LEPTOSPIROSIS
IN MALAYSIA
by Agnes Ling & Estella Chua
The Various Names
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
Swineherd's disease, swamp fever, or mud
fever, Weil's disease, Weil's syndrome,
canicola fever, canefield fever, nanukayami
fever, 7-day fever, Rat Catcher's Yellows, Fort
Bragg fever, and Pretibial fever
In Malaysia: Penyakit Kencing Tikus (Rat
Urine Disease)
Introduction




Most common zoonotic disease worldwide
Most prevalent in trophics, subtrophics
Caused by pathogenic spiral bacteria that
belong to the genus: Leptospira,
family:Leptospiraceae
order: Spirochaetales
the organism enters the body when mucous
membranes or abraded skin come in contact
with contaminated environmental sources.
Leptospires
Images above generated in 3DS
Max and are based on direct
measurements and sectional profiles
of Leptospira Interrogans.
Etiology
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

In 1883,first recognized as an occupational
disease of sewer workers
In 1886, Weil described the clinical
manifestations in 4 men who had severe
jaundice, fever, and hemorrhage with renal
involvement.
in 1916, Inada et al identified the causal agent
in Japan
Epidemiology

The most important reservoirs are rodents( rats) also
dogs, livestock, wild animals, and cats.

Urinary shedding of organisms from infected animals

A person can only be affected by direct exposure to
the bacteria physically entering the bloodstream.

Likelihood in freshwater, damp alkaline soil,
vegetation, and mud with temperatures higher than
22°C.

It is NOT contagious that is, it will not be passed from
human to human.
Risk factors



Partial or total immersion in mud and water
plays a role in facilitating infection in sewer
workers and rice field workers.
Milkers may be splattered in the face, causing
subsequent infection via the conjunctivae.
Infection of military troops occurs as a result of
direct exposure to infected urine or indirect
contact with contaminated soil and water.
Cases
Cases of Leptospirosis in Malaysia
Year
Number of Cases
2004
263
2005
378
2006
527
2007
929
2008
1263
2009
1418
Source: Report of Morbidity and Mortility for
Health of Ministry Hospitals 2004-2009
Development of disease

Pathogen enters –multiplies in blood and
tissue (usually lasts about 7 days)– affect liver
and kidney.


(Anicteric leptospirosis) Systemic with aseptic
meningitis
(Icteric leptospirosis) Overwhelming disease
(Weil’s disease)
 Vascular
collapse
 Thrombocytopenia
 Hemorrhage
 Hepatic and renal dysfunction
Clinical Progression
Treatment
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Antimicrobial therapy(severe)
Dialysis(renal failure);renal function is restored
in most.
Those with Weil syndrome may need
transfusions of whole blood, platelets, or both.
Supportive therapy and careful management
of renal, hepatic, hematologic, and CNS
complications
Sources
http://news.yahoo.com/s/ap/20100823/ap_on_he_me/as_malaysia_bacterial_disease
http://www.leptospirosis.org/
http://www.medicinenet.com/leptospirosis/article.htm
http://news.yahoo.com/s/ap/20100823/ap_on_he_me/as_malaysia_bacterial_disease
http://www.theborneopost.com/?s=leptospirosis
http://www.mylongkang.com/2010/08/25/leptospirosis/#more-13305
http://www.malaysia-chronicle.com/2010/07/blog-post_4507.html
http://www.outwardbound.my/?cat=5
http://en.wikipedia.org/wiki/Leptospirosis
http://ocw.tufts.edu/Content/2/coursehome/191643/191652
http://www.asiaone.com/News/AsiaOne+News/Malaysia/Story/A1Story20100822-233270.html
http://news.yahoo.com/s/ap/20100823/ap_on_he_me/as_malaysia_bacterial_disease
http://emedicine.medscape.com/article/220563-overview