EDITORIAL
Fry et al., Journal of Medical Microbiology 2019;68:289–289
DOI 10.1099/jmm.0.000899
Leptospirosis
Norman K. Fry,1,2,* Roberto M. La Ragione3 and Derren Ready1
Leptospirosis is a zoonosis caused by infection with
pathogenic strains of the bacterium Leptospira. This
infection has a worldwide distribution, and is an emerg-
ing/re-emerging public-health problem, particularly in
large urban centres of tropical and subtropical regions.
The Journal of Medical Microbiology has recently pub-
lished three papers on different aspects of the disease
and its causative organisms by Nisansala et al. [1], Jae-
ger et al. [2] and Jacob et al. [3].
Nisansala et al. [1] describe the challenges in diagnostic
methods with a particular focus on culturing Leptospira
from human blood samples in their setting and report
the successful isolation of Leptospira interrogans from
two human cases in Sri Lanka. Motile spirochaetes were
observed in both patients’ samples and phylogenetic
analysis of the flaB gene demonstrated isolates were clus-
tered with L. interrogans, with this identification being
supported by results from microscopic agglutination test
analysis.
Jaeger et al. [2] describe the genotypic characterization
of Brazilian L. interrogans isolates recovered from animal
populations. These authors used secY sequencing, vari-
able-number tandem-repeat analysis (VNTR), multilocus
sequence typing (MLST) and multi-spacer typing (MST)
analysis to genotype six isolates, which were character-
ized as belonging to ST17. Results of secY sequencing,
VNTR and MLST were all congruent with each other
and the reference strain; however, of note, the MST
revealed two distinct genotypic groups.
Jacob et al. [3] present a retrospective analysis on the
prevalence of anti-leptospiral antibodies in the city of
Chennai, India. These authors used a microscopic agglu-
tination test with a panel of six serovars and a titre cut-
off of >1 : 80 to determine seropositivity and concluded
that the high seropositivity rate, particularly in male chil-
dren, strongly supported the inclusion of leptospirosis
Received 10 October 2018; Accepted 22 November 2018; Published 3 January 2019
Author affiliations: 1Respiratory and Vaccine Preventable Bacteria Reference Unit, Public Health England – National Infection Service, London, UK; 2
Immunisation and Countermeasures Division, Public Health England – National Infection Service, London, UK; 3Department of Pathology and
Infectious Diseases, School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK.
*Correspondence: Norman K. Fry, norman.fry@phe.gov.uk
000899 ã 2019 Public Health England
289
into the differential diagnosis for febrile illnesses in chil-
dren living in such areas.
In order to reduce the morbidity and mortality from
leptospirosis, it is apparent that we require greater
understanding of animal reservoirs and environmental
conditions that affect the survival and transmission of
Leptospira in its natural surroundings. The provision of
an accurate, timely diagnosis combined with appropriate
patient management can be challenging in many set-
tings, and it is key that we focus our efforts on the
control and prevention of leptospirosis, by improving
our understanding of this pathogen. Confirmation of
identification and further characterization of the species
responsible are clearly important, as is the recognition
of likely sources of infection. Progress in these key areas
should help to develop effective public-health strategies
to overcome this neglected disease.
Funding information
The authors received no specific grant from any funding agency.
Conflicts of interest
Dr Norman K. Fry is Co-Editor-in-Chief for the Journal of Medical Micro-
biology, Professor Roberto La Ragione is the Section Editor for the One
Health – Emerging, Zoonotic and Environmental Disease Section of
the Journal of Medical Microbiology, and Dr Derren Ready is the Section
Head for Respiratory and Systemic Bacteria Section of Public Health
England, which provides laboratory reference services for Leptospira.
References
1. Nisansala GGT, Muthusinghe D, Gunasekara T, Weerasekera MM,
Fernando SSN et al. Isolation and characterization of Leptospira
interrogans from two patients with leptospirosis in Western Prov-
ince, Sri Lanka. J Med Microbiol 2018;67:1249–1252.
2. Jaeger LH, Pestana CP, Carvalho-Costa FA, Medeiros MA,
Lilenbaum W. Characterization of the clonal subpopulation Fiocruz
L1-130 of Leptospira interrogans in rats and dogs from Brazil. J
Med Microbiol 2018;67:1361–1367.
3. Jacob SM, Geethalakshmi S, Karthikeyan S, Durairaj A, Gopal P
et al. A 3-year retrospective analysis on the prevalence of antilep-
tospiral antibodies among children in Chennai City, India. J Med
Microbiol 2018;67:1706–1710.