Leptospirosis in Kolenchery, Kerala, India: epidemiology, prevalent local serogroups and serovars and a new serovar.

Abstract

Leptospirosis is the most widespread zoonosis in the world. It is mostly an occupational disease especially in rural areas. Kolenchery is in the midlands of Kerala. The landscape consists of marshy land and dry land interspersed by rivulets and ponds. Irrigation of dry lands for cultivation during the summer months started in mid 1980s after the irrigation projects were commissioned. Cases of leptospirosis were rarely diagnosed in Kolenchery before 1987. Since then a yearly increase in incidence is observed. No major study on either epidemiology or clinical picture has been done on human leptospirosis in Kerala so far. The aim of this study was to define the major clinical presentations, epidemiology of the infection and demonstrate the predominant serogroups and serovars causing the illness in this limited geographical area. The study involves 976 cases of leptospirosis confirmed by culture and/or serological tests. Serogroups Autumnalis, Australis and Icterohaemorrhagiae were the commonest. Mortality rate was 5.32%. The increase in incidence is probably due to the geographical characteristics, continuous moisture of the soil due to irrigation in summer and year-round cultivation making food and cover available to host rodents. Close interaction of humans, animals, soil and water in this region make the spread of leptospirosis to humans easy. Confirmation of cases has been done by enzyme linked immunosorbent assay (ELISA) and/or microscopic agglutination test (MAT) and/or by culture. Serovar identification has been done in 21 cultures isolated from patients. One new serovar belonging to serogroup Australis has been identified from a patient and named serovar Australis bharathy.