![]() After Hurricane Hortense in 1996, heavy rainfall and flooding swept the island. In Puerto Rico, for example, leptospirosis was rarely reported despite the occurrence of 208 cases between 19. 4 Because many of the signs and symptoms of leptospirosis are virtually the same as those of dengue, leptospirosis has often been misdiagnosed. Reporting is also limited because of the lack of access to appropriate diagnostic laboratory services in high-risk areas. The clinical signs and symptoms are difficult to differentiate from those of other endemic diseases. The true incidence of leptospirosis is unknown owing to underreporting and insufficient understanding of the disease. 8 However, the actual incidence in Hawaii is estimated to be double what has been reported. 7 Of the 100 to 200 cases identified each year in the United States, half occur in Hawaii. ![]() 1 Recent outbreaks have been reported in popular travel destinations, including the Caribbean and Latin America, the Indian subcontinent, Southeast Asia, Oceania, and some parts of Eastern Europe. 6 This disease was considered to be limited to the tropics and rural regions, but there has been an increase of cases in urban areas of industrialized and developed countries as well. ![]() 5 It is estimated that, each year, more than one million cases occur worldwide that result in 58,900 deaths. 4 EpidemiologyĪccording to the World Health Organization, the incidence of leptospirosis in tropical regions is 10 times higher than in temperate climates. 3 Outbreaks are often perpetuated by changing environmental trends, especially the hurricanes and the increased rainfall and flooding that occur more frequently in warmer regions. Leptospirosis is both an occupational and a recreational hazard, and the bacteria can survive in water or soil for weeks to months. 3 The bacteria can enter the body through portals of cuts and abrasions, the mucous membranes, or the conjunctiva of the eyes however, they are not thought to penetrate intact skin. 1,2 Transmission takes place via the urine or feces of infected animals, and humans become infected by ingesting contaminated food or water. Leptospirosis, the most prevalent and widespread zoonotic disease in the world, is a leptospiral (spirochete) infection that occurs in temperate and tropical environments. Prophylaxis, early diagnosis, and antibiotic treatment are essential for preventing severe complications, as well as death, from leptospirosis. Symptoms range from mild and nonspecific to serious and fatal. The use of protective gear and sanitation precautions can help minimize the risk of infection. The infection is transmitted by host animals to humans through contaminated food and water. This infection has previously been underrecognized and underreported however, awareness is slowly increasing given the leptospirosis outbreaks that have followed recent heavy rains and hurricanes. ABSTRACT: Leptospirosis is a bacterial infection that is emerging as a public-health concern with significant impact around the world.
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