12-28-2006, 01:13 PM
Good thing he got it taken care of. A bit 'rare', but it sounds like nasty stuff. There is a lot on it on the internet. Rats are not the only vectors:
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The Cause; Swimming in Streams and Natural Pools:
Leptospirosis is a bacterial disease caused by Leptospira interrogans. Although leptospirosis is an infrequent disease in on the mainland, it is much more of a problem in Hawaii, where the reservoir is most likely the wild pigs and goats in the upcountry which contaminate the streams.
The best preventative is not to swim in streams and pools, or to luxuriate under waterfalls --but the experience of doing exactly these things are why a lot of us go to Hawaii in the first place.
It can be contracted by swallowing contaminated stream water. The bacteria can also enter through the intact mucous membrane of the mouth, even if you do not have a cut there. Or it can enter through an open cut on the skin. So, the best thing would be to keep out of streams altogether if you have a cut, or to keep your mouth shut so as not to ingest water while swimming in these places.
Signs and Symptoms of Infection:
Mild to Moderate infection which acounts for 90% of cases of leptospirosis is characterized by;
* abrupt onset of remitting fever
* headache
* abdominal pain
* nausea and vomiting
* severe muscle pain
Symptoms may last 4-7 days. Of the patients with Mild to Moderate disease, up to 90% will have symptoms similar to meningitis; headache, neck stiffness and discomfort at looking at light.
There is a more severe form of leptospirosis that is seen in 10% of people infected with the bacteria.
* Liver abnormalities most notably jaundice (yellow pigment deposition in the skin)
* kidney failure
* bleeding abnormalities
* severe mental status changes
If you develop any of theses signs, seek medical attention immediately! The cure requires intravenous antibiotics.
Diagnosis
Diagnosis is via a special rapid reagent blood test, which will detect the organism in the blood 2-5 days into the acute illness. Blood cultures may be negative because special media is required and may not reveal growth for 5-6 weeks.
So your doctor must have a high level of suspicion for leptosirosis. If your symptoms don't manifest until your back to the Mainland your physician may not think about leptospirosis - be sure to mention it by name.
Prevention is easy (it can also save your vacation plans!):
Doxycycline is an effective prophylaxis (preventation) against infection: the dosage is 200mg once a week, beginning right before your vacation. This prevents infection. You'll need to ask your doctor for a prescription, and fill it before your leave for your vacation.
Treatment of Leptospirosis:
The treatment dose for those already experiencing symptoms of leptospirosis is Doxycycline 100 mg twice daily for mild to moderate cases.
For severe cases, Penicillin G 1.5 million units IV every 6 hours is the recommended treatment
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The Cause; Swimming in Streams and Natural Pools:
Leptospirosis is a bacterial disease caused by Leptospira interrogans. Although leptospirosis is an infrequent disease in on the mainland, it is much more of a problem in Hawaii, where the reservoir is most likely the wild pigs and goats in the upcountry which contaminate the streams.
The best preventative is not to swim in streams and pools, or to luxuriate under waterfalls --but the experience of doing exactly these things are why a lot of us go to Hawaii in the first place.
It can be contracted by swallowing contaminated stream water. The bacteria can also enter through the intact mucous membrane of the mouth, even if you do not have a cut there. Or it can enter through an open cut on the skin. So, the best thing would be to keep out of streams altogether if you have a cut, or to keep your mouth shut so as not to ingest water while swimming in these places.
Signs and Symptoms of Infection:
Mild to Moderate infection which acounts for 90% of cases of leptospirosis is characterized by;
* abrupt onset of remitting fever
* headache
* abdominal pain
* nausea and vomiting
* severe muscle pain
Symptoms may last 4-7 days. Of the patients with Mild to Moderate disease, up to 90% will have symptoms similar to meningitis; headache, neck stiffness and discomfort at looking at light.
There is a more severe form of leptospirosis that is seen in 10% of people infected with the bacteria.
* Liver abnormalities most notably jaundice (yellow pigment deposition in the skin)
* kidney failure
* bleeding abnormalities
* severe mental status changes
If you develop any of theses signs, seek medical attention immediately! The cure requires intravenous antibiotics.
Diagnosis
Diagnosis is via a special rapid reagent blood test, which will detect the organism in the blood 2-5 days into the acute illness. Blood cultures may be negative because special media is required and may not reveal growth for 5-6 weeks.
So your doctor must have a high level of suspicion for leptosirosis. If your symptoms don't manifest until your back to the Mainland your physician may not think about leptospirosis - be sure to mention it by name.
Prevention is easy (it can also save your vacation plans!):
Doxycycline is an effective prophylaxis (preventation) against infection: the dosage is 200mg once a week, beginning right before your vacation. This prevents infection. You'll need to ask your doctor for a prescription, and fill it before your leave for your vacation.
Treatment of Leptospirosis:
The treatment dose for those already experiencing symptoms of leptospirosis is Doxycycline 100 mg twice daily for mild to moderate cases.
For severe cases, Penicillin G 1.5 million units IV every 6 hours is the recommended treatment