Leptospirosis Main
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Transcript of Leptospirosis Main
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Kamilah Fernandez, Kemba Lewis and
Resul Boncu.
Leptospirosis
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Leptospirosis
Leptospirosis is caused by exposure toseveral types of the Leptospira, abacteria
is from the genus spirochete which can be
found in fresh water that has been
contaminated by animal urine.
Scan showing the
leptospira bacteria and its
characteristic elongatedspiral structure.
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MODES OF TRANSMISSION
By direct or indirect contact of nasal, oral, or eyemucosal membranes or abraded or traumatized
skin with urine or carcasses of infected animals.
Urine: Indirect exposure through water, soil, or
foods contaminated by urine from infected
animals is the most common route. After a short
period of circulating high levels of the spirochete
in their blood, animals shed the spirochete intheir urine, contaminating the environment.
Inhalation of droplet aerosols of contaminated
fluids can occasionally occur.
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Leptospirosis- Chain of Infection
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Leptospirosis- Symptoms Symptoms can take 2 - 26
days (average 10 days) todevelop, 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
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Leptospirosis Diagnosis
The diagnosis of Leptospirosis is made
by culture of the bacterial
organism Leptospirafrom infected
blood, spinal fluid, or urine.
The diagnosis can also be made on
rising Leptospiraantibody levels in the
blood
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Leptospirosis Treatment
Medications to treat Leptospirosis include: Ampicillin
Ceftriaxone
Doxycycline
Penicillin
Complicated or serious cases may need
supportive care or treatment in a hospitalintensive care unit (ICU).
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Leptospirosis in Georgia
Year Number of cases Prevalence per100000
2001 9 0.203
2002 7 0.157
2003 7 0.157
2004 10 0.225
2005 6 0.135
2006 27 0.608
2007 28 0.631
2008 18 0.405
2009 16 0.36
2010 72 1.623
Total 200 4.504
Table #1 : The prevalence per 100000 of
Leptospirosis in Georgia
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A sporadic occurrence of
leptospirosis can be observed
within the Republic of Georgia.
Cases showed similar occurrences
in the years 2001 to 2005, Then a
slight increase in the years 2006
and 2007. It then decreased slightlyin the years 2008 and 2009 with a
sudden increase to 72 in the year
2010.
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Leptospirosis in Georgia
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Leptospirosis in Georgia
Ages Age Specific Rate per 100000
>1 0
1-4 0
5-14 0.2
15-19 1.17
20-29 0.99
30-59 0.98
60 0.81
Table#2: Table showing the Age Specific Rate
of Leptospirosis in Georgia
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No cases occurred under the age of 4
years of age while a rate of 0.2 occurred
between the ages of 5-14.
An average of 0.93 occurred within the
age groups 20 to 60 years of age.
The highest cases occurred within the age
group 15 to 19.
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Leptospirosis in Georgia
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Leptospirosis in Georgia
Month Number of cases
January 1
February 1
March 1
April 1
May 1
June 1
July 5August 8
September 9
October 5
November 2
December 0
Table#3: Table showing the monthly distribution of
Leptospirosis in Georgia from 2008 to 2010
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Leptospirosis in Georgia
The most cases occurred between the
months of July to October.
These months had the highest rainfall.
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Leptospirosis In Georgia
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Leptospirosis in Georgia
Region Number of Cases Prevalence per 100000
Tbilisi 5 0.46
Kakheti 3 0.737
Imereti 3 0.428Samgrelo and Zemo
Svaneti
2 0.429
Adjara 16 4.25
Shida Kartli 2 0.636
Kvemo Kartli 2 0.40
Guria 1 0.699
Samtskheti Javakheti 1 0.48
Mtsketa Mtianeti 0 0
Kacha Lechkhumi 0 0
Table#4: Table showing the number of cases and prevalence of
Leptospirosis for the regions of Georgia
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Leptospirosis in GeorgiaSpot Map showing the cases of Leptospirosis in the different
regions in Georgia.
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Leptospirosis in Georgia
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Leptospirosis in Georgia
Region Prevalence Per 100000 Average AnnualPrecipitation (mm)
Tbilisi 0.46 568
Kakheti 0.737 1000
Imereti 0.428 1730
Samgrelo 0.429 2100
Adjara 4.25 8060
Shida 0.636 585Kvemo 0.40 425
Guria 0.699 1900
Samtskhe 0.480 550
Mtsketa 0 650
Racha 0 900
Table#5: Table showing the prevalence and average annualprecipitation for each region in Georgia
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Leptospirosis in Georgia
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
Prevalenceper100000
Average
AnnualPrecipitation
Regions in Georgia
Graph showing the relationship between the prevalence ofleptospirosis and the average annual precipitation
Average Annual Precipitation
Prevalence per 100000
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Leptospirosis in Georgia
From the graph showing the relationshipbetween Leptospirosis prevalence and
average annual precipitation it can be
seen that the greater the amount ofrainfall the greater the prevalence
This is especially seen in the region of
Ajara where the prevalence of
Leptospirosis and the average annual
precipitation were both substantially high
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Leptospirosis in Georgia Trend of Leptospirosis was studied in
Georgia. Prevalence rate has significantlyincreased since 2006 to 2007 with a
decrease in 2008 to 2009 and 500%
increase from 2009 to 2010 the highest rate 1.632 per 100 000 population.
The highest prevalence was observed the
age group 15-19. There was an increase prevalence from the
month of July to October.
Ajara had the highest prevalence
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Leptospirosis in Georgia
Source of infection were: Contact with a natural water
reservoir- 54%
Ground contaminated with rodentexcretions- 8%
Cattle-raising activity- 8%
Unknown source- 15.5%
Leading to an overall fatality of 7-
14%
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Leptospirosis in Trinidad and
Tobago
A total of 278 cases were recorded, with an
average annual incidence rate of 1.84 per
100,000 population. 75% of the cases
occurred during the wet season, with thehighest number of cases recorded in
November.
A positive correlation was found betweennumber of cases and rainfall.
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Leptospirosis in Trinidad and Tobago
(1996 to 2007)
Males constituted 80% of all cases, and theoverall male: female ratio was 4.6:1
The total case fatality rate was 5.8%, withdeaths among males four times more
common than in females.
Clinical Leptospirosis was greatest in the 10-
19 age group and lowest in the 0-9 age
group.
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Leptospirosis in Trinidad and
Tobago The total prevalence was 22 per 100,000
population, with the highest prevalence 41
per 100,000 recorded in the regional
corporation of Sangre Grande and the lowest(6 per 100,000) in the city of Port of Spain.
The lack of important information and active
surveillance showed that the level of
awareness of the disease is low in the
country.
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Leptospirosis in T&T and
GeorgiaParameter Country
Georgia Trinidad and Tobago
Highest Annual Prevalence per 100000 1.632 1.84
Age most Prevalent 15-19 10-19
Month most Prevalent September November
Sex most Prevalent NA Males
Region most Prevalent Ajara Sangre Grande
There is also a direct relationship between Leptospirosis prevalenceand season as Leptospirosis is most prevalent in Trinidad and
Tobago during the rainy season and Leptospirosis is most prevalent
in Georgia during the rainiest periods (July to October) of the year at
the end of summer to the beginning of autumn.
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Leptospirosis- Conclusion
Leptospirosis has a direct correlation withthe rainy periods of the year and cases
occurred in areas with the highest
prevelance of rainfall (hospital/general practitioner/laboratory) to
intermediate level.
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Recommendations
Inform the public that 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.
Immediate case-based reporting ofsuspected or confirmed cases.
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All cases must be investigated since
investigation can identify environmentalpoint sources of transmission and lead to
control measures.
Routine reporting of aggregated data ofconfirmed cases from intermediate to
central level. Hospital-based surveillance
may give information on severe cases of
leptospirosis. Serosurveillance may give
information on whether leptospiral
infections occur or not in certain areas or
populations
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References
Epidemiology of human leptospirosis in Trinidad and Tobago, 1996-2007: aretrospective study.
Mohan AR, Cumberbatch A,Adesiyun AA, Chadee DD.
Source
Department of Life Sciences, The University of The West Indies, St. Augustine,
Trinidad and Tobago.
http://www.ncbi.nlm.nih.gov/pubmed?term=Mohan%20AR%5BAuthor%5D&cauthor=true&cauthor_uid=19679092http://www.ncbi.nlm.nih.gov/pubmed?term=Cumberbatch%20A%5BAuthor%5D&cauthor=true&cauthor_uid=19679092http://www.ncbi.nlm.nih.gov/pubmed?term=Adesiyun%20AA%5BAuthor%5D&cauthor=true&cauthor_uid=19679092http://www.ncbi.nlm.nih.gov/pubmed?term=Chadee%20DD%5BAuthor%5D&cauthor=true&cauthor_uid=19679092http://www.ncbi.nlm.nih.gov/pubmed?term=Chadee%20DD%5BAuthor%5D&cauthor=true&cauthor_uid=19679092http://www.ncbi.nlm.nih.gov/pubmed?term=Adesiyun%20AA%5BAuthor%5D&cauthor=true&cauthor_uid=19679092http://www.ncbi.nlm.nih.gov/pubmed?term=Cumberbatch%20A%5BAuthor%5D&cauthor=true&cauthor_uid=19679092http://www.ncbi.nlm.nih.gov/pubmed?term=Mohan%20AR%5BAuthor%5D&cauthor=true&cauthor_uid=19679092