Cases of leptospirosis confirmed in England

In the United Kingdom, 4 cases of leptospirosis were confirmed in England during the first three months of 2022, including two in the southwest, one in London and one in the east of the country. The cases included males aged between 28 and 69 years: one case associated with canal water, two cases associated with exposure to mice, and one case to farm animals. There are also 23 probable cases of the disease nationwide in the first quarter of 2022, according to the National Health Service (NHS).

reminder on leptospirosis.

Leptospirosis is a bacterial disease found worldwide. Leptospirosis is caused by bacteria Leptospira interrogans. This can be easily maintained in the external environment (fresh water, muddy soil), adding to the pollution. The seasonality of the disease is very noticeable, with a sudden rise in summer and fall associated with heat and precipitation.

sex bacteria Leptospira It is likely to infect a large number of wild mammals (rodents and insect pests: rats, tenges, shrews, etc.) and domesticated mammals (cattle, sheep, goats, pigs, dogs), which act as reservoirs and excrete it in their urine. Bacteria can live for several months in a moist, warm environment. There are over 250 Leptospira species, with many serovars endemic to a particular geographic area.

Certain occupations (farmers, breeders, sanitation workers, garbage collectors, etc.) and people who engage in water sports (swimming, canoeing, kayaking, fishing, hunting, canoeing, etc.) are particularly at risk. In humans, the bacteria mainly penetrate the affected skin or mucous membranes.

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

  • In the mild form, the disease begins with a high fever accompanied by chills, headache, muscle aches and diffuse pains in the joints. In 20% of cases it is complicated by hemorrhagic syndrome.
  • Severe forms (larval hemorrhage or Weil’s disease) combine acute renal failure, neurological impairment (convulsions, coma) and more or less severe bleeding (pulmonary, gastrointestinal).

Nonspecific initial clinical signs (headache, fever, myalgia) can lead to diagnostic and therapeutic delay by confusion with differential diagnoses such as influenza, chikungunya or dengue.

Individual prevention and protection measures against leptospirosis:

  • avoid bathing in fresh water, especially when you have wounds and when the water is murky 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 outdoor sections);
  • protect wounds from contact with water with waterproof bandages;
  • Wear protective equipment when:

High-risk occupational activities (breeding, sanitation workers, garbage collectors, farming, land operation etc…) including boots, gloves, waders, protective clothing, and even anti-splash goggles drop risk status;
Practicing white water sports such as kayaking and kayaking, including wetsuit protector, socks and gloves;

  • Rodent control is a reservoir of disease.

After exposure:

  • wash with drinking water and disinfect wounds;
  • A physician should be consulted without delay if symptoms appear and informed of the hazardous activity undertaken in the past two weeks.

These measures should be reinforced during the rainy season.
There is a vaccination against leptospirosis. Its effectiveness is limited to certain strains of leptospirosis, and it is rarely performed in practice, especially in relation to professionals.

Source: ProMED.

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