Leptospirosis: an occupational hazard to veterinarians

Leptospirosis occurred in two veterinarians in Alberta, following their exposure to leptospires of domestic animal origin. The disease at onset resembled "flu" with fever, muscle and joint pain, and lassitude. It progressed through an extremely debilitating period with mild to severe hepatic and renal dysfunction, icterus and hemorrhage in one case, and cerebral meningitis in the other. Both patients were hospitalized for 11 to 14 days, where they responded to supportive and specific antibiotic and steroid therapy (penicillin G 10(6) IU q.i.d. and steroids, or tetracycline 500 mg q.i.d.). Diagnosis rested in one case on clinical signs and the observation of leptospires in blood and urine. In the other case, a tentative diagnosis of leptospirosis based on history and clinical signs was confirmed by serological test results and by the isolation of Leptospira interrogans serovar pomona from the patient's blood on day 6. Current occurrences of leptospirosis in man are reviewed. Convenient diagnostic methods, treatment and behavioural sequellae of leptospirosis are discussed.