Leptospirosis

Veterinary Client Brochure

Educate clients with the brochure Leptospirosis in Dogs and Cats, also available in Spanish (Leptospirosis en Perros y Gatos).

Leptospirosis is a disease caused by infection with Leptospira bacteria. These bacteria can be found worldwide in soil and water. There are many strains of Leptospira
bacteria that can cause disease. Leptospirosis is a zoonotic disease, which means it can be spread from animals to people. Infection in people can cause flu-like
symptoms and can cause liver or kidney disease. In the United States, most cases of human leptospirosis result from recreational activities involving water. Infection
resulting from contact with an infected pet is much less common, but it is possible.

Leptospirosis is more common in areas with warm climates and high annual rainfall but it can occur anywhere.

Risk factors for leptospirosis

Dogs are most commonly affected. Leptospirosis in cats is rare and appears to be mild although very little is known about the disease in this species. Common risk factors
for leptospirosis in dogs residing in the United States include exposure to or drinking from rivers, lakes or streams; roaming on rural properties (because of exposure to
potentially infected wildlife, farm animals, or water sources); exposure to wild animal or farm animal species, even if in the backyard; and contact with rodents or other
dogs.

Dogs can become infected and develop leptospirosis if their mucous membranes (or skin with any wound, such as a cut or scrape) come into contact with infected urine,
urine-contaminated soil, water, food or bedding; through a bite from an infected animal; by eating infected tissues or carcasses; and rarely, through breeding. It can also be
passed through the placenta from the mother dog to the puppies.

Signs of leptospirosis
The signs of leptospirosis in dogs vary. Some infected dogs do not show any signs of illness, some have a mild and transient illness and recover spontaneously, while
others develop severe illness and death.

Signs of leptospirosis may include fever, shivering, muscle tenderness, reluctance to move, increased thirst, changes in the frequency or amount of urination, dehydration,
vomiting, diarrhea, loss of appetite, lethargy, jaundice (yellowing of the skin and mucous membranes), or painful inflammation within the eyes. The disease can cause
kidney failure with or without liver failure. Dogs may occasionally develop severe lung disease and have difficulty breathing. Leptospirosis can cause bleeding disorders,
which can lead to blood-tinged vomit, urine, stool or saliva; nosebleeds; and pinpoint red spots (which may be visible on the gums and other mucous membranes or on
light-colored skin). Affected dogs can also develop swollen legs (from fluid accumulation) or accumulate excess fluid in their chest or abdomen.

Leptospirosis may be suspected based on the exposure history and signs shown by the dog, but many of these signs can also be seen with other diseases. In addition to a
physical examination, your veterinarian may recommend a number of other tests such as blood tests, urine tests, radiographs (x-rays), and an ultrasound examination.

Treatment and prevention

Leptospirosis is generally treated with antibiotics and supportive care. When treated early and aggressively, the chances for recovery are good but there is still a risk of
permanent residual kidney or liver damage.

Currently available vaccines effectively prevent leptospirosis and protect dogs for at least 12 months. Annual vaccination is recommended for at-risk dogs. Reducing your
dog’s exposure to possible sources of the Leptospira bacteria can reduce its chances of infection.

Although an infected pet dog presents a low risk of infection for you and your family, there is still some risk. If your dog has been diagnosed with leptospirosis, take the
following precautions to protect yourself:

 Administer antibiotics as prescribed by your veterinarian;

 Avoid contact with your dog’s urine;

 If your dog urinates in your home, quickly clean the area with a household disinfectant and wear gloves to avoid skin contact with the urine;

 Encourage your dog to urinate away from standing water or areas where people or other animals will have access;

 Wash your hands after handling your pet.

Leptospirosis
From Wikipedia, the free encyclopedia

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Leptospirosis
Other names Rat fever,[1] field fever,[2] rat catcher's yellows,
[3]
pretibial fever[4]

Leptospira magnified 200-fold with a dark-field microscope

Specialty Infectious disease

Symptoms None, headaches, muscle pains, fevers[5]

Complications Bleeding from the lungs, meningitis, kidney

failure[5][6]

Usual onset 7–12 days[7]

Causes Leptospira typically spread by rodents[5][8]

 Risk factors Exposure to infected animals or contaminated

water[9]

Diagnostic Testing blood for antibodies against the bacterium

method or its DNA[10]

Differential Malaria, enteric fever, rickettsiosis, dengue[11]

diagnosis

Treatment Doxycycline, penicillin, ceftriaxone[5]

Frequency ~8.5 million people per year[12]

Deaths 58,900 per year[13]

Leptospirosis is an infection caused by corkscrew-shaped bacteria called Leptospira.[5] Signs and symptoms can range from none to mild such
as headaches, muscle pains, and fevers to severe with bleeding from the lungs or meningitis.[5][6] If the infection causes the person to turn yellow,
have kidney failure and bleeding, it is then known as Weil's disease.[6] If it also causes bleeding into the lungs then it is known as severe
pulmonary haemorrhage syndrome.[6]
Up to 10 different genetic types of Leptospira may cause disease in humans.[14] It is transmitted by both wild and domestic animals. [6] The most
common animals that spread the disease are rodents.[8] It is often transmitted by animal urine or by water or soil containing animal urine coming
into contact with breaks in the skin, eyes, mouth, or nose.[5][15] In the developing world the disease most commonly occurs in farmers and low-
income people who live in cities.[6] In the developed world it most commonly occurs in those involved in outdoor activities in warm and wet areas of
the world.[5] Diagnosis is typically by looking for antibodies against the bacterium or finding its DNA in the blood.[10]
Efforts to prevent the disease include protective equipment to prevent contact when working with potentially infected animals, washing after this
contact, and reducing rodents in areas where people live and work. [5] The antibiotic doxycycline, when used in an effort to prevent infection among
travelers, is of unclear benefit.[5] Vaccines for animals exist for certain type of Leptospira which may decrease the risk of spread to humans.
[5]
Treatment if infected is with antibiotics such as: doxycycline, penicillin, or ceftriaxone.[5] Weil's disease and severe pulmonary haemorrhage
syndrome result in death rates greater than 10% and 50%, respectively, even with treatment. [6]
It is estimated that seven to ten million people are infected by leptospirosis per year. [12] This results in about 58,900 deaths per year.[13] The disease
is most common in tropical areas of the world but may occur anywhere. [5] Outbreaks may occur in slums of the developing world.[6] The disease was
 first described by physician Adolf Weil in 1886 in Germany.[5][16] Animals which are infected may have no symptoms, mild symptoms, or severe
symptoms.[17] Symptoms may vary by the type of animal. [17] In some animals Leptospira live in the reproductive tract, leading to transmission during
mating.[18]

Contents

 1Signs and symptoms

 2Cause
o 2.1Bacteria

o 2.2Transmission

 3Pathogenesis

 4Diagnosis

 5Prevention

 6Treatment

 7Prognosis

 8Epidemiology

 9History

 10Other animals

 11References

 12External links
Signs and symptoms[edit]

Jaundice, one of the features in leptospirosis.

The symptoms appear after an incubation period of 7–12 days.[7] However, the incubation period can vary from 6 days to 29 days.[19] Leptospirosis
is a biphasic disease.[20] The first phase (acute or septic phase) ends after 3–7 days of illness. [7] The second phase (immune phase) starts with the
resolution of symptoms and appearance of antibodies. [21] Ninety percent of cases of the disease are mild leptospirosis. The rest experience severe
disease, which develops during the second stage or occurs as a single progressive illness. [22]
Leptospiral infection in humans causes a range of symptoms, and some infected persons may have no symptoms at all. The disease begins
suddenly with fever accompanied by chills, intense headache, severe muscle aches, abdominal pain, and occasionally a skin rash.[20] The
headache in leptospirosis is characteristically located at the bilateral temporal or frontal regions with throbbing pain. The person could also have
pain behind the eyes and sensitivity to light.[19] Muscle pain usually involves the calf muscle and the lower back.[19] The most characteristic feature of
leptospirosis is the conjunctival suffusion (conjunctivitis without exudate) which is not commonly found in other febrile illnesses. Other
characteristic findings on the eye include subconjunctival bleeding and jaundice.[19] Rash is rarely found in leptospirosis. When rash is found, other
alternative diagnoses such as Dengue fever and Chikungunya fever should be considered.[19] Dry cough is observed in 20% to 57% of people with
leptospirosis. Thus, this clinical feature can mislead a doctor to diagnose the disease as respiratory illness. Additionally, gastrointestinal symptoms
such as nausea, vomiting, abdominal pain, and diarrhea frequently occurs. Vomiting and diarrhea may contribute to dehydration in conjunction with
kidney failure due to excessive urine output. [19] The abdominal pain can be due to acalculous cholecystitis or inflammation of the pancreas.
[19]
Rarely, the lymph nodes, liver, and spleen may be enlarged and palpable.[21]
The disappearance of symptoms coincides with the appearance of antibodies against Leptospira and the disappearance of bacteria from the
bloodstream. The patient is asymptomatic for 3–4 days until the second phase begins with another episode of fever. [20] The immune phase can last
from 4 to 30 days. It can be anything from brain to kidney complications. [23] The hallmark of the second phase is meningitis (inflammation of the
membranes covering the brain).[24] Signs and symptoms of meningitis include severe headache and neck stiffness. In 5% to 10% of those infected
with jaundice, the disease can be rapidly progressive to multiorgan failure. [25]
Severe leptospirosis can cause liver, kidney, lungs, and brain damage. For those with signs of inflammation of membranes covering the brain and
the brain itself, altered level of consciousness can occur. A variety of neurological complications can occur such as paralysis of half of the
body, complete inflammation of whole section of spinal cord, and muscle weakness due to immune damage of the nerves supplying the muscles.
[19]
Signs of bleeding such as non-traumatic bruises at 1 mm, non-traumatic bruises more than 1 cm, nose bleeding, blackish stools due to bleeding
in stomach, vomiting blood and bleeding from the lungs can also be found. Prolongation of prothrombin time in coagulation testing is associated
with severe bleeding manifestation. However, low platelet count is not associated with severe bleeding.[19] In less than 5% of those infected,
pulmonary haemorrhage can occur at the 4th to 6th day of the illness and can be rapidly fatal. [25] Leptospira causes alveolar haemorrhage (bleeding
into the alveoli of the lungs) and massive coughing up blood. This causes acute respiratory distress syndrome. This feature increases the risk of
death to more than 50%.[19] Rarely, inflammation of heart muscles, inflammation of membranes covering the heart, abnormalities in pacemaker of
the heart and abnormal heart rhythms may occur.[21] The classic form of severe leptospirosis is known as Weil's disease, which is characterized by
liver damage (causing jaundice), kidney failure, and bleeding.[26]

Cause[edit]
Bacteria[edit]

Scanning electron micrograph of a number of Leptospira sp. bacteria atop a 0.1 µm polycarbonate filter

Leptospirosis belongs to the genus Leptospira which are aerobic,[21] right-handed helical[14] bacteria ; sized at 6 to 20 micrometers. Hooked ends of
this bacterium give it a "question mark" shape.[27] Like Gram-negative bacteria, Leptospira have an outer membrane studded
with lipopolysaccharide (LPS) on the surface, an inner membrane, and a layer of peptidoglycan. However, unlike Gram-negative bacteria, the
peptidoglycan layer in Leptospira lies closer to the inner membrane than the outer membrane. This results in a fluid outer membrane loosely
associated with the cell wall.[28] In addition, Leptospira have two flagella located in the periplasm.[27] Chemoreceptors at the poles of the bacteria
sense various substrates and change the direction of the bacteria's movement. [14] The bacteria are traditionally visualised using dark-field
microscopy with silver staining or immunofluorescence staining.[29]
A total of 22 species of Leptospira have been identified.[14] The species can be divided into three clades based on their 16S rRNA sequence. The
first is the "pathogens" clade comprising the eight species that can cause severe disease in humans: L. alexanderi, L. borgpetersenii,