Leptospirosis
Prevention strategies of human leptospirosis include
Leptospirosis is an infection in rodents and other wild and
domesticated species. Rodents are implicated most often
in human cases. The infection in man is contracted
through skin abrasions and the mucosa of the nose, mouth
and eyes. Exposure through water contaminated by urine
from infected animals is the most common route of
infection. Human-to-human transmission is rare.
Outdoor and agricultural workers (rice-paddy and
sugarcane workers for example) are particularly at risk but
it is also a recreational hazard to those who swim or wade
in contaminated waters. In endemic areas the number of
leptospirosis cases may peak during the rainy season and
The Global Burden of Leptospirosis
What do we know?
Leptospirosis is a zoonotic disease caused by bacteria of
the genus Leptospira. It is most commonly spread via
water contaminated with urine from infected animals, but
contaminated food or soil can also act as vehicles for the
disease. The main animal reservoirs are rodents, livestock
and dogs. Disease in humans can vary from mild flu-like
illness to serious disease. Some severe complications
include kidney damage, liver failure, respiratory distress,
meningitis and death.
Although Leptospirosis can occur worldwide, there are a
number of risk factors associated with the disease. It is
most common in urban slum areas, where there is
inadequate sewage disposal and water treatment. It can
also be an occupational hazard for those working outdoors
or with animals and a recreational hazard for those
participating in water-related activities. Epidemics are
typically seen during flooding, and changing environmental
trends, with extreme weather patterns, may perpetuate
these epidemics.
Did you know?
The actual incidence of Leptospirosis in Hawaii is
estimated to be double the reported incidence.
A study in Peru demonstrates high levels of under-
diagnosis of Leptospirosis and under-recognition of severe
complications especially in urban areas.
A study from Gabon shows that over 15% of people in
slum communities show evidence of infections
with Leptospira.
Unusual flooding in Bangladesh, India, and Sri Lanka
caused overflowing of rodent-infested sewers exposing
inhabitants to Leptospirosis infection.
Leptospirosis soared across Central America following
Hurricane Mitch (1998).
Global travel to high-risk areas increases the exposure of
individuals to Leptospirosis.
What do we still need to know?
Very little is currently known regarding the true incidence
of Leptospirosis. It is estimated that 0.1 to 1 per 100 000
people living in temperate climates are affected each year,
with the number increasing to 10 or more per 100 000
people living in tropical climates. If there is an epidemic,
the incidence can soar to 100 or more per 100 000 people.
The disease is underreported for many reasons, including
difficulty in distinguishing clinical signs from those of other
endemic diseases and a lack of appropriate diagnostic
laboratory services.
even may reach epidemic proportions in case of flooding
because the floods cause rodents to move into the city.
wearing protective clothing for people at occupational risk
and avoidance of swimming in water that may be
contaminated. Leptospirosis control in animals is
dependent on the serovar and animal species but may be
either vaccination, a testing a culling programme, rodent
control or a combination of these strategies.
Surveillance
The attached excerpt provides WHO recommended
standards and strategies for the surveillance, prevention
and control of Leptospirosis. This section is part of a larger
document entitled "WHO recommended standards and
strategies for surveillance, prevention and control of
communicable diseases " developed by the WHO Emerging
Diseases and Pandemic Response Department (EPR), in
collaboration with the Department Food Safety and
Zoonoses (FOS), for major zoonoses involving livestock.
Each section, after giving essential information on the
main characteristics of the disease and its causative
agent(s) and mode of transmission, provides definitions
for possible, probable and definite cases of the disease as
well as the rational for surveillance and WHO
recommended systems for surveillance. Major control and
prevention activities in humans and animal hosts are also
described. A list of WHO reference materials is provided at
the end.