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The cycle of leptospiral infection. Mammalian species excrete leptospiral pathogens in their urine and serve as reservoirs for their transmission. The pathogens are maintained in sylvatic and domestic environments by transmission among rodent species. In these reservoirs, infection produces chronic, asymptomatic carriage. Leptospires can then infect livestock and domestic and wild animals and cause a range of disease manifestations and carrier states. Maintenance of leptospirosis in these populations is due to their continued exposure to rodent reservoirs or to transmission within animal herds. Leptospirosis is transmitted to humans by direct contact with reservoir animals or by exposure to environmental surface water or soil that is contaminated with their urine. Leptospires penetrate abraded skin or mucous membranes, enter the bloodstream and disseminate throughout the body tissue. Infection causes an acute febrile illness during the early ¡®leptospiraemic¡¯ phase and progresses during the late ¡®immune¡¯ phase to cause severe multisystem manifestations such as hepatic dysfunction and jaundice, acute renal failure, pulmonary haemorrhage syndrome, myocarditis and meningoencephalitis. Although the immune response eventually eliminates the pathogens, leptospires may persist for prolonged periods in immunoprivileged sites, such as the renal tubules and the anterior chamber and vitreous humor of the eye, where they can produce, respectively, urinary shedding weeks after resolution of the illness and uveitis months after exposure. Humans are an accidental host and do not shed sufficient numbers of leptospires to serve as reservoirs for transmission. [ Last edited by conanthird on 2010-12-3 at 10:18 ] |
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