|Credits: O. Chavez|
Leptospirosis is an endemic disease with epidemic potential throughout the Region of the Americas. Among the outbreaks recorded in the Region in recent years, there are the ones occurred in Nicaragua in 2007, where there was an average of more than 1 case per week, although after a flood there were up to 100 cases reported in a period of two weeks; Guyana in 2005, with an outbreak that caused six deaths and more than 40 probable cases in the first three days of flooding; and Brazil in 2008, with 3,493 confirmed cases after heavy rains and floods in the state of Santa Catarina.
The Region of the Americas has presented the vast majority of alerts for leptospirosis in recent years. Reviewing the HealthMap database that utilizes different online sources for real-time surveillance of emerging public health threats, 568 alerts for leptospirosis were found between 2007 and 2011 worldwide. More than half of them were located in the Americas, particularly in Brazil (140 alerts), Nicaragua (53), the Dominican Republic (28) and Honduras (19).
The burden of disease is still not precisely estimated due to, on one hand, the lack of surveillance and on the other, the frequently disease misdiagnosis, especially in vulnerable populations. Leptospirosis, in its initial stages, have symptoms and signs similar to a variety of diseases, most frequently dengue, malaria, hepatitis, among others, in addition, laboratory diagnosis is not readily available in several countries of the Region.
|Credits: O. Chavez|
The magnitude of the problem in tropical and subtropical regions can be largely attributed to climatic and environmental conditions, as well as result of the probability of humans and animals coming into contact with Leptospira polluted environments due to, for example, local farming practices or poor housing with inadequate disposal of household waste, resulting in different sources of infection. Studies in the Region show that men acquire the disease more frequently than women, probably because of their higher occupational exposure as rice farmers, slaughterhouse workers, others.
Leptospirosis is a disease that still has a long way to go, most of the countries of the Americas report cases, but few of them have a reliable surveillance system for this disease. It is important to prepare countries to identify and respond to outbreaks, thus avoiding high mortality.
Similarly, better understanding the epidemiological situation of the countries where it is known that outbreaks are occurring and identifying the areas of greater risk and the driving factors, allow countries to be better prepared in the prevention and training of health services in case leptospirosis outbreaks occur.
Leptospirosis is a great example of the human-animal-ecosystem interface, as part of the "One Health" framework, where cooperation between sectors is essential.