Ocular leptospirosis

Abstract

Uveitis is a well-known late complication of systemic leptospirosis, a zoonotic disease caused by the water-borne spirochete Leptospira. Although it is one of the world's most widespread febrile diseases, it remains underdiagnosed, mainly because of protean manifestations, lack of awareness, and nonavailability of laboratory support. Systematic collection of published literature was conducted using Medline, the Cochrane library, and bibliographies of retrieved reports. Articles directly applicable to ocular leptospirosis and current reports on the epidemiology, basic research, clinical presentations, and management of leptospirosis were reviewed. Changing trends in risk factors and an expanding spectrum of ocular and systemic findings have been reported. Molecular research on leptospirosis has shown remarkable progress; several rapid diagnostic modalities are currently under study. Awareness of this entity is absolutely essential to arrive at an accurate diagnosis and to prevent its potential reversible and irreversible ocular complications.

Using discrete choice modeling to evaluate the preferences and willingness to pay for leptospirosis vaccine

“…[7][8][9][10]55,56 The side-effects have been reported to include: mild local reactions such as skin redness, hard lump, swelling, local pain and itching; systemic reactions such as fever, headache, fainting, nausea and vomiting; and serious autoimmune disease like inflation of vascular structure of the eyes. 7,8,10,57 The use of recombinant, lipopolysaccharide and DNA-based vaccines may offer solutions to some of the limitations of current leptospirosis vaccine 53,54 . However, their applications are still in exploratory and may take years until new leptospirosis vaccines will be commercially available.…”

Insights into Leptospirosis, a Neglected Disease

“…The state of Kerala, called the Venice of the East, receiving heavy rainfall during several months of the year shows high prevalence of the disease, with the districts of Kottayam, Alleppey and Kozhikode being the worst affected [Vijayachari et al, 2008]. Patients present symptoms including history of fever, vomiting, jaundice, abdominal pain [Venkataraman et al, 1991], renal dysfunction [Muthusethupathi et al, 1995] and the involvement of the eye [Priya et al, 2007;Priya et al, 2008;Rathinam, 2002;Rathinam et al, 1997]. In 1994, there was an outbreak of leptospiral uveitis at Aravind Eye hospital, Madurai following severe flooding of the state of Tamil Nadu in the autumn of 1993; out of 46 patients, 80% of them were positive for leptospiral DNA and 72% were positive by serological tests.…”

Characterization, Comparison Study of Outer Membrane Protein OMPL1 of Pathogenic Leptospira Species for Disease Diagnosis

“…However, these vaccines do not confer cross-protective immunity to the serogroups that are not represented in the vaccine (Koizumi and Watanabe, 2005;Sonrier et al, 2000) allowing the unrepresented serovars to continue causing outbreaks of leptospirosis. Vaccination along with the whole-cell vaccines may lead to short-term, incomplete immunity and also certain serious side effects (Martinez et al, 2004;Rathinam, 2002;Yan et al, 2003). A universal perfect vaccine against leptospirosis is not available so far and makes the identification of genus-specific protein antigens (GP-Ag) that display extensive cross immunity very valuable for developing new vaccines and serodiagnostic methods Outer Membrane Proteins (OMPs) are important pathogenic components and highly conserved in different serogroups and serovars of pathogenic Leptospiras.…”