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Leptospirosis in travelers
R van Crevel1, P Speelman, C Gravekamp
1Department of Internal Medicine, Academic Medical Center, University of Amsterdam, The Netherlands.
Summary
Imported leptospirosis is an increasing concern for travelers. This study found that leptospirosis, often acquired in Southeast Asia, presents with common symptoms like fever and headache, necessitating its consideration in tropical fever cases.
Area of Science:
- Infectious Diseases
- Tropical Medicine
- Public Health
Background:
- Leptospirosis is a zoonotic disease caused by pathogenic Leptospira species.
- Imported cases of leptospirosis are increasingly diagnosed in non-endemic regions.
- Travelers to tropical and subtropical areas are at risk of acquiring leptospirosis.
Purpose of the Study:
- To describe the clinical characteristics and outcomes of leptospirosis in Dutch travelers.
- To identify risk factors and common exposure routes for imported leptospirosis.
- To emphasize the importance of considering leptospirosis in the differential diagnosis of febrile illness in returning travelers.
Main Methods:
- Retrospective case series analysis of 32 Dutch travelers diagnosed with leptospirosis between 1987 and 1991.
- Data collection included patient demographics, travel history, clinical presentation, laboratory findings, and treatment.
- Leptospiral isolation and serological testing were performed.
Main Results:
- Infections were predominantly acquired in Thailand and Southeast Asia, with surface water contact in most cases.
- Common symptoms included fever, headache, and myalgia; key signs were conjunctival injection, lymphadenopathy, jaundice, and impaired renal function.
- Leptospires were isolated from nine patients, and 31 developed an antibody response; all patients recovered despite varied treatment adequacy.
Conclusions:
- Leptospirosis should be considered in the differential diagnosis for travelers returning from the Tropics with fever, especially given its non-specific symptoms.
- Increased incidence of imported leptospirosis highlights the need for heightened clinical awareness.
- Prompt diagnosis and appropriate management are crucial for favorable outcomes in leptospirosis patients.