- Zoonotic disease caused by Leptospira interrogans, a spirochete bacteria
- Spread via contact with infected water; outbreaks common during increased rainfall or during floods
- 100 to 200 annual U.S. cases; 50% in Hawaii
- Estimated incidence 0.1 to 10/100,000 worldwide
- Most cases occur in tropical climates; can occur in temperate areas
- Outbreaks can occur following increased rainfall or during floods.
Etiology and Pathophysiology
- Caused by L. interrogans, a spirochete harbored in mammals (usually rodents) and shed into water or soil
- There are >25 serogroups and 250 serovars; illness severity not linked to type
- Organism is inoculated through breaks in the skin or contact with mucous membranes.
- Spirochetes migrate through the lymphatic and vascular system to cause disease.
- Life cycle is completed when spirochetes infect the kidneys and urinary tract and are excreted into fresh water or soil.
- Disease can be spread transplacentally to cause fetal complications; risk of abortion as high as 50%
- Leptospira can be transmitted through breast milk (1).
- Frequent animal contact (farmers, veterinarians, abattoirs)
- Fresh water exposure (military personnel, aid workers, adventure racers)
- Increased rainfall or floods, particularly in tropical environments
- Avoid contaminated water.
- Wear protective clothing/gear.
- Consume clean water.
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