been 201 leptospirosis reports in the 12 months to April 17.

“This is above the 5-year average for the same period, which is 129 cases,” she said The medical republic† “Most cases occurred in Queensland and NSW in the past year.”

Lucky for Australians, the dirtiest strains of leptospira are not endemic here, according to Professor Adler.

“We have a limited number of serovars here,” he said. “And they are not the ones causing the really serious illness. In other countries it’s a different story, where leptospirosis is largely a disease of inequality.”

The other good news for Australians is that, despite there being no human vaccine, treatment with standard antibiotics such as doxycycline (100 mg twice daily), amoxicillin, and erythromycin is effective because there is no resistance.

“In humans, lepto is a dead-end infection,” said Professor Adler.

“There is no human-to-human spread, so a human gets infected and that’s the end. Even if drug-resistant leptos were to develop, they would not spread to anyone else.”

The key is early treatment, in which it is recommended to start antibiotics even before the diagnosis is confirmed by pathological tests and continued for at least 7 days

What role will climate change play in the occurrence of leptospirosis outbreaks, given the increasing number of floods, at least in some states?

“There is good evidence that it already is,” Professor Adler . told me InSight+

“There have been outbreaks all over the world with extreme weather events, especially when there is sudden flooding.

“The last major cyclone in Fiji, there was major flooding and what followed was a spike in lepto cases. The same is happening in India, Sri Lanka, Indonesia, Thailand, the Philippines.”

Some recreational activities can increase the risk of infection, according to the Federal Ministry of Health

“People can also get sick after swimming, wading, washing or doing water sports in polluted waterways. Shrubs and camping in areas near polluted rivers and swampy areas are also a risk. leptospira bacteria can survive for weeks in soil and fresh water, extreme weather conditions can resurface these bacteria, especially in flood waters.”

Leptospirosis agents:

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