Journal
LANCET INFECTIOUS DISEASES
Volume 3, Issue 12, Pages 757-771Publisher
ELSEVIER SCI LTD
DOI: 10.1016/S1473-3099(03)00830-2
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Funding
- FIC NIH HHS [D43 TW007120, D43 TW007120-01, 1R01TW005860] Funding Source: Medline
- NIAID NIH HHS [5T35AI00764, K24 AI068903, 1F32AI055235-01] Funding Source: Medline
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In the past decade, leptospirosis has emerged as a globally important infectious disease. It occurs in urban environments of industrialised and developing countries, as well as in rural regions worldwide. Mortality remains significant, related both to delays in diagnosis due to lack of infrastructure and adequate clinical suspicion, and to other poorly understood reasons that may include inherent pathogenicity of some leptospiral strains or genetically determined host immunopathological responses. Pulmonary haemorrhage is recognised increasingly as a major, often lethal, manifestation of leptospirosis, the pathogenesis of which remains unclear. The completion of the genome sequence of Leptospira interrogans serovar lai, and other continuing leptospiral genome sequencing projects, promise to guide future work on the disease. Mainstays of treatment are still tetracyclines and beta-lactam/cephalosporins. No vaccine is available. Prevention is largely dependent on sanitation measures that may be difficult to implement, especially in developing countries.
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