Human Leptospirosis: Guidance for Diagnosis, Surveillance and Control

Leptospirosis is a potentially serious but treatable zoonotic disease, representing a worldwide public health hazard. Its symptoms may mimic those of a number of other unrelated infections such as influenza, meningitis, hepatitis, dengue or viral haemorrhagic fevers. It is important to distinguish leptospirosis from these diseases. For this reason, new diagnostic methods have been developed in recent years. In humid tropical and subtropical areas, where most developing countries are located, leptospirosis poses a greater health problem than in areas with a temperate climate. Because leptospirosis is easily overlooked and consequently under-reported in many parts of the world, it is necessary to increase awareness and knowledge of the disease as a public health interest. The aim of these guidelines is to assist in this process. The target groups to which these guidelines are directed consist of health workers, clinicians, laboratory technicians, microbiologists, public health workers, veterinarians and biologists with an interest in zoonoses, having no specialized knowledge of leptospirosis but who wish to be generally informed about the micro-organism concerned and the disease that it may cause. This is not a handbook and it avoids technical details, but the interested reader can find further information in the annexes and the general bibliography. These guidelines are concerned essentially with human leptospirosis.

Table of Contents:
Microbiology and immunology; clinical features and treatment; laboratory support; animal sources of infection; typing; transmission and exposure; prevention and intervention; diagnostic services, surveillance and outbreak management. Appendices: addresses of expert centres and the International Leptospirosis Society (ILS); risk factors and risk groups; control of leptospirosis; surveillance; clinical features and differential diagnosis of leptospirosis; microscopy and staining; pathogenic versus saprophytic leptospires; serotyping and preparation of rabbit antiserum; DNA-based classification; serological techniques (MAT and ELISA); serological techniques other than MAT and ELISA; isolation and culture of leptospires; isolation of leptospires using external animals; polymerase chain reaction (PCR); commercial tests, culture, media, sera, monoclonal antibodies and leptospira strains; preparation of culture media; safety in the laboratory.

About the Author :
World Health Organization is a Specialized Agency of the United Nations, charged to act as the world's directing and coordinating authority on questions of human health. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries, and monitoring and assessing health trends.