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Leptospirosis: An Infectious Emerging Waterborne Zoonosis of Global Significance

Mahendra Pal and Angesom Hadush

Leptospirosis, caused by Leptospira interrogans, is a highly infectious emerging water borne zoonosis of global significance. It is an enigmatic life threatening disease, which results into high morbidity and mortality, particularly in poor resource nations. Disease is endemic in many countries of the world including India. Currently, over one million people are affected with leptospirosis worldwide annually. Leptospirosis presents an occupational hazard of the persons who have direct or indirect contact with the urine of infected animals. The common mode of transmission of the disease is exposure to and ingestion of urine contaminated water. Clinical signs in humans may vary from asymptomatic to severe stage with a range of non-specific symptoms. Rodents are the chief reservoir of Leptospira, and organisms are excreted in urine, thus contaminating the environment including water. Disease is endemic in tropical regions of the world with maximum cases in young male adults during the rainy season. Pollution of city water supply may result in outbreak of disease. Severe epidemics of leptospirosis are related to water recreational activities. The diagnosis of disease is confirmed by detection of serum antibodies against Leptospira and also by isolation of the pathogen from clinical specimens such as blood, cerebrospinal fluid and urine. Early treatment with antibacterial antibiotics may shorten the duration of fever and reduce the severity of the disease. As leptospirosis is attributed to physical contact with contaminated water supplies, environmental detection is important in the development of adequate control measures. There is a need to develop an effective surveillance system to monitor the trends of disease. Sincere attempts should be made to estimate the annual burden of cases and deaths due to leptospirosis. Additional studies on the epidemiology, diagnosis, chemotherapy and vaccines are required to control this life threatening zoonosis.