Human leptospirosis: guidance for diagnosis, surveillance and control

Abstract

Why were these guidelines written? Leptospirosis is a worldwide public health problem. In humid tropical and subtropical areas, where most developing countries are found, it is a greater problem than in those with a temperate climate. The magnitude of the problem in tropical and subtropical regions can be largely attributed to climatic and environmental conditions but also to the great likelihood of contact with a Leptospira-contaminated environment caused by, for example, local agricultural practices and poor housing and waste disposal, all of which give rise to many sources of infection. In countries with temperate climates, in addition to locally acquired leptospirosis, the disease may also be acquired by travellers abroad, and particularly by those visiting the tropics.

Leptospiral Culture without 5’-Fluorouracil Revealed Improved Leptospira Isolation from Febrile Patients in North-Eastern Malaysia

“…The microscopic agglutination test (MAT) was performed following the standard method [14]. Serum samples were serially diluted in microtiter plates and live Leptospira serovars were added to each well.…”

“…The supernatant was removed and 200 µL of deposit was left for inoculation into the culture media. Whole blood and deposit from spun plasma were cultured in 5 mL modified Ellinghausen McCullough Johnson Harris (EMJH) medium following the standard method [14]. The medium was incorporated with different concentrations of 5'-fluorouracil (5-FU) (0.2 and 0.4 mg/mL of antibiotic concentration) and without antibiotic.…”

“…The medium was incorporated with different concentrations of 5'-fluorouracil (5-FU) (0.2 and 0.4 mg/mL of antibiotic concentration) and without antibiotic. 5-FU was added into media because Leptospira is resistant to 5-fluorouracil and it suppressed the growth of contaminating bacteria [14].…”

“…The media containing 5-FU was compared with the media without 5-FU to observe the effect of Leptospira growth. 5-FU was used as antibiotic inside the media because leptospires is resistant to 5-FU and to suppress the growth of contaminating bacteria [14]. Besides that, EMJH containing 5-FU is broadly used for the selective isolation of Leptospira, although it does not inhibit most of the Gram negative bacteria and fungi [19].…”

12 Novel Clonal Groups of Leptospira Infecting Humans in Multiple Contrasting Epidemiological Contexts in Sri Lanka

“…Leptospira spp. have the ability to colonize proximal convoluted tubules of kidney tissue of various mammals (including rodents), birds and marsupials, and the hosts excrete the bacteria to the environment via urine [3][4]. Humans are incidental hosts who acquire the disease by direct contact with urine or tissues of reservoir animals or, more frequently by indirect contact with contaminated water sources [5][6].…”