Leptospirosis: A Zoonotic Disease of Global Importance.

AJAY R. BHARTI; JARLATH E. NALLY; JESSICA RICALDI; MICHAEL MATTHIAS; M. MÓNICA DÍAZ; MICHAEL LOVETT; PAUL LEVETT; ROBERT GILMAN; MICHAEL R. WILLIG; E. GOTUZZO; J.M. VINETZ

LANCET

ELSEVIER SCIENCE INC

Lugar: London; Año: 2003 vol. 3 p. 757 - 771

0140-6736

In the past decade, leptospirosis has emerged as a globally important infectious disease. It occurs in urban environments of industrialised and developing countries, as well as in rural regions worldwide. Mortality remainssignificant, related both to delays in diagnosis due to lack of infrastructure and adequate clinical suspicion, and to other poorly understood reasons that may include inherent pathogenicity of some leptospiral strains or geneticallydetermined host immunopathological responses. Pulmonary haemorrhage is recognised increasingly as a major, often lethal, manifestation of leptospirosis, the pathogenesis of which remains unclear. The completion of the genomesequence of Leptospira interrogans serovar lai, and other continuing leptospiral genome sequencing projects, promise to guide future work on the disease. Mainstays of treatment are still tetracyclines and  -lactam/cephalosporins. No vaccine is available. Prevention is largely dependent on sanitation measures that may be difficult to implement,especially in developing countries.