Introduction to Leptospirosis

Leptospirosis is an infectious disease caused by a type of bacteria called a spirochete. Leptospirosis can be transmitted by many animals such as rats, skunks, opossums, raccoons, foxes, and other vermin. It is transmitted though contact with infected soil or water. The soil or water is contaminated with the waste products of an infected animal. People contract the disease by either ingesting contaminated food or water or by broken skin and mucous membrane contact with the contaminated water or soil. The infection causes a systemic illness that often leads to renal and hepatic dysfunction.

The disease was first recognized as an occupational disease of sewer workers in 1883. In 1886, Weil described the clinical manifestations in 4 men who had severe jaundice, fever, and hemorrhage with renal involvement.

Leptospirosis is also transmitted by the semen of infected animals. Workers may contract the disease through contact with infected blood or body fluids. Though recognised among the world's most common diseases transmitted to people from animals, leptospirosis is nonetheless a relatively rare bacterial infection in humans.

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The infection is commonly transmitted to humans by allowing water that has been contaminated by animal urine to come in contact with unhealed breaks in the skin, the eyes, or with the mucous membranes. Outside of tropical areas, leptospirosis cases have a relatively distinct seasonality with most of them occurring in spring and autumn.

Leptospirosis is caused by pathogenic spiral bacteria that belong to the genus Leptospira, the family Leptospiraceae, and the order Spirochaetales. These spirochetes are finely coiled, thin, motile, obligate, slow-growing anaerobes.

Their flagella allow them to burrow into tissue. The genus Leptospira was originally thought to comprise only 2 species: L interrogans, which is pathogenic, and L biflexa, which is saprophytic. More recent work has identified 7 distinct species of pathogenic leptospires, which appear as more than 250 serologic variants Leptospirosis occurs worldwide, but it is most commonly acquired in the tropics. The U.S. Centers for Disease Control and Prevention states 100-200 cases of leptospirosis are reported each year in the United States, with about 50% of cases occurring in Hawaii. Although the incidence in the United States is relatively low, leptospirosis is considered the most widespread disease that is transmitted by animals in the world.

Scope and Limitations

The scope of the study was the utilization of the nursing process and application of the twelve core competencies in the standards of nursing practice to an adult patient diagnosed with Leptospirosis. This is a Retrospective B study. This study focuses on the care of an adult with Leptospirosis. Its purpose is to identify and analyze variable that contributed to the development of the problem. The study was conducted at the Pavilion 6 of a goverment hospital. The researcher were able to handle the patient for 1 day (Feb.3) of February, 2011 respectively. The aspects that were looked into were the demographic profile of the patient, significant others and event, past and present health condition medication and intervention utilized for the patient condition.

Data collection was done during the day of interaction with the patient up to a time designated by the researcher to be the limitation of the study. The information was gathered based on the researcher’s observation, the patient’s verbalizations and physical assessment,. Nursing history and physical assessment form was accomplished on the day of the researcher-client interaction. Observations were also made during the taking and checking of the vital signs, and during actual conversations with the patient and his companions. The researcher experienced a limitation with the time left for the client to be handle since the researcher was only able to handle patient for 1 day only.

Significance and Justification

The results of the study will benefit the following

For the patient, as the direct benefeciary of care, this study will provide an opportunity for the adult to be comprehensively assessed and receive a well formulated quality plan of care appropriate for his condition. The study will also provide patients with further knowledge about the disease. For the family members. The result of this study will help them gain necessary knowledge, skills and attitude in order to participate in the care of the adult, as they become aware to the responsibilities as support system to the patient to ensure continuity of care after discharge. For the clinical instructor.

The study will give her an opportunity to evaluate the students’ performance in the clinical duty. Furthermore, the clinical instructor can enhance the student nurses’ knowledge, skills and attitude, and can even make recommendation to enhance the student’s competency. For the future researchers. This study will serve as a tool in developing the proper knowledge, skills and attitude in rendering quality and effective nursing care. Through this study, the future researchers may be inspired to make a research regarding the same topic and reinforce or verify all the data gathered.

Background of the Study

The case study was conducted at a selected tertiary hospital in the city of Manila. The study conducted by the researchers utilized a retrospective type B because the researchers only handled the patient on February 3, 2012 from 1300H to 1600H. This said hospital is a referral facility for Infectious/ Communicable Diseases. It is one of the retained special tertiary hospitals of the Department of Health (DOH) which is subsidized by the national government. The hospital has a 500-bed capacity that provides free health care delivery service particularly among the depressed, underserved and underprivileged sectors of the society. The adult male ward of the said hospital was located at the 2nd floor of the institution. The floor specializes in communicable diseases. Its vision is “to be the center of excellence in infectious diseases and tropical medicines” and it’s mission “to provide quality care according to standard of treatment such as comprehensive programs and quality care” The hospital provides the ultimate care for patients with communicable diseases from admission to discharge.

The hospital has 4 floors in which it is subdivided into two sections: The first section of the left side of first floor or pavilion 1 is the central supply room wherein all medical instruments, equipments, and supplies are stored. And at the right side is where the pavilion 5 is located wherein the OPD area is found. It specializes on the treatment of patients with minor diseases or injuries. The 2nd pavilion is the Adult Infectious Disease Dept. or IDTM. It caters female clients who are inflicted with communicable diseases and adjacent to this floor is the pavilion 6 male IDTM.

The 3rd floor at the right side is where the pavilion 3, adolescent male and female ward wherein it also provides care to patients with communicable disease and adjacent to it is the pavilion 7 philhealth ward where patients that are entitled with a philhealth card are being taken care of. And the last floor where pavilions 8 and 4 are found is the pedia ward. It also provides services and procedures like, admission of the patient, nurse and physician rounds, medication administration and discharge instruction to patient and family constituents.