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Travel-related leptospirosis: a series of 15 imported cases
Charlotte van de Werve1, Alice Perignon, Stéphane Jauréguiberry
1Travel Clinic, Clinique Saint-Pierre, Ottignies, Belgium. vandewervecharlotte@yahoo.fr
Background:
Leptospirosis belongs to the spectrum of travel-related infections.
Methods:
We retrospectively studied all the consecutive cases of travel-related leptospirosis seen in our department between January 2008 and September 2011. Patients were included with a clinical picture compatible with the disease within 21 days after return, the presence of a thermoresistant antigen or IgM antibodies, Elisa ≥ 1 /400, and a positive microagglutination test (MAT) ≥ 1/100.
Results:
Fifteen leptospirosis cases were evaluated. Exposure occurred in Asia (47%), Africa (20%), the Caribbean (20%), and Indian Ocean (13%). Fourteen patients were infected during water-related activities. On admission the most frequent symptoms were fever (100%), headache (80%), and digestive disorders (67%). Relevant laboratory findings included impaired liver function tests (100%), lymphocytopenia (80%), thrombocytopenia (67%), and elevated C-reactive protein (CRP) (67%). Our cases were confirmed by MAT that found antibodies against nine different serovars. Seven patients were cured with amoxicillin, four with doxycycline, two with ceftriaxone, one with ceftriaxone, doxycycline, and spiramycin, whereas one recovered spontaneously (retrospective diagnosis). Eight patients were hospitalized. All patients recovered.
Conclusion:
Our cases involved nine different serovars. They were related to travel in Asia, Africa, and the Caribbean. Bathing or other fresh-water leisure activities (canoeing, kayaking, rafting) are the most likely at-risk exposure. Any traveler with fever and at-risk exposure should be investigated for leptospirosis.
Insights
Travelers can contract leptospirosis, a bacterial infection, from contaminated freshwater activities, particularly in Asia, Africa, and the Caribbean. Early investigation for fever and exposure is crucial for prompt diagnosis and treatment.
Area of Science:
- Infectious Diseases
- Travel Medicine
- Microbiology
Background:
- Leptospirosis is a significant travel-related infection.
- Understanding its epidemiology and risk factors is crucial for preventing and managing cases in travelers.
Purpose of the Study:
- To analyze travel-related leptospirosis cases.
- To identify common exposure routes and clinical presentations.
- To highlight diagnostic criteria and treatment outcomes.
Main Methods:
- Retrospective study of 15 travel-related leptospirosis cases (2008-2011).
- Inclusion criteria: compatible symptoms within 21 days of return, positive serology (ELISA ≥ 1:400, MAT ≥ 1:100).
Main Results:
- Most exposures occurred in Asia (47%), Africa (20%), and the Caribbean (20%).
- Water-related activities were the primary source of infection (14/15 patients).
- Common symptoms included fever (100%), headache (80%), and digestive issues (67%), with characteristic laboratory findings like impaired liver function and thrombocytopenia.
Conclusions:
- Leptospirosis cases involved nine different serovars and were linked to travel in Asia, Africa, and the Caribbean.
- Freshwater leisure activities pose the highest risk.
- Travelers presenting with fever and relevant exposure history should be evaluated for leptospirosis.
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