Leptospirosis: a zoonotic disease of global importance.
In the past decade, leptospirosis has emerged as a globally important infectious disease. It occurs in urban environments of industrialised and developing countries, as well as in rural regions worldwide. Mortality remains significant, related both to delays in diagnosis due to lack of infrastructure and adequate clinical suspicion, and to other poorly understood reasons that may include inherent pathogenicity of some leptospiral strains or genetically determined host immunopathological responses. Pulmonary haemorrhage is recognised increasingly as a major, often lethal, manifestation of leptospirosis, the pathogenesis of which remains unclear. The completion of the genome sequence of Leptospira interrogans serovar lai, and other continuing leptospiral genome sequencing projects, promise to guide future work on the disease. Mainstays of treatment are still tetracyclines and beta-lactam/cephalosporins. No vaccine is available. Prevention is largely dependent on sanitation measures that may be difficult to implement, especially in developing countries.
Bharti
Ajay R
AR
Division of Infectious Diseases, Department of Medicine, University of California San Diego School of Medicine, La Jolla, CA 92093, USA.
Nally
Jarlath E
JE
Ricaldi
Jessica N
JN
Matthias
Michael A
MA
Diaz
Monica M
MM
Lovett
Michael A
MA
Levett
Paul N
PN
Gilman
Robert H
RH
Willig
Michael R
MR
Gotuzzo
Eduardo
E
Vinetz
Joseph M
JM
D000818:Animals; D004197:Disease Reservoirs; D016680:Genome, Bacterial; D014943:Global Health; D006801:Humans; D007919:Leptospira / Q000145:classification / Q000235:genetics*; D007922:Leptospirosis / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000517:prevention & control* / Q000635:transmission; D015047:Zoonoses