Abstract
Severe leptospirosis with pulmonary hemorrhage is emerging globally. Measures to control leptospirosis through sanitation depend on accurate case finding and reporting. Rapid death certificate reporting, plus necropsy of persons who died of leptospirosis, facilitates public health intervention and could provide an important tool in assessing the global burden of leptospirosis.
Highlights
Severe leptospirosis with pulmonary hemorrhage is emerging globally
Pulmonary involvement has been well recognized as a major component of leptospirosis [1], worldwide attention to severe pulmonary hemorrhagic syndrome (SPHS) emerged after an outbreak in rural Nicaragua in 1995 in which most cases lacked jaundice and renal failure, the classic manifestations of severe leptospirosis [2]
A report from Peru, where leptospirosis is endemic, pointed out that SPHS can complicate human leptospirosis without jaundice or renal failure [3]
Summary
Severe leptospirosis with pulmonary hemorrhage is emerging globally. Measures to control leptospirosis through sanitation depend on accurate case finding and reporting. The annual reported incidence of leptospirosis from 1969 through 1996 was 0.53–1.13 cases per 100,000 inhabitants [6]. In the São Paulo metropolitan area (population 10.5 million), which accounts for 68% of all reported cases, the annual incidence of leptospirosis was 1.9–3.7 cases per 100,000 inhabitants in the period 1998–2004. In the São Paulo urban setting, SPHS is a common feature of leptospirosis.
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