Leptospirosis alert in the state of Rio de Jean…

In Brazil, after heavy rains in Petropolis, Rio de Janeiro, in February 2022, several cases of leptospirosis were identified, according to the State Department of Health (SES; Secretariat of the Estado da Saude). In the first 3 months of 2022, Petropolis has reported 99 probable cases, compared to 3 notifications in the same period in 2021.

This bacterial disease is associated with contact with polluted water, with the storms of the last days. The city administration warned of the possibility of new cases of the disease.

Reminders about leptospirosis :

Leptospirosis is a bacterial disease that is common throughout the world. Leptospirosis is caused by bacteria Leptospira interrogating. It is rather easily preserved in the external environment (fresh water, muddy soils), which contributes to infection. The seasonality of the disease is very pronounced, with summer-autumn outbreaks associated with heat and precipitation.

leptospira bacteria capable of infecting a large number of wild mammals (rodents and insectivores: rats, tenge, shrews, etc.) and domestic ones (cattle, sheep, goats, pigs, dogs), which serve as reservoirs and excrete them with urine. The bacteria can survive for several months in a humid and warm environment. There are over 250 serovars of Leptospira species, with several serovars endemic to this geographical area.
Certain professions (farmers, livestock keepers, sewer workers, garbage collectors, etc.) and people involved in water sports (swimming, canoeing, kayaking, fishing, hunting, canyoning, etc.) are particularly susceptible risk. In humans, the bacterium penetrates mainly through damaged skin or mucous membranes.

The disease is often mild, but complications are possible, including kidney failure, which can be fatal in 5–20% of cases. 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 pain in the joints. In 20% of cases it is complicated by hemorrhagic syndrome.
  • Severe forms (icterohemorrhagic or Weil’s disease) combine acute renal failure, neurological disorders (convulsions, coma) and more or less severe bleeding (pulmonary, digestive).

Initial non-specific clinical signs (headaches, fever, myalgia) may delay diagnosis and treatment due to confusion with differential diagnoses such as influenza, chikungunya, or dengue fever.

Prevention and measures of individual protection against leptospirosis:

  • Avoid swimming in fresh water, especially if you have wounds and also when the water is cloudy or cloudy;
  • Avoid contact with water, nose, mouth and eyes;
  • Avoid walking barefoot or in open sandals on muddy ground, puddles, stagnant water, ravines (especially in overseas departments);
  • Protect wounds from contact with water with waterproof dressings;
  • Wear protective gear when:
  • high-risk occupations (breeding, sewer workers, garbage collectors, farmers, earthworks, etc.) including boots, gloves, waders, protective clothing, even goggles in case of risk of splashing;
  • water sports activities such as canyoning, kayaking, including a protective suit, boots and gloves.
  • Control of rodents, which are a reservoir of the disease;

After risk exposure:

  • Rinse with drinking water and disinfect wounds;
  • Seek immediate medical attention if symptoms develop, informing him/her of the risky activities carried out in the previous two weeks.

These measures should be strengthened during the rainy season.
There is a vaccine against leptospirosis. Since its effectiveness is limited to certain strains of Leptospira, it is rarely used in practice, mainly by specialists.

Source: ProMED.

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