Leptospirosis

Leptospirosis is a globally important zoonotic disease that affects humans on all continents, in both urban and rural contexts, and in temperate and t ropical climes. Leptospirosis is a disease of the environment; transmission depends on interactions between humans and mammalian reservoir hosts. A va riety of infectious diseases that present as undifferentiated febrile syndr omes, such as malaria, dengue and influenza, as well as viral hemorrhagic f evers can mimic leptospirosis. The importance of pulmonary hemorrhage as a lethal complication of leptospirosis has become more widely recognized. In contrast to textbook dogma, population-based studies indicate that there is a poor correlation between infecting leptospiral strain and clinical expre ssion of disease. Genetic transformation of a Leptospira sp. has now been r eported, which should allow for detailed analysis of a variety of leptospir al genes. Publication of the whole Leptospira genome is eagerly awaited. Fo llowing recent reports of a new, highly effective conjugate typhoid vaccine , new efforts to find leptospirosis vaccines should include the manufacture and testing of conjugate leptospiral lipopolysaccharide vaccines. Recent a dvances, particularly in epidemiology, molecular genetics and pathogenesis, are placing leptospirosis at the cutting edge of biomedical science. Curr Opin Infect Dis 14:527-538. (C), 2001 Lippincott Williams & Wilkins.