Leptospirosis.pdf

Volume 29 Number 1
Spring 2002
Inland Waterways News

Weil's Disease (Leptospirosis)
Dr John Fleetwood

Weil's Disease has been in the news recently. It is the most serious form of a group of illnesses
known collectively as leptospirosis. When one examines the leptospirosis germs under a
microscope, they look rather like corkscrews which wriggle actively.
These organisms can be found in practically any animal, wild or domestic, including cats, dogs,
foxes, horses, cattle and sheep, but rodents are the biggest culprits. The cycle of infection is
that the germs are excreted in the animal's urine or motions. They can live for long periods in
water or moist areas, such as farmyards, at summer temperatures. Transmission to a human
occurs either by swallowing the water, by contact through an open cut or sore and occasionally
by contact with the eyes, nose or mouth even though the water is not swallowed.
Symptoms may develop within 48 hours but delays of up to 26 days have been recorded
between contact and the person falling ill. The early symptoms suggest a dose of flu, are often
treated as such and may clear up quickly if one of the less virulent germs is involved, but in
Weil's Disease it is soon obvious that there is a major problem.
The patient may recall possible contact with infected water or a sick animal. Blood tests are
available to make a firm diagnosis and it is important that, in any suspect case, these be carried
out promptly. Early treatment with massive doses of penicillin or other antibiotics is called for,
along with plenty of fluids to combat possible dehydration and kidney damage. Other
complications include skin rashes, haemorrhages, jaundice, eye inflammation, severe muscle
and bone pain, vomiting and delirium. There is a very considerable death rate in these severe
cases. Sometimes the person seems to improve but may relapse several times. In general, the
fitter and younger the patient, the better the outlook.
An old proverb says "Prevention is better than cure." Nowhere is this more applicable than in
Weil's Disease. Scrupulous personal and environmental hygiene is the key to success. In many
underdeveloped countries, and even in rural and slum areas of countries with high public health
standards, it is possible for water to become contaminated from animal excreta.
Everyone should avoid direct skin contact with soil, vegetation or water where there may be
animal droppings or urine. One should never go barefoot into stables, byres, muddy soil or
anywhere that animals may have been grazing. Swimming or paddling in ponds, lakes or pools
to which animals have access is potentially dangerous.
These precautions are especially important where there are open cuts or sores on the skin.
These should be washed gently, painted with iodine or some similar disinfectant and covered
with a protective dressing. If flu-like symptoms develop within a couple of weeks, one should be
sure to mention any possible exposure to the doctor so that appropriate blood tests can be done
quickly.
On a boat or caravan, if rats, mice or their droppings are seen, all food which is not securely
covered should be destroyed and the area washed with water to which acetic acid (vinegar) has
been added. A pint of water to the average bucket of water hastens destruction of the leptospira
germs. Traps or poison should be put down, taking the usual precautions to protect children and
domestic pets.
NEWSLETTER OF THE INLAND WATERWAYS ASSOCIATION OF IRELAND
leptospirosis.doc
Leptospirosis cannot be treated lightly and environmental health measures are an important part of its control, but it wasn't always so. Before laws were passed restricting the passage of raw sewage into rivers Queen Victoria commented on the numerous pieces of paper she saw floating on the surface of the Cam. "These, Your Majesty," said the Provost, "are notices warning that bathing here is dangerous." NEWSLETTER OF THE INLAND WATERWAYS ASSOCIATION OF IRELAND
leptospirosis.doc

Source: http://iwn.iwai.ie/v29i1/leptospirosis.PDF