Leptospirosis cases confirmed in England

In the UK, 4 cases of leptospirosis were confirmed in England in the first three months of 2022, including 2 in the South West, 1 in London and 1 in the East of the country. The cases involved males between the ages of 28 and 69: one case was related to sewer water, 2 cases were related to exposure to rats and one case had been related to livestock. There are 23 probable cases of the disease nationwide in the first quarter of 2022, according to the National Health Service (NHS).

memories of the leptospirosis.

Leptospirosis is a bacterial disease spread worldwide. Leptospirosis is caused by bacteria Leptospira interrogans. This is fairly easily maintained in the external environment (fresh water, muddy bottoms) which encourages contamination. The seasonality of the disease is very pronounced, with a summer-autumn outbreak associated with heat and rain.

bacteria of the genus leptospira can infect a large number of wild mammals (rodents and insectivores: rats, tengues, shrews, etc.) and domestic animals (cattle, sheep, goats, pigs, dogs), which serve as a reservoir and excrete them in their urine. Bacteria can survive for several months in a humid and warm environment. There are over 250 serovars of Leptospira species, with several serovars being endemic to a given geographic area.

Certain professions (farmers, breeders, canal workers, garbage collectors, etc.) and water sports enthusiasts (swimming, canoeing, kayaking, fishing, hunting, canyoning, etc.) are particularly at risk. In humans, the bacterium penetrates primarily through injured skin or mucous membranes.

The disease is often mild, but complications are possible, including kidney failure, which can result in death in 5 to 20% of cases. The incubation of the disease lasts from 4 to 14 days.

  • In the moderate form, the disease begins with a high fever with chills, headache, muscle and diffuse joint pain. In 20% of cases it is complicated by hemorrhagic syndrome.
  • Severe forms (icterohemorrhagic or Weil’s disease) combine acute renal failure, neurological impairment (convulsions, coma) and more or less heavy bleeding (pulmonary, digestive).

The initially non-specific clinical symptoms (headache, fever, myalgia) can lead to diagnostic and therapeutic delays if they are confused with differential diagnoses such as influenza, chikungunya or dengue fever.

Prevention and individual protective measures against leptospirosis:

  • Avoid bathing in fresh water, especially if you have wounds and when the water is cloudy or muddy.
  • avoid contact with water, nose, mouth and eyes;
  • Avoid walking barefoot or in open sandals on muddy ground, in puddles, stagnant water, ravines (especially in overseas departments);
  • Protect wounds from contact with water with waterproof dressings;
  • Wear protective equipment when:

High-risk occupations (breeding, sewer workers, garbage collectors, agriculture, land management). etc.) including boots, gloves, waders, protective clothing and even splash goggles case of projection risk;
the practice of white water sports such as canyoning, kayaking, including wetsuit protectors, booties and gloves;

  • Control rodents, which are the reservoir of the disease.

After exposure to risk:

  • Wash with drinking water and disinfect the wounds;
  • If you develop symptoms, consult a doctor immediately and tell them about the risky activity that has been carried out in the last two weeks.

These measures are to be intensified during the rainy season.
There is a vaccination against leptospirosis. Since its effectiveness is limited to certain Leptospira strains, it is rarely carried out in practice, mainly among professionals.

Source: ProMED.


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