Leptospira-IgM Test

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Last Updated December 20th, 2021

What is a Leptospira-IgM test?

A Leptospira-IgM test is a blood test that is carried out to detect the anti-Leptospira IgM antibody. It is an ELISA test (an enzyme-linked immunosorbent assay) with high sensitivity (>99%); and specificity (>96%).

What is Leptospirosis?

Leptospirosis is the most common zoonotic disease (a disease that can be transmitted to human beings from animals) in the world. The disease is caused by Leptospirainterrogans or leptospiraborgpetersenii, the two pathogenic species of the bacteria Leptospira.

Rodents (rats and mice mainly) are the primary source of infection. Other sources of infection include dogs, cats, horses, and cattle. They excrete the pathogens through their urine as the bacteria thrive in their renal tissue. You can get infected when these organisms enter your body via small cuts in your skin. Contact with contaminated water is the most common mode of infection. Leptospira can also enter the human bloodstream via-

– Close contact with infected animals
– Contact with moist soil/ vegetation (contaminated with the urine of the infected animal)
– Handling infected animal tissues
– Ingestion of contaminated food and water
– In very rare circumstances, human to human transmission is seen.
The incubation period (the time taken from getting infected to the manifestation of the disease) is usually 5-14 days.

Serious outbreaks have been reported in cases of natural calamities such as floods whereas any exposure to contaminated water bodies (including water sports) can expose you to infection.Majority of the people (90%) who get infected exhibit mild flu-like symptoms. In severe cases, a hepatorenal syndrome known as Weil’s disease may occur leading to multiorgan involvement and high morbidity. A potentially fatal pulmonary hemorrhagic syndrome is another serious manifestation of Leptospirosis.

Why has my physician asked me to undergo a Leptospira-IgM test?

Your physician may order a Leptospira-IgM test for you if you present with the following features-

– Fever
– Chills
– Myalgia (muscle pain)
– Fatigue
– Headache
– Sore throat
– Pleuritic chest pain
– Vomiting
– Pain abdomen
– Tachycardia (increase in heart rate)
– Hypotension (fall in blood pressure)

The diagnosis of Leptospirosis is often very difficult as the signs and symptoms are non-specific. A person suffering from Leptospirosis is often confused to be suffering from aseptic meningitis, influenza, liver disease, dengue, pneumonia or pyrexiaof unknown origin.
In most of the cases, a diagnosis is reached at only when a severe form of the disease manifests. The mortality of multi-systemic manifestation of this disease rangers from 5-40%. Thus, an early diagnosis and aggressive treatment remains the cornerstone of treatment.

How should I prepare for the Leptospira-IgM test??

No specific preparation is required. You need to discuss with the physician your medical history. As Leptospira-IgM test is a blood test and involves the standard techniques of venipuncture, you need to inform your physician if-

– You are taking any blood thinners
– You are suffering from any coagulopathy
– You should also inform your physician about the medications (including ayurvedic, homeopathic and natural remedies) that you might be consuming. Appraise him if you suffer from any drug allergy. It will help him in charting out a treatment plan in case you test positive for this test.

Do I need to fast before a Leptospira-IgM test??

There is no need to fast before A Leptospira-IgM test. You can consume normal meals before this test.

Can I undergo a Leptospira-IgM testif I am pregnant?

Yes, it is perfectly safe to undergo a Leptospira-IgM testify you are pregnant or breastfeeding your child.

Can children undergo a Leptospira-IgM test?

Yes, children of all ages can undertake a Leptospira-IgM testas it is a safe, risk free and easy to perform procedure.

What are the risks involved?

A Leptospira-IgM test is a blood test. It is easy to perform, safe and quick tests. Complications are rarely seen. However, as this test involves the puncture of a vein to collect a blood sample, the following complications may arise-

– You may feel a stinging sensation when the needle pricks your skin.

– The perception of pain varies in different patients.

– The act of puncturing a vein and drawing blood may be scary for some. You may feel lightheadedness at the sight of blood. It is advisable to distract yourself during this step if you are faint-hearted.

– A bruise at the sight of the prick may appear. You can prevent it by pressing on the site of the prick for a few minutes.

– In some cases, bleeding may be encountered at the site of venous invasion.

– A hematoma may form at the site of puncture.

There are chances of infection at the site of venesection at a later stage. If you encounter the presence of pus or signs of inflammation (phlebitis) at the site, consult your physician.

What are the contraindications of a Leptospira-IgM test?

There are no absolute contra-indications to a Leptospira-IgM test. However, as it is a blood test including venesection, your physician may defer performing this test if you suffer from a bleeding tendency.

How is a Leptospira-IgM test performed?

A Leptospira-IgM testis a blood test carried out on an outpatient basis unless the patient is already admitted to a hospital. The standard technique of venipuncture is employed. The few simple steps are as follows-

– You will be escorted to an area dedicated to collecting samples.

– You will be asked to sit on a comfortable chair or lie down on a hospital bed.

The technician will apply a tourniquet proximally to the site chosen for venipuncture. This makes the veins more prominent, allowing easier access.

– The antecubital area of the arm is the region most commonly used for the purpose of venipuncture. This is the area on the inner side of the elbow and contains three vessels-: the median cubital, the cephalic and the basilic veins. In certain cases, the technician may have to resort to other veins, but these are the vessels routinely used for phlebotomy.

– The area is cleaned with a disinfectant.

– A sterile needle is used to puncture the vein and draw about 5 ml of blood.

– The pressure is applied to the vein with sterile gauze after the needle is withdrawn.

– Tourniquet is released.The blood sample is collected in a vial.

How long does the procedure last?

The entire procedure is over in 5-10 minutes. In obese patients, patients belonging to geriatric age group and very young children, venous access is sometimes difficult, leading to more than one prick.

When can I get the results of my test?

You can get the results of your test on the same day.

What is the cost of conducting a Leptospira-IgM test in India?

The cost of undergoing a Leptospira-IgM test in India varies from INR 1250-1500. The actual cost may vary, depending on the city you reside in and the diagnostic center whose services you avail.

What other tests are usually performed to detect Leptospirosis?

The Leptospira-IgM test is the most commonly used diagnostic tool for Leptospirosis, but the antibodies cannot be detected in the first week of the disease. Moreover, IgM antibodies tend to persist for a long time after the initial infection. Therefore, other tests are also resorted to in order to arrive at a correct diagnosis. This serious disease can also be diagnosed by the following tests-

Leptospira IgG test-IgG antibodies can be detected in the blood after 2 weeks of infection.

Dark Field Microscopy (DFM)- In this method, the spirochetes (Leptospira) can be visualized using a microscope. But this test suffers from a lack of specificity. Moreover, a large volume of organisms should be present in the blood for detection.

Microscopic Agglutination Test (MAT)- This test is the gold standard as far as the diagnosis of Leptospirosis concerned. But this test has its limitations too. It cannot be relied upon in the earlier stages of the disease. Moreover, it is a complicated procedure.

Polymerase Chain Reaction (PCR)- This test can detect Leptospira DNA in your blood and urine. It is a very effective but costly procedure.

Culture of Leptospira (from blood, urine, cerebrospinal fluid, tissues)- This is another effective procedure, but it is time-consuming. It can take up to 3 months to prepare a culture of this bacteria.

What is the treatment of Leptospirosis?

About 5 cases/100,000 population/year globally are reported for Leptospirosis which is not a small number. Early diagnosis and judicious treatment can go along way in avoiding morbidity and mortality related to this disease with protean manifestations.

Antibiotic therapy remains the cornerstone of the treatment of Leptospirosis. The treatment should be started as early as possible after a diagnosis of Leptospirosis has been made. In mild cases, doxycycline, ampicillin or amoxicillin may suffice.

Intravenous therapy with Penicillin G is required for severe cases. Systemic involvement is treated with symptomatic supportive therapy. As this disease has the potential to affect multiple organs, monitored care is the need of the hour. The patient should be treated in a hospital setting with provisions for cardiac monitoring and ventilator support.

References

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