Prevention & Treatment of Leptospirosis


Prevention

  • Disease prevention consists of good sanitation.
  • The use of boots and gloves in hazardous places. Protective clothing or footwear should be worn by those exposed to contaminated water or soil because of their job or recreational activities.
  • Rodent control and immunization of farm and pet animals can also minimize the risk of spread.
  • The risk of acquiring leptospirosis can be greatly reduced by not swimming or wading in water that might be contaminated with animal urine.
  • Vaccination of domestic mammals prevents the disease, but cannot avoid the infection, and the shedding of Leptospira in the urine and the consequent human infection.
  • Minimize contact with fresh water and mud that might be contaminated with the urine of infected animals.
  • Minimize contact with fresh water, mud, and vegetation that might be contaminated with the urine of infected animals, especially rodents.
  • If your travel plans might put you at risk for leptospirosis, consider taking antibiotics before and during travel to help prevent infection from short–term, high–risk exposures.
  • Get rid of rats.
  • Don’t touch them with unprotected hands.
  • Consult your vet about the cattle infection.
  • Cover all cuts and broken skin with waterproof plasters before and during work.

Wash your hands after handling any animal, or any contaminated clothing or other materials, and always before eating, drinking or smoking. How to Prevent Transmission?

  • Educate the public on modes of transmission avoid swimming or walking in potentially contaminated waters, and to use proper protection when work requires such exposure.
  • Protect workers in hazardous occupations with boots and gloves.(sewer workers).
  • Rodents control.
  • Proper disposal of waste.

Treatment The antibiotics of choice are penicillin, streptomycin, tetracycline and erythromycin which should be given early in the course of the disease. Intravenous antibiotics may be required for persons with severe symptoms. Persons with symptoms suggestive of leptospirosis should contact a health care provider as soon as possible.

Kidney dialysis may be necessary in some cases. Most cases, even those regarded as severe, tend to complete recuperation despite specific management. General supportive therapy is essential in the management of severe leptospirosis to detect and deal with life–threatening complications (renal failure, hypotension and hemorrhage).

In relation to anti–microbial therapy, there is agreement that either penicillin G or tetracycline may shorten the course of the illness, but only if therapy is started by the fourth day of the illness.

In humans, a number of antibiotics (streptomycin, penicillin and tetracycline) have been administered to treat acute leptospirosis. Penicillin is the drug of choice but other antibiotics are also effective.

  • Penicillin – 6 million units daily intravenously.
  • Must be given within 4-7 days of onset.

Tetracycline for penicillin sensitive patients.

A single dose of 25 mg/kg of dihydrostreptomycin has proven to be an effective procedure.

Non specific treatment – analgesics, antipyretics, antihistaminics.

Treatment for complications i.e., dialysis for ARF, mechanical ventilation for acute respiratory distress syndrome (ARDS).

May require Intensive Care Unit (ICU) management.