Leptospirosis and salmonellosis powerpointpptx

Leptospirosis and salmonellosis powerpointpptx

1. LEPTOSPIROSIS & SALMONELLOSIS Dr.E.SuganyaArvinth Assistant Professor, Community Medicine 1

2. L EPTOSPIROSIS 2

3. Leptospirosis is essentially animal infection by several serotypes of Leptospira (Spirochetes) and transmitted to men under certain environmental conditions . 3

4. AGENT 23 serotypes L.Interrogans (Pathogenic) 4

5. SOURCE OF INFECTION Excreted in the urine of infected animals for a long time. ANIMAL RESERVOIRS: Rodents – mice, rats and voles. Domestic animals – cattle, sheep, goat, water buffalo, pigs, horses, dogs may act as carriers. RATS: R. norvegicus most important Mus musculus reservoirs 5

6. HOST FACTORS Human infection: accidental. Age: Children > adults Gender: Males > females due to greater occupational exposure. Low immunity Occupation: Agricultural workers, Fishermen , sewer workers, Lorry drivers and masons 6

7. ENVIRONMENTAL FACTORS Occurs due to contact with urine and feces of reservoir animal Water and soil- survive for weeks Poor housing Poor waste disposal 7

8. NOTE- Direct man to man infection is rare. 8

9. MODE OF TRANSMISSION 9

10. ICTERIC LEPTOSPIROSIS It is the severe form of the disease . It is characterized by jaundice and is usually associated with involvement of other organs. About 5-10% of patients have these type of manifestations ANICTERIC LEPTOSPIROSIS It is the milder form of the disease . Patients have fever, myalgia but do not have jaundice. Almost 90% Of patients have this type of illness. 10

11. SIGNS & SYMPTOMS Fever with chills Myalgia of calf, abdominal & lumbosacral muscles Conjunctival Suffusion Headache- throbbing, frontal Renal infestation- mild proteinuria with few casts/cells Pulmonary infestation- cough/chest pain/ haemoptysis PETECHIAL hemorrhage ANICTERIC 11

12. CONJUNCTIVAL SUFFUSION PETECHIAL RASH 12

13. JAUNDICE Fever(Same as in anicteric leptospirosis but may be more severe) All the symptoms and signs of Anicteric along with Organ Involvement. ICTERIC 13

14. ORGAN INVOLVEMENT- ORGAN CLINICAL FEATURES KIDNEY Decrease in urine output, features of uremia LIVER Jaundice, hepatomegaly LUNG Cough, haemoptysis , dyspnoea with increase in respiration rate and basal crepts HEART Hypotension, irregular pulse BLOOD Bleeding tendencies BRAIN Altered consciousness with neck rigidity 14

15. IS IT IMPORTANT TO STUDY LEPTOSPIROSIS ?? 15

16. July, 2015 – Outbreak in Mumbai, Maharashtra CASES : 21, DIED : 12 16

17. Blood culture-1-6 weeks to become positive Urine culture- D10 to 6 weeks to become positive Agglutination test-after D7 to D10, max at 3-6 weeks IgM ELISA –Early diagnosis, within 2days Leptodipstick test available 17

18. CONTROL ANTIBIOTICS Penicillin- Drug of choice, Tetracycline or doxycycline is also effective Environmental measures Vaccination- only for high risk, but has to be strain specific 18

19. SALMONELLOSIS Complex group of Food borne infections affecting both man and animals

20. EPIDEMIOLOGICAL DETERMINANTS

21. AGENT FACTORS Agent: Gram negative rod, 2500 serotype, relatively resistant to environmental factors Resistant to- drying,salting,smoking,freezing even for years Sensitive to Heat, will not survive >70 deg

22. Classification Infects man: S.typhi,S.Paratyphi A and C Infects particular species of animals: S.cholera-suis,S.dublin ,S.abortus equi . Infect both man and animals(2200): S.Typhimurium (50%) and S.Entteriditis Reservoir: Intestinal tract of Man and animals

23. Source a) Foods: Foods of animal origin (meat/egg/poultry) and Processed foods-Chocolates/spices/ cocunut b) Animals c) Environment: Environment and multidrug resistant Modes of Transmission Ingestion of contaminated food Direct contact with animals- infected feco oral transmission Incubation period: 6-72 hours

24. CLINICAL FEATURES Due to invasive and enterotoxic properties Enteric Fever : Fever,chills,step ladder fever,abdominal pain,constipation Salmonella Enterocolitis (Gastroenteritis) Most common/6-48 hrs after infection/ Low grade fever,nausea,headache,vomitting,mild diarrhoea /resolves in 2-3 days Septicaemia with focal lesions :Invasion into blood stream/ Suis /Focal infection- osteomyelitis,pyelonephritis

25. Prevention and Control Farm level ( zoonotic origin) : Disease control-immunization Use of hygienic animal feed Ensuring sanitary free environment Other approaches: Hygiene slaughter house and milking Pasteurization of milk and eggs Proper disposal of Liquid and solid waste Health education and training