Abstract
In the Netherlands, 97 human leptospirosis cases were notified in 2014. This represents a 4.6-fold increase in autochthonous cases (n = 60) compared with the annual average between 2010 and 2013. Most cases had symptom onset between June and November. This marked increase in humans coincided with an increase of leptospirosis in dogs. In 2014, 13 dogs with leptospirosis were reported, compared with two to six dogs annually from 2010 to 2013. The majority of the autochthonous cases (n = 20) were linked to recreational exposure, e.g. swimming or fishing, followed by occupational exposure (n = 15). About sixty per cent (n = 37) of the autochthonous cases were most likely attributable to surface water contact, and 13 cases to direct contact with animals, mainly rats. A possible explanation for this increase is the preceding mild winter of 2013-2014 followed by the warmest year in three centuries, possibly enabling rodents and Leptospira spp. to survive better. A slight increase in imported leptospirosis was also observed in Dutch tourists (n = 33) most of whom acquired their infection in Thailand (n = 18). More awareness and early recognition of this mainly rodent-borne zoonosis by medical and veterinary specialists is warranted.
Highlights
Leptospirosis is a zoonosis caused by pathogenic Leptospira species and may result in a broad clinical spectrum of disease, ranging from asymptomatic infections to severe disease manifestations known as Weil’s syndrome, characterised by the triad of jaundice, acute renal failure and bleeding manifestations, and severe pulmonary haemorrhage syndrome (SPHS) with a high case–fatality rate [1,2,3]
A marked increase in autochthonous cases of leptospirosis was observed in the Netherlands in 2014, during the second half of the year, from June until November, resulting in one of the highest incidence rates in Europe [12]
Cases mainly acquired leptospirosis during recreational activities such as swimming and fishing, in contrast with other western European countries, where autochthonous leptospirosis infections are predominantly associated with occupational activities [13,14,15]
Summary
Leptospirosis is a zoonosis caused by pathogenic Leptospira species (spp.) and may result in a broad clinical spectrum of disease, ranging from asymptomatic infections to severe disease manifestations known as Weil’s syndrome, characterised by the triad of jaundice, acute renal failure and bleeding manifestations, and severe pulmonary haemorrhage syndrome (SPHS) with a high case–fatality rate [1,2,3]. Transmission to humans usually occurs via direct or indirect contact with urine of infected animals. Leptospirosis can cause severe, life-threatening infections with vascular damage, liver and renal failure. There are nearly 300 pathogenic Leptospira serovars, often specific to particular host reservoirs, belonging to 29 serogroups, and an indication for the most likely source of human infections [2]
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