LEPTOSPIROSIS DISEASE IN HUMANS

Leptospirosis is a disease transmitted by rodents (rat urine) is prevented by eradicating rats and hygiene utensils. Leptospirosis is a bacterial disease caused by Leptospira sp. which can be transmitted from animals to humans or vice versa (zoonoses). Leptospirosis also known as Weil's disease, fever Icterohemorrhage, Disease Swineherd's, Fever pesawah (Ricefield fever), fever Cutting cane (Cane-cutter fever), fever Lumpur, Jaundis bloody, Disease Stuttgart, fever canicola, jaundice non-virus, the disease red water on the calf, and typhoid dog.

Infection in the subacute form is not so show clinical symptoms, whereas acute infection characterized by symptoms of sepsis, interstitial nephritis, hemolytic anemia, hepatitis and miscarriage. Leptospirosis in animals is usually subclinical. In this state, the patient showed no clinical symptoms of disease. Leptospira survive a long time in the kidneys of animals so that the bacteria will be a lot of animals released through urine.

Leptospirosis in animals may occur many months whereas in humans only last for 60 days. Humans are the last landlady to human transmission is rare.

This disease was first reported in 1886 by Adolf Weil with symptoms of high fever accompanied by some nervous symptoms and an enlarged liver and spleen. Disease with the symptoms mentioned above by Goldsmith (1887) referred to as Weil's Disease. In 1915 Inada proved that "Weil's Disease" is caused by the bacterium Leptospira icterohemorrhagiae.

In Indonesia, the most common infection in mice through flood conditions. The state of flooding caused changes to the environment as many puddles, the environment becomes muddy, muddy, and many piles of garbage that causes Leptospira bacteria breed easily. Flood-borne rat urine then enters the body through broken skin surfaces, mucous membranes of the eyes and nose. So far the mice are the main reservoir and at the same spreader leptospirosis, because it acts as a natural host and have a high reproductive power. Some other animals such as cows, goats, sheep, horses, pigs, dogs leptospirosis can be attacked, but the potential to infect humans are not as big as a mouse.

The incubation period for leptospirosis in humans is 2-26 days. Manifestations of leptospirosis infection have a very varied and sometimes without symptoms, so it often goes wrong diagnosis. L. Infection interrogans may be subclinical infection characterized by mild to severe cold, Almost 15-40 percent of patients exposed to infection are asymptomatic but serologically positive. Approximately 90 percent of people with mild jaundis, while 5-10 percent by weight jaundis often known as Weil's disease. Spira disease course consists of two phases, namely phase and phase immune septisemik. At the phase transition period for 1-3 days condition of the patient improved. In addition there is Weil's Syndrome which is a severe form of leptospirosis infection.

Septisemik phase is known as the initial phase or phases leptospiremik because the bacteria can be isolated from blood, cerebrospinal fluid, and most of the body's tissues. At this stage, the patient will experience flu-like symptoms for 4-7 days, characterized by fever, chills, and muscle weakness. Other symptoms are sore throat, cough, chest pain, vomiting of blood, headache, fear of light, mental disorders, inflammation of the lining of the brain, as well as an enlarged spleen and liver.

Immune phase is often called the second phase or leptospirurik because antibodies can be detected circulating bacteria isolation from urine, and may not be available anymore from the blood or cerebrospinal fluid. This phase occurs in 0-30 days due to the response of the body's defense against infection. Symptoms depend body's organs such as the lining of the brain, heart, eyes or kidneys.

If the lining of the brain is attacked, there will be depression, anxiety, and headaches. In liver function tests obtained jaundis, liver enlargement (hepatomegaly), and signs of coagulopathy. Lung disorders such as cough, coughing up blood, and difficulty breathing. Bleeding and hematologic disorders such as an enlarged spleen (splenomegaly). Abnormalities of heart failure or heart marked pericarditis. Aseptic meningitis is the most important clinical manifestations of immune phase.

Leptospirosis can be isolated from the blood for 24-48 hours after the onset of jaundis. In 30 percent of patients have diarrhea or difficulty in bowel movements (constipation), vomiting, weakness, and sometimes a decrease in appetite. Sometimes there is bleeding under the eyelid and renal impairment in 50 percent of patients, and lung disorders in 20-70 percent of patients.

Symptoms are also determined by the infecting serovar. As many as 83 percent of patients with infections of L. icterohaemorrhagiae jaundiced, and 30 percent in L. pomona. L. Infection grippotyphosa generally cause digestive system disorders. While L. pomona or L. canicola often causes inflammationof the lining of the brain (meningitis).