To rates. In general the antibiotics treatment has

          To increase the chances of
surviving leptospirosis an to reduce the number of illness, treatment for leptospirosis
have been introduced. For example, introduction of peritoneal dialysis in cases
of renal failure has markedly reduced the fatality rates. In general the antibiotics
treatment has been thought to be beneficial to the course of disease while latest
treatment later might reduce the recovery periods. However with rapid clearance
of leptospirosis the treatment with penicillin is having a problem which associated
with the life-threatening Jarish-Herxheimer reaction. In extreme cases, high
doses of intravenous penicillin for four times a day, 2 million units are
recommended. In less extreme cases, oral antibiotics such as amoxicillin,
ampicillin, doxycycline or erythromycin can be prescribed. Third generation
cephalosporin and quinolone antibiotics also seem to be effective. In the
elimination of leptospires from carrier animals, a number of antibiotics have
been shown to be useful. Moreover, serological testing is usually done by
central reference laboratories. Most diagnoses are made by isolating the
pathogen from the blood or cerebrospinal fluid.

               Prevention
of transmission can be achieved by wearing protective clothes but this is not
always practical for example not an option to wear boots in a paddy field.
Intervention can be achieved by improving water and food storages but there are
probability for the increasing of awareness about the disease and the infection
risks in clinicians so the population and public health decisions makers is an
effective approach for reducing infection risks. The information on human vaccines
is limited. These are available only in certain countries such as China, Cuba,
France and Russia. As in animals, these vaccines are largely serovar-specific
and protect for a relatively short time. To maintain protective titres of
antibodies boosting at regular is necessary. These vaccines are also focused on
the local situation and do not cover the needs in other regions where the other
serovars are endemic. For the animal vaccines, those humans are composed of
crude antigens consisting of leptospires killed by phenol or formaldehyde that
give unwanted side effects. (Shi Manhua, personal communication)

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