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Cirion Foundation

the impact of infectious diseases


Leptospirosis is a significant global zoonosis caused by infection with the pathogenic leptospira species. Humans can become infected if they come into direct contact with the urine of infected animals.
Outbreaks of leptospirosis frequently occur after heavy rainfall and flooding. However, leptospirosis is also an occupational disease that affects abattoir and rice field workers, for example. In Western Europe leptospirosis is usually imported by adventurous tourists returning from endemic regions, such as South East Asia.

Because leptospires survive longer in warm and humid conditions, leptospirosis is more predominant in the tropics and sub tropics. However, transmission can occur in both industrialized and developing countries. The incidence of leptospirosis during outbreaks and in high exposure risk groups is estimated to exceed 100/100,000 persons per year (WHO). However, this incidence is probably heavily underestimated, due to the lack of diagnostic tools in endemic areas and the atypical presentation of the disease because it resembles many other illnesses, such as dengue and other hemorrhagic fevers.

indonesiaMost cases of leptospirosis are mild: fever, muscle ache and malaise are often the only obvious symptoms. Severe leptospirosis is characterized by jaundice, kidney- or even multi-organ failure and bleeding manifestations such as skin-, gastro-intestinal tract- and lung-bleedings. Generally speaking, patients die from septic shock with multi-organ failure or severe pulmonary hemorrhage. The latter is increasingly reported and accounts for a case fatality rate of over 50%.

The diagnosis of leptospirosis is difficult, laborious and expensive, meaning it is often missed. Fortunately, leptospirosis can be treated with regular antibiotics, such as amoxicillin. Severely ill patients often need renal dialysis, mechanical ventilation and/or blood products.



  • A study on the epidemiology, pathophysiology and clinical case management of leptospirosis in Java, Indonesia. Tugumuda study. 2005-2008. Collaboration Slotervaart Teaching Hospital/Royal tropical institution (KIT)/University of Diponegoro (UNDIP), Semarang, Indonesia/CRED, Brussels, Belgium.

    PhD candidates J.F.P. Wagenaar (Slotervaart Hospital) PhD expected 2009, M. Goris (KIT) PhD expected 2010 and M.S. Adi (UNDIP) PhD expected 2010.