In India, as soon as monsoons arrive, there are talks of the prevention and treatment of diseases such as malaria, dengue, and typhoid. It is known that the incidence of these diseases will rise during the season. However, the high rainfall and tropical climate in India provide a breeding ground for agents of several other diseases during monsoons too. 

One such seasonal disease is leptospirosis, which usually increases in incidence at the start of the rainy season in India.

If you have never heard of the disease or know very little about it, take a look at the frequently asked questions about leptospirosis, and their answers.

1. What is leptospirosis and how is it caused?

Leptospirosis (लेप्टोस्पायरोसिस in Hindi) is a rare infectious disease caused by several species of the Leptospira genus of bacteria. 

It is spread to humans through several animal carriers of the bacteria, including rodents, cattle, rabbits, buffalo, goats, sheep, and pigs. 

The animals carry the bacteria in their kidneys and excrete them in their urine, which can contaminate soil and water bodies. Rats and other rodents are the main carriers of the bacteria that cause leptospirosis.

If you come in contact with the contaminated soil or water bodies, you can get infected by the bacteria through breaks in your skin, or through your nose, mouth, or genitals. Drinking contaminated water can also cause leptospirosis.

2. What are the types of leptospirosis disease?

Leptospirosis is mainly of two types:

Mild leptospirosis: This type is seen in the majority (around 90%) of the cases and presents as mild symptoms including muscle pain, chills, and headache. Most individuals with mild leptospirosis recover in around a week without treatment. 

Severe leptospirosis: A lesser percentage of leptospirosis (around 5 to 15%) progresses to severe leptospirosis. The causative bacterium infects the liver, kidneys, and other major organs and may lead to organ failure, internal bleeding, and death.

3. Why is there an increase in cases of leptospirosis disease during monsoons?

Though leptospirosis occurs throughout the year and around the world, it is more common in tropical and subtropical countries with high rainfall rates. It has a seasonal distribution that increases with increased rainfall or higher temperatures.

In a country with a tropical climate like India, the heavy concentrated rainfall during monsoons causes a lot of surplus water to accumulate. The natural drainage of rainwater may be obstructed by developmental activities. 

Further, waterlogging may force the rodent population to leave their burrows and contaminate the stagnant water with their urine. 

Anybody who comes in contact with the contaminated water during activities such as work or travel is at risk of contracting leptospirosis. 

4. What are the symptoms of leptospirosis?

Leptospirosis disease is difficult to spot because it presents a wide range in severity and symptoms. Some individuals show no signs of the disease at all. 

In those who show visible signs, the symptoms appear abruptly around 5-14 days after infection, and include:

  • High fever and chills

  • Cough

  • Muscle pain, especially calf pain and lower back pain

  • Headache

  • Jaundice 

  • Abdominal pain

  • Diarrhoea

  • Vomiting

  • Skin rashes

  • Red eyes with irritation

5. Is there a test to diagnose leptospirosis?

Yes, there are tests to diagnose leptospirosis. Many symptoms of leptospirosis are similar to other diseases, such as influenza (also called flu, a viral infection) and meningitis (microbial infection of the brain and spinal cord membranes), so testing is important for confirming a diagnosis. 

Your doctor may ask for your travel history to see if you have been to areas where leptospirosis is common. Your doctor can confirm leptospirosis by doing a blood test for antibodies (proteins produced by your immune system in response to a foreign agent such as bacteria). 

Other tests that are performed for leptospirosis diagnosis include:

  • Microscopic agglutination test (MAT)

  • Blood culture

  • Urine test

  • Complete blood count

  • Enzyme test (for example, test for creatine kinase and liver enzymes)

  • Polymerase chain reaction (PCR) test

6. How do you treat leptospirosis?

Since leptospirosis is a bacterial infection, it is treated with antibiotics (chemicals that kill bacteria or halt their growth). The antibiotics usually employed are penicillin and doxycycline. 

For severe cases of leptospirosis, antibiotics may need to be given intravenously (into the veins). In severe leptospirosis, the affected organs may need to be treated individually for the damage caused. 

If left untreated, leptospirosis can lead to kidney damage, liver failure, respiratory issues, meningitis, and even death.

7. How can you prevent leptospirosis?

It is possible to prevent leptospirosis by following certain precautionary measures which include:

  • Consuming only boiled and/or purified drinking water.

  • Wearing boots and gloves, especially when there is a possibility of coming in contact with waterlogged areas or soil.

  • Covering skin cuts with waterproof dressings.

  • Keeping wounds clean and dry. 

  • Avoiding wading through waterlogged areas, especially during monsoons. 

  • Showering or washing up after possible exposure to contaminated soil or water.

  • Avoiding contact with ill or dead animals.

  • Maintaining hygienic measures during handling any animal.

  • Disinfecting areas that may have been contaminated with the urine of infected animals. 

  • Taking steps to control the rodent population in your area. 

8. Is there a vaccine for humans for preventing leptospirosis?

At present, there is no commercially available vaccine against leptospirosis for humans.

9. Can animals also get leptospirosis?

Yes, leptospirosis affects both humans and animals, including your pets. Any animal can get infected with leptospirosis, and they can spread it to humans. It is commonly seen in cattle, sheep, goats, pigs, horses, and dogs, but is rare in cats. 

Animals also become infected when they come in contact with soil and water bodies contaminated with the urine of infected host animals. The animals may inhale the causative bacteria (in the form of aerosol) or drink the contaminated water. 

The clinical symptoms of leptospirosis in animals vary, and some animals may not show any symptoms at all. 

10. Can you get leptospirosis from a dog?

Yes, since leptospirosis spreads from animals to humans, it is possible that you get it from your pet dog if it is infected. Leptospirosis in dogs is known as canine leptospirosis. 

If you feel unwell after coming in contact with your infected dog, seek medical help immediately. 

Once it is confirmed that your pet dog has leptospirosis, take all possible precautions while caring for it. Use face masks and gloves, and follow frequent hand-washing to avoid getting the dog’s infected urine in your eyes, mouth, nose, or broken skin. Disinfect contaminated areas thoroughly and be careful about handling soiled belongings. 

This monsoon season, stay home, stay dry, and keep yourself and your family safe from this relatively lesser-known disease. If you notice any symptoms suggestive of leptospirosis, seek medical attention immediately. 


References:

1. Cdc.gov. 2021. Leptospirosis | CDC. [online] Available at: <https://www.cdc.gov/leptospirosis/index.html> [Accessed 28 July 2021].

2. Encyclopedia, M., 2021. Leptospirosis: MedlinePlus Medical Encyclopedia. [online] Medlineplus.gov. Available at: <https://medlineplus.gov/ency/article/001376.htm> [Accessed 28 July 2021].


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