Leptospirosis

Question 1

Is leptospirosis nationally notifiable?

Answer 1

Yes - routine, labs only.
Outbreak a high priority

Question 2

What organism causes leptospirosis?

Answer 2

Leptospira spirochete bacteria

Many serovars.

Question 3

What are the main reservoir hosts for leptospirosis?

Answer 3

Cattle, pigs, horses, dogs, rodents, marsupials

These animals can carry the bacteria and transmit it to humans.

Question 4

How is leptospirosis transmitted?

Answer 4

• Direct contact with animal urine/tissue
• Contact with contaminated water, soil, or vegetation

Broken skin, mucous membranes, inhaled (dust)

Question 5

What are the clinical features of leptospirosis?

Answer 5

Fever, chills, headache, severe myalgia

Severe disease: jaundice, renal failure, meningoencephalitis, pulmonary hemorrhage, ARDS.

Question 6

Who are considered high-risk groups for leptospirosis exposure?

Answer 6

Frequent exposure to outdoors
* Farmers, farm workers, meat industry workers
* Recreational freshwater exposure
* Flood affected areas

Question 7

Which groups are at higher risk of severe disease?

Answer 7

Older age
Comorbidities

Question 8

What are the case definitions for leptospirosis?

Answer 8

IgM titre and PCR

• Confirmed: isolation/4-fold rise in agglutination titre/high agglutination titre + IgM
• Probable: PCR

Question 9

What is the typical incubation period for leptospirosis?

Answer 9

10-12 days
(range 4-19 days)

This period is the time from exposure to the onset of symptoms.

Question 10

What are the outbreak definitions for leptospirosis?

Answer 10

2+ cases in 3 months in a workplace

This helps in identifying and managing outbreaks effectively.

Question 11

What factors increase the risk of leptospirosis outbreaks?

Answer 11

Flooding, high rainfall, poor sanitation

Outbreaks usually due to contaminated water sources or environmental contamination (e.g. rodent infestations)

Question 12

Why is leptospirosis a re-emerging disease globally?

Answer 12

Environmental - climate change
Sociodemographic - urbanisation, population growth

Question 13

What is the primary method for diagnosing leptospirosis?

Answer 13

Serology

PCR is increasingly used, and blood/CSF can be culture positive within the first 7-10 days.

Question 14

What are the reference labs for leptospirosis?

Answer 14

QLD reference lab
VIDRL in VIC

Question 15

What are some prevention strategies for leptospirosis?

Answer 15

• PPE (boots/gloves); cover abrasions
• Avoid swimmingwading in contaminated waters
• Rodent control
• Animals - prompt treatment / isolation of infected animals; vaccination

Vaccination is available for animals to help control the disease.

Question 16

What resources are available for public health management?

Answer 16

DH protocol
(No SoNG)

Question 17

How sohuld cases of leptospirosis be managed?

Answer 17

• Confirm test results (second serology if needed)
• Interview - DRSVECTA - exposure hx 30 days prior (occupational, animal, water, flooding, travel)
• T - clinician, ABx;
• I - NA
• E - sx, transmission; contact precautions - disinfect articles soiled with urine

Question 18

How should contacts (co-exposed) be managed?

Answer 18

• Co-exposed - simialr occupational, animal, environmental exposure; soiled items
• T - consider ABx PEP
• I - NA
• M - monitor and test
• E - sx, transmission, actions to reduce risk e.g. PPE (boots, gloves, hand washing, cover cuts/abrasions)

Question 19

What should be included in the case interview for leptospirosis?

Answer 19

Symptoms, exposure history (30 days prior)

This includes occupational exposures, animals, rodents, water, flooding, and travel.

Question 20

What are the recommendations for contacts of leptospirosis cases?

Answer 20

Education, seek testing if symptoms develop, actions to reduce risk

Contacts should be informed about their potential exposure and symptoms.

Question 21

What are environmental control measures for leptospirosis?

Answer 21

• Environmental clean-ups
• Draining or restricting access to contaminated water bodies
• Dep of Ag investigated suspected animals sources; dairies, pigggeries; animal vaccination / other control measures

Investigations may include checking animal industry sources and recommending vaccination or control measures.

Question 22

What actions should be taken during an outbreak of leptospirosis?

Answer 22

• SHs - WorkSafe, Ag, NRE (Vets) local councils
• Active case finding
• Inform workers of risks in occupational settings
• Implement control measures
• Review health and safety aspects ASAP e.g. rodent control