Leptospirosis: Old and New Concerns
- 1. Armed Forces Hospital and Catholic University, Brasília-DF, Brazil
CITATION
dos Santos VM (2018) Leptospirosis: Old and New Concerns. J Vet Med Res 5(1): 1118.
LETTER TO EDITOR
The risks of infections from animals to humans increase if susceptible individuals do not have awareness about the mechanisms of transmission in a variety of environments. Leptospirosis is a main cosmopolitan anthropozoonosis with significant adverse effects in Human Medicine, often related to misdiagnosis, or unsuspected and late diagnoses [1-5]. Natural reservoirs of leptospiras are wild and domestic animals, whereas professional, sport and leisure activities make easier direct and indirect contacts with the agent [3,5]. Human exposure often involves a contact of the skin and Leptospira-contaminated water; therefore, leptospirosis is a recurrent disease in hot and rainy season of tropical zone [5]. Classical features including fever, headache, myalgia, arthralgia, jaundice, renal failure and hemorrhages (Weil’s syndrome) frequently contribute to early diagnosis and control, but under diagnoses are often due to lack of specific tests in the low income regions [1-5]. On the practical stand point, the possibility of severe complications increases in anicteric courses of disease that can evolve under diagnosed and without prompt treatment [1-3]. Major concerns include human endemic arboviruses as Dengue, Chikungunya, Zika and Hantavirus, and malaria, which may have similar features with human leptospirosis; additionally, co-infections with these entities may occur in the same environment [1-3,5]. The outbreaks of some of these conditions may increase possible diagnostic pit falls [5], especially in primary care attention if health workers are not aware about this matter. More recent laboratory resources can constitute a promisor tool to solve diagnostic conundrum; however, novel sophisticated tests are cumber some in developing countries. In this setting, there is a one-step multiplex real-time PCR assay that detects RNA of Chikungunya and Dengue viruses and leptospiral DNA in a routine diagnostic use [5]. Assays as the commented are useful to identification of these pathogens, either isolated or in co-infected individuals presenting clinical manifestations indicative of leptospirosis. This resource would have major role in public health actions against leptospira infections, because antimicrobial therapy is more effective if started in early phase of disease [3-5]. The manifestations of septicemic first phase have good improvement with antibiotic administration [1,3-5], including penicillin G, doxycycline, ampicillin, or ceftriaxone. The effectiveness of postexposure prophylaxis with doxycycline remains nonconsensual, but it has been utilized for people with high-risk exposures during outbreaks after floods. Anamnesis with detailed data about occupation and leisure classical risk factors, and recent travels for endemic areas strongly contribute to early diagnosis of leptospirosis. Conjunct efforts of veterinarians and physicians to enhance the awareness of colleagues and people in general are essential to reduce the consequences of this anthropozoonosis. Therefore, the comments herein included might contribute to enhance the suspicion index of all protagonists of the of leptospiral multidisciplinary animal and human infections.