Leptospirosis

Pathophysiology: Leptospirosis is a type of bacterial infection spread by animals. It's caused by a strain of bacteria called leptospira. Leptospirosis is a bacterial disease that affects both humans and animals. The early stages of the disease may include high fever, severe headache, muscle pain, chills, redness in the eyes, abdominal pain, jaundice, haemorrhages in skin and mucous membranes (including pulmonary bleeding), vomiting, diarrhoea and a rash. Leptospiral infection in humans causes a range of symptoms, and some infected persons may have no symptoms at all.

Treatment: Effective antibiotics include penicillin G, ampicillin, amoxicillin and Doxycycline. In more severe cases cefotaxime or ceftriaxone should be preferred.Glucose and salt solution infusions may be administered; dialysis is used in serious cases. Elevations of serum potassium are common and if the potassium level gets too high special measures must be taken. Serum phosphorus levels may likewise increase to unacceptable levels due to renal failure.

Statistics: The incidence of leptospirosis is low in Hong Kong. There were one local case in 2001, 2 local cases in 2002, 1 imported case in 2003. So far this year, there are 1 imported and 4 local cases.Geomapping of cases showed a geographical clustering for some exposures. Future preventive measures could include raising awareness among clinicians about the risks and prevention of exposure in specific groups (fish farmers, farmers and travellers) to reduce leptospirosis in Hong Kong.