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Abstract

In the three-year period 1994 1996, 222 reports on human cases of leptospirosis were received by the Italian Ministry of Health. The average annual number of reports was 29.2% lower than in the preceding eight years. In all cases but two the infections were thought to have been acquired in Italy. As in previous years, the majority of cases was observed in the northern regions of the country (83.8%), mostly in males (88.9%). Cases occurred in all age groups, but were more common in the working-age population (15-64 years). There was no common-source outbreaks. The typical leptospiral seasonal course, with a peak in August, was observed. During 1994, leptospirosis was the reported cause of death in 19 patients. Mortality was higher among males than females. The overall fatality rate was 22.6%. During the study period, a total of 126 cases of leptospirosis were confirmed by the National Centre for Leptospirosis or one of the 12 Regional Leptospira Laboratories. Of the 103 patients for whom information on place of residence, contact with animals, occupational and recreational activities was available, 98 (95.1%) were people who live in rural areas or devote themselves to occupational or recreational activities at risk. The likely source of infection and the mode of exposure were known for 55 patients. Forty-five patients (81.8%) were likely infected by contaminating water (43 cases) or soil (2 cases), ten (18.2%) by direct contact with animals or animal urine. Both running (51.2%) and stagnant water (27.9%) have been reported as a source of infection. Rodents were implicated in 50.0% of the 10 cases involving animals. In comparison with the preceding eight-year period, the risk of contracting leptospirosis was found to have increased for recreational activities (from 34.7 to 38.2%) and decreased for occupational activities (from 45.8 to 32.7%). A large number of infections, however, was ascribed to accidental events (25.5%). As in the previous period, besides fever, the involvement of the liver was the most frequent clinical manifestation (70.8%). Influenza-like symptoms were the only signs of illness in 15.1% of cases. Infections by 9 different serogroups were detected. The most frequent antibodies were those against serovars icterohaemorrhagiae, poi, copenhageni and brattislava. The presence of co-agglutinins against serovars belonging to different serogroups prevented the identification of the presumptive infecting serogroup in 19.8% of subjects.

Leptospirosis in Germany, 1962–2003

“…Along with ecologic and structural changes, including mechanization of agriculture and improvements in sanitation, the relevance of leptospirosis in the rural economy diminished in the 1960s (17). A similar reduction in disease activity was reported from other industrialized countries, where leptospirosis has traditionally been a common occupational disease among agricultural workers (18,19). At present, some of the traditional occupations described as risks for leptospirosis (e.g., livestock farmers and sewage and abattoir workers) are still found in Germany.…”

Leptospira Contamination in Household and Environmental Water in Rural Communities in Southern Chile

“…In Italy, 53% of cases reported an occupation that involved contact with animals and/or polluted waters and among 78% of cases with established mode of exposure, water exposure was the likely mechanism [13]. In Germany, 59% of cases were reported as environment or water-related; either through occupational or recreational activities [37].…”

“…The association between contact with environmental water and the risk of Leptospira infection is less clear in temperate climates. Environmental exposure sources implicated in human leptospirosis cases in temperate regions have included tap water, stagnant pools and wells, waste water, and recreational waters [13,14]. In rural populations in particular, human leptospirosis has historically been attributed to direct contact with infected livestock urine through animal caretaking [15].…”

Environmental Exposure and Leptospirosis, Peru

“…In most epidemiologic studies of leptospirosis, infection rates differ for men and women, related to gender-specific activities (16,27–31) and associated leptospiral serovars (32). In the Iquitos study populations, the prevalence and incidence were very similar between the sexes, although the occupations of men and women were very different.…”