Leptospirosis has been diagnosed clinically in two men recently returned from a fishing holiday at a resort in the Picardie region of north-east France. One case has since been serologically confirmed. Both patients were at the same resort at the same time (mid-September), and became unwell about one week after their return to the United Kingdom.
We wish to alert clinicians and laboratory staff to the possibility of leptospirosis in other people who have been on similar activity holidays.
Leptospires infect a variety of wild and domestic animals, including rodents, cattle and pigs, which then excrete organisms in their urine. Leptospires are naturally aquatic organisms and are found in fresh water, damp soil, vegetation, and mud. Human leptospirosis thus usually occurs following exposure to water or environments contaminated by infected animal urine, and is associated with a variety of occupations and activities in which this contact occurs; farming, agricultural work and sewer maintenance. Recreational activities with possible exposure include canoeing, windsurfing, swimming in lakes and rivers, pot holing, and fishing.
Typically, symptoms develop seven to 14 days after infection, though, on rare occasions the incubation period may be short as two to three days or as long as 30 days. Symptoms vary, and are usually biphasic. There is an abrupt onset of a ?flu-like? illness with high fever, severe headache, chills, muscle aches, and vomiting. Jaundice, red eyes, abdominal pain, diarrhoea, or a rash may follow.
Diagnostic serological tests, which include a screening IgM ELISA and a confirmatory Microscopic Agglutination Test, are done at the Leptospirosis Reference Laboratory, County Hospital, Hereford, HR1 2ER (tel: 01432 277117).
Please notify CfI via the duty doctor service on (tel: 020 8200 4400) if you become aware of any related cases. The relevant authorities in France are being informed.