Leptospirosis is an infectious disease caused by spiral shaped bacteria Leptospira which attacks the kidneys (urinary system) animals and humans and can live in fresh water for about 1 month.This type is generally endemic disease when the rice harvest season or the rainy season with high humidity.
Transmission of Leptospirosis
Letospirosis generally transmitted by a vector of mice but also can be transmitted by animals also pigs, goats, sheep, horses, dogs, cats, insects, birds, bats, squirrels and hedgehogs. Transmission of leptospirosis from rats to humans through contact with water, soil or plants that have been contaminated by the urine of animals suffering from leptospirosis.
The bacteria enter the body through mucous membranes (mucosa) of eyes, nose, or skin abrasions or food contaminated by infected animal urine leptospira. victim will experience clinical symptoms after the incubation period of 4-19 days.
Clinical Symptoms of Leptospirosis
Typical complaints that are commonly found from the victim, among others: sudden fever, poor general state of helplessness, nausea, vomiting, decreased appetite, and felt the eyes of the longer growing yellow and severe muscle pain, especially the calves and thighs.
These symptoms are almost similar to the symptoms of fever is generally caused by influenza, meningitis, hepatitis, dengue fever, dengue fever and other viral fever, which is often undiagnosed, therefore, in each case with symptoms of fever, leptospirosis must always be considered as one diagnosis of the appeal, especially in endemic areas.
Approach to diagnosis of leptospirosis can be divided into two, namely: leptospirosis and leptospirosis anikterik jaundice. The majority of cases of leptospirosis anikterik leptopirosis is composed of 2 phases / stages of phase leptospiremia / phase of septicemia and immune phases, separated by asymptomatic periods. Clinical manifestations of mild or high fever which is remittances, myalgia, especially in the calf muscles, conjungtival suffusion (red eyes), headache, chills, nausea, vomiting and anorexia, non-specific aseptic meningitis.
In leptospirosis jaundice, the patient continuously in a state of sclera jaundice accompanied by fever, severe circumstances occur in acute renal failure, jaundice and bleeding manifestations that are typical clinical picture of Weil's disease.
In leptospirosis jaundice, fever can be persistent and immune phase is unclear or appears to overlap with the phase of septicemia. The presence of immune phase is influenced by the type and amount of bacteria leptospira serovar infecting, immunological status, nutritional status of patients and the speed of obtaining the appropriate treatment. Clinical symptoms of leptospirosis is more severe jaundice, which is acute renal failure, jaundice and bleeding manifestations (Weil's disease).
Moreover, it can happen Adult Respiratory Distress Syndromes (ARDS), uremia coma, shock, septicemia, cardiorespiratory failure and hemorrhagic shock as the cause of death of patients with leptospirosis jaundice.
Examination Leptospirosis
Clinical symptoms of leptospirosis are similar to other infectious diseases such as influenza, meningitis, hepatitis, dengue fever, dengue fever and other viral fever, which is often not diagnosed, so to ensure viktim attacked leptospirosis necessary laboratory scale test.
Diagnosis of leptospirosis can be divided into 3 classifications are: Suspect, if any clinical symptoms, without the support of laboratory tests.
Probable, if appropriate clinical symptoms of leptospirosis and serology results filter namely dipstick, lateral flow, or dri dot positive. Definitive, when laboratory test results directly to positive, or in accordance with clinical symptoms and test results leptospirosis MAT / serial ELISA showed seroconversion or increase in titer of 4 times or more.
Prevention
Prevention of transmission of the bacteria leptospira can be done through three channels interventions include interventions source of infection, intervention on the routes of transmission and intervention on the human host.
- Various activities that can prevent leptospirosis:
• Familiarize yourself with the Clean and Healthy Behavior (PHBS)
• Store food and beverages properly to avoid the rats.
• washing hands with soap before eating.
• washing hands, feet and other body parts with soap after working in the field / garden / waste / ground / sewers and polluted places other.
• Protect workers who are at high risk of leptospirosis (cleaners, farmers, animal cutters officer, etc.) using the boots and gloves.
• Maintaining environmental cleanliness
• Clean the places where water and swimming pool.
• Avoid the rats in the house / building.
• Avoid contamination by rodents.
• Conduct disinfection of certain places contaminated by rat
Treatment and Prognosis
Early treatment is very helpful because the Leptospira bacteria are easily killed by antibiotics encountered in many markets such as penicillin and its derivatives (Amoxylline) Streptomycine, Tetracycline, Erithtromycine.When complications occur lematian figure can reach 20%.
Therapeutic aspects of leptospirosis include therapy causative aspect, with procaine penicillin antibiotics, Amoxicillin, Ampicillin, doxycycline in the first week infekasi, as well as aspects of symptomatic and supportive with antipyretic administration, nutrition, etc..
All cases of mild leptospirosis can be cured completely, in contrast with severe leptospirosis who have a high CFR number, between 5? 40%. Prognosis is determined by various factors such as the virulence of the bacteria leptospira, the physical condition of the patient, patient's age, the presence of jaundice, presence of acute renal failure, severe liver function disorders and how quickly medical treatment by the team.----------------------------------------------------------------------------------------------------------------
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