leptospirosis by anggi fix.ppt

7/24/2019 Leptospirosis by Anggi fix.ppt

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PTOSPIROS


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Tropical Infections: DenTropical Infections: Den

Infectious diseases that eitheroccur uniquely or more commonlyin

tropical andsubtropicalregions, are

either more widespread in the tropics or

more difficult to prevent or control.


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Tropical and SubtropicalTropical and Subtropical

RegionsRegions

230

350


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Endemic

Locations where the infection iscommonplace, caused by high rainfallclose human contact with livestock orwild animals, poor sanitation or workp

exposure (rice farming, etc). Example countries : ndia, !entral

"merica and certain areas of the #acif$im.


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General

Locations where the infection is at theinternational average of %.%& cases per'%%,%%%, and infection is usually the reof accidental exposure through wild ra

livestock or direct contact with waterthrough leisure or occupation.

Example countries are orth "merica,Europe, "ustralia and the former ovie

territories.


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Situation in Thailand


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1883 it was recognied as an occupatiodisease of sewer wor!ers

188" rst description #b$ %eil& 'rofess(edicine at )eidelberg #188"* * of t+e

manifestations seen in men #se,ere -afe,er& and +emorr+age wit+ renal in,ol

1./0 Stimson described t+e lesion in ttubules w+o died of so called $ellow fe,

1.1" t+e causal agent was identied b$in apan

4oguc+i proposed t+e name 56eptospirspirals* in 1.18


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9lassication:

'+$lum: Spiroc+aetes

9lass: Spiroc+aetes

rder: Spiroc+aetales

Species: Leptospira;amil$: 6eptospiraceae


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" microscopic view of Lebacteria stained apple grefluorescent dye (from the

#ublic ealth mage Libra


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T+e etiologic agent of leptospirosis isLeptospira interrogans2

It is a t+in spiral organism /21mm < "

=/mm& wit+ tig+tl$ set coils It is c+aracteried b$ ,er$ acti,e mot

rotating #>spinning?* and bending2 @sone or bot+ ends of t+is singlecell orgare bent or +oo!ed

Aecause of t+eir narrow diameter& t+eleptospires are best ,isualied b$ dar!illumination or p+ase contrast microscand t+e$ do not stain readil$ wit+ anild$es2


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#athogenic Lepto

ancet Infec

--

/.&

0.&

' each


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aprophytic Leptospiraspecies

pecies erovar $eference strain er

1enomospecies 2 holland 3a4 olland(#52-)

o

L. biflexa patoc #atoc em

L. wolbachii codice !*!

ancet Infec


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Reser,oir +osts of commonReser,oir +osts of common

leptospiral sero,arleptospiral sero,ar

ancet Infec

Ri ! f fRi ! f t f


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Ris! factors for e


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'."n outbreakoccurs during the rainy sbecause of widespread contaminationinfected rodent urine in flood water.

0.$odentsare displaced from their burrodrains by the water.

2.igh humidityand heavy rainfallinten

outbreak.5.$ats and bandicootsdistribute more vleptospires through their urine into theenvironment than other animals.


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LE#!8!LE 6$"9

' + i' t+ i


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'at+ogenesis'at+ogenesis

$oute of transmission:&brasion ' cuts in s(in

)ucous membrane*+onunctiva

Intact s(in after prolong immersion in water

Inhalation of aerosol*water

Ingestion

6oxin production:-

/emolysin

+ytotoin

7uter envelope:&ntiphagocytic

component

7uter membraneprotein:

Interstitial nephritis

mmune coinflammatioInterstitial n

1asculitis


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LE#

9linical manifestations9linical manifestations


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9linical manifestations9linical manifestations"nicteric leptospirosis cteric lepto

3eil+s

(ncubationperiod 0


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9linical manifestationn ca man estat on

ancet Infec


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6aborator$ diagnosis6aborator$ diagnosis$ulture

%ntibody detection&Screening test

'S%T, (!%, (F%, )%, *)(S%, )*"TO dipstick

&$onfrmation test

'icroscopic agglutination test%ntigen detection

"olymerase chain reaction +"$

"athology


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TreatmentTreatment

'ild #orm

&o.ycycline

&%mo.icillin&*rythromycin

'oderate-to-severe

&"enicillin /

&o.ycycline&$e#tria.one

upportive ? ymptomatic 6reatment

"ntimicrobial therapy


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're,ention're,ention "rotective clothing Try avoiding walking in 0ood

you have to, wear gum boots1 "roviding proper prclothing, shoes, gloves, etc1 to high-risk Occupatio

*nvironmental 'easures1 "rotected water supply to all1 "roper collection, transport, treatment and secure

o# garbage1 rinking boiled water1 isin#ections o# contaminated work areas1 "roviding proper protective clothing, shoes, gloves

high-risk Occupational groups1


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'REBE4TI4

$hemoprophyla.iso.ycycline 233 mg once a week

4accine%nimal

!uman 5 2 developing vaccines but no license

approval in human use

En,ironmental (easures


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En,ironmental (easures

To pre,ent illness& pre,ent contamination of li,wor!ing and recreational areas b$ urine of infectanimals2

9ontrol rodent populations in areas of +uman +Domestic animal owners s+ould ta!e necessar$precautions to minimie t+eir animal7s potential wit+ wildlife # e2g2& do not feed pets outside or aanimals to roam unsuper,ised*2

Do not allow animals to urinate in or near ponds

Ceep animals awa$ from gardens& pla$grounds&sandbo


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9+lorination is seldom useful& as ,irulent lepwit+stand up to ppm in potable water2

;iltered water is not safe2

@sing boiled or ultra,iolet irradiated water is %ater tan!s must be sealed if possible2

;ood articles must be stored in properl$ tticontainers2

Aat+room and !itc+en waste pipes must be

nig+t2 )ea,$ drin!ing and smo!ing predispose dam

li,er and t+e !idne$s w+ic+ in turn become ,to leptospiral infection2


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T)4CSn$uestionsH


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Disinfection

Leptospira species can be inacti,at1sodium +$poc+lorite

0/et+anol&

glutaralde+$de&

formalde+$de& detergents and acid2

T+is organism is sensiti,e to moist #1=1 J 9 for a minimum of 1K min**a

also !illed b$ pasteuriation2


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leptospirosis by anggi fix.ppt

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