July 2010



Volume 39, No.7, July 2010 Pages 495-498

Andrew Slack

This article forms part of our travel medicine series for 2010, providing a summary of prevention strategies and vaccination for infections that may be acquired by travellers. The series aims to provide practical strategies to assist general practitioners in giving travel advice, as a synthesis of multiple information sources which must otherwise be consulted.


Leptospirosis is one of the many diseases responsible for undifferentiated febrile illness, especially in the tropical regions or in the returned traveller. It is a disease of global importance, and knowledge in the disease is continually developing.


The aim of this article is to provide clinicians with a concise review of the epidemiology, pathophysiology, clinical features, diagnosis, management and prevention of leptospirosis.


Leptospirosis should be included in the broad differential diagnosis of febrile illness. The clinical manifestations of the disease vary from mild, nonspecific illness through to severe illness resulting in acute renal failure, hepatic failure and pulmonary haemorrhage. Diagnosis is dependant on accurate prediction of the time of infection: culture, polymerase chain reaction and serology may be used to confirm the diagnosis. Management is centred on prompt antibiotic therapy using doxycycline or intravenous penicillin G or intravenous ceftriaxone/cefotaxime. Prevention of leptospirosis revolves around the ‘cover-wash-clean up’ strategy.

Leptospirosis is the infection caused by the spirochaete genus of Leptospira. It was first identified in Germany in 1886 by Weil.1 Leptospirosis was first identified in Australia in 1933 after an outbreak in the northern Queensland town of Ingham.2 Leptospirosis is considered an emerging infectious disease given its worldwide distribution and profound effect on developing world medicine.3

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