[Epidemiologic and clinical study of leptospirosis in Bourail (New Caledonia)]

Leptospirosis is a frequent zoonosis in New Caledonia, mostly in the Bourail area, with an incidence of 9.5/1000 inhabitants. This town is an important cross-roads between the main town, Noumea, and the bush. An agricultural show takes place every year in this town, concentrating a great number of domestic animals and several thousand people coming from all over the island. A study was carried out on 78 patients with leptospirosis. The patients were mostly men (70%) of all ages of Melanesian and European origin. People who were living in the bush were more often attacked by leptospirosis than people living in towns. There were two annual peak values (March-April and July-August). Three symptoms (fever, headache, myalgia) were frequent (56%). Leucocytosis increased in 45% of cases. The serogroup icterohaemorrhagiae was the more common (38%). After treatment by penicillin, patients recovered in 83% of cases, but a fatal outcome occurred in 4 patients. An information campaign was necessary in order that people seek medical care as soon as the first symptoms appeared. At present, vaccination does not seem to be possible in such a context.