Leptospirosis is endemic in Malaysia and third most fatal infection after dengue and malaria. In 2010, leptospirosis was gazetted as a notifiable disease in Malaysia. Since then, the number of reported cases and their mortality have been recorded. As one of the most prevalent zoonotic diseases in the country, leptospirosis poses a significant public health challenge, particularly in regions where human activities intersect with natural habitats. Join us as we unravel the complexities of leptospirosis in Malaysia and delve into the ongoing efforts to combat this stealthy adversary.
What is Leptospirosis?
Leptospirosis is an infectious disorder of animals and humans. It is the most common zoonotic infection in the world. It is easily transmitted from infected animals through their urine, either directly or through infected soil or water. Common animals that transmit Leptospirosis include farm animals such as cattle, pigs, and horses but can range from wild animals such as raccoons and porcupines to domesticated dogs. More than 160 species of animals found to carry the disease show no signs/symptoms if infected. They can be vectors of disease for several months after inoculation, sometimes never showing any signs/symptoms of infection.
Bacterium leptospira that cause leptospirosis are spread through the urine of infected animals, which can get into water or soil and can survive there for weeks to months. Infected animals may continue to excrete the bacteria into the environment continuously or every once in a while for a few months up to several years. Humans can become infected via contact with urine (or other body fluids, except saliva) from infected animals or in contact with water, soil, or food contaminated with the urine of infected animals.
Symptoms of leptospirosis can vary widely and may include fever, headache, muscle aches, chills, nausea and vomiting, jaundice, rash, abdominal pain, red eyes, cough, and kidney failure.
Clinical presentation of leptospirosis is non-specific and variable, and most of the early signs and symptoms point to the so-called “acute fever of unknown origin”, a major diagnostic challenge in tropical and subtropical areas. However, leptospirosis can rapidly evolve to life-threatening complications, especially if left untreated. There is a need for good awareness of leptospirosis and rapid antibiotic treatment based on clinical and epidemiological suspicion. Severe leptospirosis cases include renal and respiratory failure, necessitating intensive care, also seldom available or with limited capacity. Hence, healthcare providers may consider a combination of clinical evaluation, laboratory testing, and history of exposure to make an accurate diagnosis of leptospirosis.
Why early diagnosis?
Early diagnosis allows for the timely initiation of appropriate antibiotic therapy, such as doxycycline or penicillin. Administering antibiotics early in the course of the disease can help prevent the progression of leptospirosis and reduce the severity of symptoms. Moreover, early diagnosis and treatment can also help to prevent or minimize complications, improving patient outcomes and reducing the risk of long-term health consequences. Early diagnosis also plays a crucial role in preventing further transmission of the bacteria to other individuals, particularly in settings where close contact with contaminated environments or infected animals is common.
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