INTRODUCTION

This video became one of the most alerting news of 24 Oras.

Leptospirosis is a disease came from the urine of infected animals, mostly rats. It is commonly occur when there's a typhoon and produces floods, some people doesn't have any choice but to walk in it and most of the children swim just to have fun. Unfortunately, some of them has wound on their feet that's why bacteria called leptospira easily affects their skin or their immune system. 

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What is Leptospirosis?

It is caused by infection with bacteria of the genus Leptospira and affects humans as well as other animals.

Leptospirosis is among the world's most common diseases transmitted to people from animals. The infection is commonly transmitted to humans by allowing water that has been contaminated by animal urine to come in contact with unhealed breaks in the skin, the eyes, or with the mucous membranes. Outside of tropical areas, leptospirosis cases have a relatively distinct seasonality with most cases occurring in spring and autumn.

Leptospirosis is a rare and severe infection that occurs when you come in contact with Leptospira bacteria.

Alternative Names

12 other names of Leptospirosis:

• Weil's syndrome, 
• canicola fever, 
• canefield fever, 
• nanukayami fever, 
• 7-day fever, 
• Rat Catcher's Yellows, 
• Fort Bragg fever, 
• black jaundice, 
• Pretibial fever
• Icterohemorrhagic fever
• Swineherd's disease
• Stuttgart disease

Causes and Transmission

CAUSES:
The Leptospira bacteria can be found in fresh water that has been contaminated by animal urine. The infection occurs in warmer climates.

It is not spread from person to person, except in vary rare cases when it is spread through breast milk or from a mother to her unborn child.

Risk factors include:

• Occupational exposure -- farmers, ranchers, slaughterhouse workers, trappers, veterinarians, loggers, sewer workers, rice field workers, and military personnel
• Recreational activities -- fresh water swimming, canoeing, kayaking, and trail biking in warm areas
• Household exposure -- pet dogs, domesticated livestock, rainwater catchment systems, and infected rodents

Leptospirosis is rare in the continental United States. Hawaii has the highest number of cases in the United States.

Transmission:

Leptospirosis is transmitted by the urine of an infected animal and is contagious as long as it is still moist. Although rats, mice, and moles are important primary hosts, a wide range of other mammals including dogs, deer, rabbits, hedgehogs, cows, sheep, raccoons, opossums, skunks, and certain marine mammals are able to carry and transmit the disease as secondary hosts. Dogs may lick the urine of an infected animal off the grass or soil or drink from an infected puddle.

Symptoms

Symptoms can take 2 - 26 days (average 10 days) to develop, and may include:

• Dry cough
• Fever
• Headache
• 
  Muscle pain
• Nausea, vomiting, and diarrhea
• Shaking chills

Less common symptoms include:

• Abdominal pain
• Abnormal lung sounds
• Bone pain
• Conjunctivitis
• Enlarged lymph glands
• Enlarged spleen or liver
• Joint aches
• Muscle rigidity
• Muscle tenderness
• Skin rash
• Sore throat

Nursing Diagnosis & Treatment

Nursing Diagnosis:

•   Impaired nutritional needs related to anorexia
•   Increased body temperature related to increased metabolic      diseases
•   Disruption of daily activities related to physical weakness

Treatment:

For Acute Leptospirosis:

Most cases of acute leptospirosis can be successfully treated with a five-to-seven-day course of antibiotic tablets. A tetracycline antibiotic called doxycycline is the preferred choice.

Side effects of doxycycline include:

• headache
• runny nose
• indigestion 
• diarrhoea

These side effects should pass once you complete the course of antibiotics. An alternative antibiotic, such as erythromycin, can be used instead of doxycycline.

Side effects of erythromycin include:

• nausea (feeling sick)
• stomach pain
• vomiting
• diarrhoea

It is very important that you finish the prescribed course of antibiotics, even if you are feeling better. This is because stopping treatment before all of the bacteria have been killed may trigger the return of a more serious infection.

Painkillers that are available over the counter, such as paracetamol or ibuprofen, can be used to help relieve symptoms, such as headache, high temperature and muscle pain.

Contact your GP for advice if, despite treatment, your symptoms fail to improve after seven days.

For Severe Leptospirosis:

Almost all cases of severe leptospirosis will require admission to hospital. The underlying infection will be treated with intravenous antibiotics (antibiotics that are injected directly into the bloodstream).

If you have experienced organ damage, additional equipment may be required to support the functions of your body. For example:

• a ventilator to assist your breathing
• dialysis, which is where the functions of your kidneys are artificially replicated by removing waste materials from your blood
• intravenous fluids to restore the fluids and nutrients in your body

The amount of time that you will need to spend in hospital will depend on how well you respond to the antibiotics and the extent of any organ damage. Some people may be well enough to leave hospital within a few weeks, while others may require several months of hospital care.

Medication:

• Ampicillin
• Azithromycin
• Ceftriaxone
• Doxycycline
• Penicillin

*Complicated or serious cases may need supportive care or treatment in a hospital intensive care unit (ICU)*

Nursing Intervention & Prevention

Nursing Intervention:

Intervention:

• ·        Impaired nutritional needs related to anorexia

Expected result:

• ·        Nutritional  needs are met
• ·        Patients are able to eat in accordance with given portion

Intervention:

• ·        Review complaints of nausea and vomiting
• ·        Give foods a little but often
• ·        Assess how to eat  that served
• ·        Give a warm meal
• ·        Measure the patient’s body weight per day
• ·        Increased body temperature (hyperthermia) related to increased metabolic diseases

Expected result:

• ·        Temperature within normal limits, free from cold
• ·        Do not experience complications related

Intervention:

• ·        Give your bathroom a warm compress, avoid alcohol use
• ·        Instruct patient to drink plenty
• ·        Collaboration in the provision of antipyretic
• ·        Disruption of daily activities related to physical weakness

Expected result:

• ·        Activities of daily needs are met
• ·        Patients capable of self-care

Intervention:

• ·        Assess the patient’s complaint
• ·        Assess the things that can and cannot be patient
• ·        Help the patient to meet their activity
• ·        Help the patient to self-care
• ·        Put  things in place, easily accessible

Prevention:

• The risk of acquiring leptospirosis can be greatly reduced by not swimming or wading in water that might be contaminated with animal urine, or eliminating contact with potentially infected animals.
• Protective clothing or footwear should be worn by those exposed to contaminated water or soil because of their job or recreational activities.

Here's a video from www.kapwako.org about Leptospirosis, to let us know more about this deadly disease.