Leptospirosis: A Clinical Perspective

Instructor

Darvin Scott Smith, MD
Infectious Disease Specialist, San Mateo Medical Center

Description

The course addresses Leptospirosis as a global threat that frequently mimics diseases like Lyme disease. It is designed to improve healthcare providers’ ability to identify the often non-specific symptoms of Leptospirosis, a challenge in its early detection.

A key component of the course is the One Health approach, which melds human, animal, and environmental health considerations. This is crucial for the comprehensive understanding and management of Leptospirosis.

Participants will delve into the diagnostic challenges of Leptospirosis and explore the limitations of current testing methods. Treatment protocols, focusing on antibiotics such as doxycycline and penicillin, will be extensively covered.

Moreover, the course includes a section on preventive measures. Strategies for avoiding exposure to contaminated environments and the use of appropriate protective gear are emphasized as key to controlling the spread of Leptospirosis.

Learning objectives

1. Identify the epidemiologic risks for acquiring leptospirosis
2. Describe the transmission of leptospirosis
3. Consider, recognize, and diagnose leptospirosis
4. Cite the limitations of current diagnostics

This session, Leptospirosis: A Clinical Perspective, is approved for 0.5 enduring AAFP Prescribed credits.

AAFP Prescribed credit is accepted by the American Medical Association as equivalent to AMA PRA Category 1 credit(s)™ toward the AMA Physician’s Recognition Award. When applying for the AMA PRA, Prescribed credit earned must be reported as Prescribed, not as Category 1.

The AAFP has reviewed One Health Medical Education for a Changing Climate and deemed it acceptable for AAFP credit. Term of approval is from 01/02/2024 to 01/01/2025. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

References

1. https://www.ecdc.europa.eu/en/leptospirosis/factsheet#

2. Centers for Disease Control and Prevention. Leptospirosis: Fact sheet for clinicians. https://www.cdc.gov/leptospirosis/pdf/fs-leptospirosis-clinicians-eng-508.pdf (accessed 11-26-23)

3. Brito Monteiro M, Egídio de Sousa I, Piteira M, Coelho S, Freitas P. Leptospirosis, a Re-emerging Threat. Cureus. 2021 Apr 5;13(4):e14295. doi: 10.7759/cureus.14295. PMID: 33968509; PMCID: PMC8098779

4. Costa F, Hagan JE, Calcagno J, et al. Global Morbidity and Mortality of Leptospirosis: A Systematic Review. PLoS Negl Trop Dis 2015; 9:e0003898.

5. Torgerson PR, Hagan JE, Costa F, et al. Global Burden of Leptospirosis: Estimated in Terms of Disability Adjusted Life Years. PLoS Negl Trop Dis 2015; 9:e0004122.

6. Guernier V, Goarant C, Benschop J, Lau CL (2018) A systematic review of human and animal leptospirosis in the Pacific Islands reveals pathogen and reservoir diversity. PLoS Negl Trop Dis 12(5): e0006503. https://doi.org/10.1371/journal.pntd.0006503

7. Haake DA, Levett PN. Leptospirosis in humans. Curr Top Microbiol Immunol. 2015;387:65-97. doi: 10.1007/978-3-662-45059-8_5. PMID: 25388133; PMCID: PMC4442676.

8. Grennan D. Leptospirosis. JAMA. 2019;321(8):812. doi:10.1001/jama.2019.0697

9. Bierque E, Thibeaux R, Girault D, Soupé-Gilbert M-E, Goarant C (2020) A systematic review of Leptospira in water and soil environments. PLoS ONE 15(1): e0227055. https://doi.org/10.1371/journal.pone.0227055

10. Rajapakse S. Leptospirosis: clinical aspects. Clin Med (Lond). 2022 Jan;22(1):14-17. doi: 10.7861/clinmed.2021-0784. PMID: 35078790; PMCID: PMC8813018

11. Covic A, Goldsmith DJ, Gusbeth-Tatomir P, Seica A, Covic M. A retrospective 5-year study in Moldova of acute renal failure due to leptospirosis: 58 cases and a review of the literature. Nephrol Dial Transplant 18: 1128-1134, 2003. 

12. Premarathne SS, Gamage C, Chandrajith R, Ratnatunge NV, Wijetunge S, Wazil A, Chou LF, Ko YC, Huang CT, Yang HY, Fonseka A, Sonnadara T, Herath D, Hewavitharane P, Yang CW, Nanayakkara N. Leptospirosis: A Potential Culprit for Chronic Kidney Disease of Uncertain Etiology. Nephron. 2023;147(8):510-520. doi: 10.1159/000528703. Epub 2023 Feb 21. PMID: 36809758; PMCID: PMC10568603

13. Rathi H, Patel A, Beblawy R, et al. (August 17, 2023) A Rare Complication of Leptospirosis: Weil’s Disease Diagnosed in the United States. Cureus 15(8): e43620. doi:10.7759/cureus.43620

14. Jayathilaka, P.G.N.S., Mendis, A.S.V., Perera, M.H.M.T.S. et al. An outbreak of leptospirosis with predominant cardiac involvement: a case series. BMC Infect Dis 19, 265 (2019). https://doi.org/10.1186/s12879-019-3905-7

15. Guzmán Pérez M, Blanch Sancho JJ, Segura Luque JC, Mateos Rodriguez F, Martínez Alfaro E, Solís García Del Pozo J. Current Evidence on the Antimicrobial Treatment and Chemoprophylaxis of Human Leptospirosis: A Meta-Analysis. Pathogens. 2021 Sep 2;10(9):1125. doi: 10.3390/pathogens10091125. PMID: 34578157; PMCID: PMC8467609.

16. Haake DA, Levett PN. Leptospirosis in humans. Curr Top Microbiol Immunol. 2015;387:65-97. doi: 10.1007/978-3-662-45059-8_5. PMID: 25388133; PMCID: PMC4442676.

17. Levett, P. N. (2020). Leptospirosis. Clinical Microbiology Reviews, 33(4), e00023-20

18. Picardeau, M. (2017). Virulence of the zoonotic agent of leptospirosis: Still terra incognita? Nature Reviews Microbiology, 15(5), 297-307.

19. World Health Organization (WHO). (2022). Leptospirosis: A global public health problem of high mortality. https://www.who.int/publications/i/item/B4221

20. Guernier V, Goarant C, Benschop J, Lau CL (2018) A systematic review of human and animal leptospirosis in the Pacific Islands reveals pathogen and reservoir diversity. PLoS Negl Trop Dis 12(5): e0006503. https://doi.org/10.1371/journal.pntd.0006503

21. Guzmán Pérez M, Blanch Sancho JJ, Segura Luque JC, Mateos Rodriguez F, Martínez Alfaro E, Solís García Del Pozo J. Current Evidence on the Antimicrobial Treatment and 

22. Chemoprophylaxis of Human Leptospirosis: A Meta-Analysis. Pathogens. 2021 Sep 2;10(9):1125. doi: 10.3390/pathogens10091125. PMID: 34578157; PMCID: PMC8467609.