Leptospirosis in India and the rest of the world

Abstract

Leptospirosis is an acute anthropo-zoonotic infection of worldwide significance caused by spirochaete Leptospira interrogans which has 23 serogroups and >200 serovars. Various factors influencing the animal activity, suitability of the environment for the survival of the organism and behavorial and occupational habits of human beings can be the determinants of incidence and prevalence of the disease. The disease was considered inconsequential till recently, but it is emerging as an important public health problem during the last decade or so due to sudden upsurge in the number of reported cases and outbreaks. Since isolation rate of the microorganism from clinical specimens is low due to prior indiscriminate use of antibiotics, serological techniques remain the cornerstone of diagnosis.

Current status of rodenticide intoxication in Brazil: a preliminary survey from 2009 to 2011

“…Among these animals, rodents present a particular in Brazil under such conditions due to their transmission of leptospirosis. Three species with distinct ecological niches are present (Rattus norvegicus, R. rattus, and Mus musculus), but all adapt readily to different environmental conditions, have high reproductive rates and are associated with several human diseases (Rao et al 2003;Silva et al 2003). Rodents are usually associated with dirt, disease, and death, and their extermination is, thus, needed.…”

A Review of Laboratory Diagnosis and Treatment of Leptospirosis

“…Reactions persist for months or years. Therefore, persistent antibodies allow retrospective diagnosis [36]. In that moment, due to the lower probability of leptospires detection in blood, serologic methods become required [37].…”

“…The titer will rise in a second specimen taken after 3 to 7 d. If the titer remains below 100 even on repeated testing, it may be assumed that it was due to the previous leptospirosis and not to current illness. A titre of 400 to 800 or more or a 4-fold rise in titer between 2 tests (between sera taken five to 10 d), is diagnostic when combined with a clinical illness compatible with leptospirosis [36,3].…”

“…In endemic areas, the diagnosis will be confirmed if the titre rises on retesting, but will be negated if it is unchanged, assuming that the infecting serovar was included among the antigens for the MAT [36]. A high titer of 400 or more in an asymptomatic patient are generally accepted, but titers as high as 1600 or more have been recommended [5].…”

“…Transmission occurs from exposure to urine or aborted tissues of infected animals either directly or via contact with contaminated water or soil [1,2]. Leptospirosis is generally underreported due to nonspecific symptoms, lack of awareness, challenging diagnostics and poor access to health care [3].…”