by: Jemarie Jimenez
Perpetual Help College Manila
Weil’s Dse, Mud fever, Canicola fever, Flood fever,
Swineherd’s Dse, Japanese Seven Days fever
Definition & Background:
- a bacterial zoonotic disease caused by spirochaetes of the genus Leptospira that affects humans and a wide range of animals, including mammals, birds, amphibians, and reptiles
- first described by Adolf Weil in 1886 when he reported an “acute infectious disease with enlargement of spleen, jaundice and nephritis”
- Leptospira-genus bacteria was isolated in 1907 from post mortem renal tissue slice
- commonly found: Leptospira pyrogenes, Leptospira manilae, & other species like L. icterohemorrhagiae, L. canicola, L. batavia, L. Pomona, L. javinica
- in animals often is subclinical; an infected animal may appear healthy even as it sheds leptospires in its urine; humans are dead-end hosts for the leptospire
- age: < 15 years of age
- sex: male
- season: rainy months
- geographic: prevalent in slum areas
Source of Infection
Infection comes form contaminated food and water, and infected wild life and domestic animals especially rodents.
- Rats ( L. leterohemoragiae) are the source of Weil’s disease frequently observed among miners, sewer, and abattoir workers.
- Dogs (L. canicola) can also be the source of infection among veterinarians, breeders, and owners of dogs.
- Mice (L. grippotyphosa) may alos be a source of infection that attacks farmers and flax workers.
- Rats (L. bataviae) are the source of infection that attacks ricefield workers.
- 6 – 15 days/ 2 – 8 weeks
1st stage: Septicemic/ Leptospiremic Phase (4 – 7 days)
– onset of high remittent fever, chills, headache, anorexia, nausea & vomiting, abdominal pain, joint pains, muscle pains, myalgia, severe prostration, cough, respiratory distress, bloody sputum.
2nd stage: Immune/ Toxic Phase (4 – 30 days)
– if severe, death may occur between the 9th & 16th day
- Anicteric (without jaundice) – return of fever of a lower degree with rash, conjunctival injection, headache, meningeal manifestations like disorientation, convulsions & signs of meningeal irritations (with CSF finding of aseptic meningitis)
- Icteric (with jaundice) – Weil syndrome; hepatic & renal manifestations: hemorrhage, hepatomegaly, hyperbilirubinemia, oliguria, anuria with progressive renal failure; shock, coma & congestive heart failure in severe cases
3rd stage: Convalescence Phase
– Relapses may occur during 4th or 5th week
- culture: blood (1st week)
CSF (5th to 12th day)
Urine (after 1st wk til pd of convalescence)
- agglutination tests ( 2nd or 3rd week)
- iridocyclitis, optic neuritis
- peripheral neuritis
- cause of death: renal & hepatic failure
- dse usually last 1 – 3 weeks but may be more prolonged; relapse may occur
- specific measures: beneficial if done < 4 days of dse
- Aqueous penicillin G (50,000 units/kg/day in 4-6 divided doses intravenously for 7-10 days
- Tetracycline (20-40 mg/kg/day in 4 doses); may not be given to children < 8 years old
- general measures
- symptomatic & supportice care
- administration of fluid, electrolytes & blood as indicated
- peritoneal dialysis (for renal failure)
- isolation of patient: urine must be properly disposed
- health teachings: keep a clean environment