Leptospirosis

[hoot72]

Leptospirosis: Not sure if this blood parasite is familiar to some of you but its a major hazard out here in Borneo and SEA especially out in the bush. Anyone come across cases like this? We had a problem at the end of Eco Challenge Borneo with quite a number of cases at the end of the event..

CDC says:

What is leptospirosis?

Leptospirosis is a bacterial disease that affects humans and animals. It is caused by bacteria of the genus Leptospira. In humans it causes a wide range of symptoms, and some infected persons may have no symptoms at all. Symptoms of leptospirosis include high fever, severe headache, chills, muscle aches, and vomiting, and may include jaundice (yellow skin and eyes), red eyes, abdominal pain, diarrhea, or a rash. If the disease is not treated, the patient could develop kidney damage, meningitis (inflammation of the membrane around the brain and spinal cord), liver failure, and respiratory distress. In rare cases death occurs.

Many of these symptoms can be mistaken for other diseases. Leptospirosis is confirmed by laboratory testing of a blood or urine sample.

How do people get leptospirosis?

Outbreaks of leptospirosis are usually caused by exposure to water contaminated with the urine of infected animals. Many different kinds of animals carry the bacterium; they may become sick but sometimes have no symptoms. Leptospira organisms have been found in cattle, pigs, horses, dogs, rodents, and wild animals. Humans become infected through contact with water, food, or soil containing urine from these infected animals. This may happen by swallowing contaminated food or water or through skin contact, especially with mucosal surfaces, such as the eyes or nose, or with broken skin. The disease is not known to be spread from person to person.

How long is it between the time of exposure and when people become sick?

The time between a person's exposure to a contaminated source and becoming sick is 2 days to 4 weeks. Illness usually begins abruptly with fever and other symptoms. Leptospirosis may occur in two phases; after the first phase, with fever, chills, headache, muscle aches, vomiting, or diarrhea, the patient may recover for a time but become ill again. If a second phase occurs, it is more severe; the person may have kidney or liver failure or meningitis. This phase is also called Weil's disease.

The illness lasts from a few days to 3 weeks or longer. Without treatment, recovery may take several months.

How is leptospirosis treated?

Leptospirosis is treated with antibiotics, such as doxycycline or penicillin, which should be given early in the course of the disease. Intravenous antibiotics may be required for persons with more severe symptoms. Persons with symptoms suggestive of leptospirosis should contact a
health care provider.

[D9 (RIP)]

It's a simple treatment. Anyone with exposure to freshwater in areas where the disease exists should be tested immediately to confirm the suspicion. Personally, i would empirically treat anyone on my team who was symptomatic w/ an exposure history.

When you are traveling to an new area, especially in the tropics, you should do your homework and make yourself aware of which diseases exist, what can be done preventatively, and what their treatments are. A little planning goes a long way.

[Richard]

Originally Posted by hoot72

Leptospirosis: Not sure if this blood parasite is familiar to some of you but its a major hazard out here in Borneo and SEA especially out in the bush. Anyone come across cases like this? We had a problem at the end of Eco Challenge Borneo with quite a number of cases at the end of the event.

Nothing new here. Leptospirosis is also common in the USA or anywhere man and animals coexist, and very common in rural farming areas. Good PM practices--especially water purification and simple hand washing--prevents most of it and the condition is easily treatable. A good medical annex to an area study should always include this issue; ours did.

Richard

[hoot72]

Originally Posted by Richard

Nothing new here. Leptospirosis is also common in the USA or anywhere man and animals coexist, and very common in rural farming areas. Good PM practices--especially water purification and simple hand washing--prevents most of it and the condition is easily treatable. A good medical annex to an area study should always include this issue; ours did.

Richard

Richard,

would you say open wounds leave a risk to contracting Lepto especially when river crossings are involved? I get the impression this is possibly carried by rats or water buffalo who urinate into slow moving streams or rivers perhaps?

[Richard]

Originally Posted by hoot72

would you say open wounds leave a risk to contracting Lepto especially when river crossings are involved? I get the impression this is possibly carried by rats or water buffalo who urinate into slow moving streams or rivers perhaps?

Absolutely.

Richard

[hoot72]

Originally Posted by Richard

Absolutely.

Richard

Understood. Thanks for confirming that for me richard. Needed clarification.

[Chris Cram]

I thought this sounded familiar.
Thanks for the in depth.

Richard: Other than boiling the water, what do you recomend be done to make this water drinkable?
I looked at http://zenbackpacking.net/WaterFilte...rTreatment.htm and...
damn that's a lot of options.

[hoot72]

Originally Posted by Chris Cram

I thought this sounded familiar.
Thanks for the in depth.

Richard: Other than boiling the water, what do you recomend be done to make this water drinkable?
I looked at http://zenbackpacking.net/WaterFilte...rTreatment.htm and...
damn that's a lot of options.

I am not sure if you can actually contract it from drinking water but I was under the impression it affected an individual if it entered the blood stream rather than from drinking it and then giving you stomach problems such as diaoreah.

You will almost certainly get that if you did drink water in streams, rivers and so forth out here in asia from the parasites or bacteria as your stomach just isn't used to it...

But I could be wrong...

[Richard]

Guys,

Good health and basic preventive med techniques (water purification--boiling, iodine tabs, calcium hypochloite; cleaning and cooking food; handwashing; cleaning and covering sores or wounds; etc) will prevent most such things. The basics work...if you'll use them.

Richard's $.02

[doctom54]

From the NC Sate Epidemiology Branch

Although the disease was first definitively described over a century ago by Adolf Weil in Germany and the etiologic agent was discovered in 1915, NC occupies a prominent place in the history of leptospi-rosis. The work of Dr. Hugh Tatlock in the 1940s with an organism isolated from a patient later documented as Leptospira autumnalis, one of the “Tatlock agents,” led the way to eventually showing this to be the cause of “Fort Bragg fever.” The disease described by Tatlock (also called “pretibial fever”) included “moderate prostration, fever, splenomegaly, a rash localizing particularly on the ante-rior aspects of the legs, and a short course.” 2 This description falls into the mid-range of the wide spectrum of clinical manifestations seen with leptospirosis.