Leptospirosis in the Andaman Islands, India

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Epidemiology

Background:

• Leptospirosis, an emerging zoonosis, has a documented history in the Andaman Islands since the early 20th century.
• Initially presenting as Weil's disease with hepato-renal complications, it evolved into Andaman haemorrhagic fever (AHF) with pulmonary involvement by the late 1980s.
• AHF was identified as a severe pulmonary manifestation of leptospirosis, a significant finding for India.

Purpose of the Study:

• To review the history, epidemiology, clinical spectrum, and control of leptospirosis in the Andaman Islands.
• To discuss the characteristics of infecting Leptospira isolates.
• To highlight the effectiveness of doxycycline in managing leptospirosis outbreaks.

Main Methods:

• Historical review of leptospirosis cases and outbreaks in the Andaman Islands.
• Analysis of clinical presentations, including hepato-renal and pulmonary syndromes.
• Review of identified Leptospira serovars and species, with a focus on Valbuzzi and Leptospira interrogans sensu stricto.

Main Results:

• Leptospirosis persists annually in the Andaman Islands, manifesting in distinct hepato-renal and pulmonary forms.
• The pulmonary form is associated with high case fatality rates (10-15%).
• Leptospira interrogans sensu stricto is the predominant species, with Valbuzzi being the most common serovar.

Conclusions:

• Leptospirosis remains a significant public health concern in the Andaman Islands, with varied clinical presentations.
• Prompt diagnosis and treatment, including the use of doxycycline, are crucial for managing severe cases and reducing mortality.
• Continued surveillance and understanding of local Leptospira strains are essential for effective control strategies.