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Leptospirosis specialist Doctor in Mumbai Leptospirosis specialist Doctor in Marine lines Leptospirosis specialist Doctor in Charni Road Leptospirosis specialist Doctor in grant road Leptospirosis specialist Doctor in Mahalaxmi Leptospirosis specialist Doctor in Lower Parel Leptospirosis specialist Doctor in Prabhadevi Leptospirosis specialist Doctor in Mumbai Central Leptospirosis specialist Doctor in Dadar Leptospirosis specialist Doctor in bandra Leptospirosis specialist Doctor in andheri Leptospirosis specialist Doctor in borivali Leptospirosis specialist Doctor in dahisar Leptospirosis specialist Doctor in Mira Road Leptospirosis specialist Doctor in Bhayandar Leptospirosis specialist Doctor in Vasai Leptospirosis specialist Doctor in Nallasopara Leptospirosis specialist Doctor in Virar Leptospirosis is a bacterial disease that affects both humans and animals, caused by infection with bacteria of the genus Leptospira. It is an important but often neglected zoonotic disease in tropical and subtropical regions, particularly during and after the monsoon season. In India, leptospirosis is a significant public health concern, especially in flood-prone areas & slums. Etiology (Cause): Leptospirosis is caused by pathogenic strains of the bacterium Leptospira interrogans, a spirochete (spiral-shaped bacteria). Over 300 serovars (serotypes) of Leptospira are known, and the pathogenic strains can infect a wide range of animals, including rodents, livestock, and pets. The bacteria thrive in moist, warm environments — particularly in stagnant water, wet soil, and sewage. Reservoirs: Rats (especially the brown rat, Rattus norvegicus) are the most important reservoir worldwide. Other reservoirs include dogs, cattle, pigs, and wild animals. Incubation period: Typically 2 to 30 days (average of 7–12 days). Transmission: Leptospirosis is a classic example of a zoonotic disease — transmitted from animals to humans. Humans acquire infection primarily through direct or indirect contact with the urine of infected animals or contaminated water/soil. Main transmission routes: 1. Skin Contact: Through cuts, abrasions, or even intact skin (especially prolonged immersion). 2. Mucous Membranes: Eyes, nose, mouth. 3. Ingestion: Drinking contaminated water or consuming contaminated food. 4. Inhalation: Rare but possible through aerosolized particles. High-risk activities: 1. Walking through floodwaters. 2. Agricultural work. 3. Cleaning drains or sewage. 4. Adventure sports (rafting, swimming in rivers/lakes). 5. Handling animals or animal products. 6. Person-to-person transmission is extremely rare but has been reported in cases of sexual contact and breastfeeding. Symptoms: The clinical spectrum of leptospirosis ranges from subclinical infection to severe life threatening illness. Most infections are mild, but about 5–15% can become severe. Mild Leptospirosis (Anicteric Leptospirosis) Seen in ~90% of cases. Symptoms resemble a flu-like illness. Common symptoms: 1. High fever (sudden onset) 2. Chills and rigors 3. Headache (often severe, behind eyes) 4. Myalgia (muscle pain), especially calf and lumbar region 5. Nausea, vomiting 6. Diarrhea Conjunctival suffusion (red eyes without discharge) — a characteristic but not pathognomonic sign Rash — sometimes present Duration: 1. Typically resolves in 1–2 weeks. 2. Severe Leptospirosis (Weil’s Disease) 3. Occurs in about 5–10% of patients. Triad: 1. Jaundice 2. Renal failure 3. Hemorrhage Clinical features: 1. Deep yellow skin (jaundice) 2. Oliguria or anuria (kidney failure) 3. Bleeding tendencies (petechiae, ecchymoses, pulmonary hemorrhage) 4. Hypotension (shock) 5. Hepatomegaly, splenomegaly 6. Respiratory distress (acute lung injury / ARDS) 7. Altered mental status (meningitis, encephalopathy) Other Possible Manifestations: 1. Aseptic meningitis 2. Myocarditis 3. Uveitis 4. Pancreatitis 5. Rhabdomyolysis 6. Biphasic Course Some patients have a biphasic illness: 1. Initial septicemic phase (with fever) 2. Followed by an immune phase (with antibodies present, aseptic meningitis, etc.) Diagnosis: Clinical suspicion is key, especially in endemic areas after flooding. Laboratory confirmation: 1. Serology (gold standard): Microscopic Agglutination Test (MAT) — most specific but technically demanding. ELISA for IgM — more commonly used. 2. Molecular tests: PCR for Leptospira DNA — sensitive in the early phase. 3. Culture: Specialized media required; takes weeks. Rarely used for routine diagnosis. Supportive lab findings: 1. Leukocytosis with left shift 2. Thrombocytopenia 3. Elevated creatinine and urea 4. Elevated bilirubin (predominantly conjugated) 5. Transaminase elevation 6. Prolonged PT / APTT in severe disease Treatment: Early antibiotic treatment significantly reduces disease severity and duration. Mild Disease Oral Doxycycline 100 mg twice daily for 5–7 days. Alternative: Azithromycin 500 mg once daily for 5 days. Moderate to Severe Disease IV Penicillin G 1.5 million units every 6 hours for 7 days. IV Ceftriaxone 1–2 g once daily for 7 days — equally effective and more commonly used now. IV Cefotaxime is another alternative. Supportive Care: Fluid and electrolyte management. Dialysis if renal failure occurs. Mechanical ventilation for respiratory distress. Management of DIC and bleeding. Important points: Start antibiotics as early as possible — do not wait for lab confirmation. Jarisch-Herxheimer reaction (febrile reaction post-antibiotic) can occur — supportive management required. Prevention: Public health measures and individual precautions are critical to prevent leptospirosis, especially during monsoon seasons. Personal Protective Measures: 1. Avoid wading through floodwaters. 2. Wear protective clothing, boots, gloves when exposure is unavoidable. 3. Cover cuts and abrasions with waterproof dressings. 4. Practice good hand hygiene after handling animals or contaminated material. 5. Water and Food Safety 6. Drink only boiled or treated water. 7. Avoid consuming food exposed to floodwaters. 8. Maintain sanitation and rodent control. Community-level Measures: 1. Drainage and flood management in urban areas. 2. Proper sewage disposal. 3. Rodent control campaigns. 4. Public awareness campaigns during monsoon. Chemoprophylaxis: For high-risk groups (e.g. rescue workers, farmers during floods): Doxycycline 200 mg once weekly during the period of exposure has shown efficacy. Not a replacement for other preventive measures but useful adjunct. Conclusion: Leptospirosis remains a major public health challenge in India, especially during the monsoon. While it is usually mild, severe cases can be life-threatening without prompt diagnosis and treatment. Awareness, early recognition, timely antibiotic therapy, and preventive strategies can substantially reduce the burden of this disease. As climate change leads to more frequent extreme weather events, the risk of leptospirosis outbreaks will likely increase — making it more important than ever to stay informed and vigilant.