Case of death from leptospirosis in Ukraine

In Ukraine, a teenager who contracted leptospirosis after swimming in one of the ponds of the Korsun-Shevchenkivsky district in Cherkasy raion, died on July 17, 2022 at Okhmatdyt Hospital in Kyiv, where he was hospitalized for his condition. I’m getting worse and worse. He first showed signs of illness more than 2 weeks after swimming in the pond, then had neurological signs in his lower extremities.

Reminder about leptospirosis:

Leptospirosis is a disease caused by bacteria worldwide. Leptospirosis is caused by bacteria Leptospira’s interrogator. This is quite easily maintained in the external environment (fresh water, muddy soil), promoting pollution. The seasonal nature of the disease is very pronounced, with summer-autumn outbreaks related to temperature and rainfall.

bacteria of the genus Leptospira capable of infecting a large number of wild mammals (rodents and insectivores: rats, tengues, shrews, etc.) and domestic animals (cattle, sheep, goats, pigs, dogs), they act as reservoirs and excrete them in the urine. Bacteria can survive for several months in a warm, humid environment. There are more than 250 serotypes of species Leptospirawith certain serotypes endemic to a certain geographical area.

Certain occupations (farmers, livestock, drainage workers, garbage collectors, etc.) and people who practice water sports (swimming, sailing, kayaking, fishing, hunting, etc.) shooting, canyoning, etc.) pose a particularly high risk. In humans, the bacteria enter mainly through injured skin or mucous membranes.

The disease is usually mild, but complications can occur, including kidney failure which can lead to death in 5 to 20% of cases. The incubation period lasts from 4-14 days.

  • In the moderate form, the disease begins with a high fever accompanied by chills, headache, and diffuse myalgia and arthralgia. In 20% of cases, it is complicated by hemorrhagic syndrome.
  • Severe forms (icterohaemorrhagic or Weil’s disease) combine acute renal failure, neurasthenia (convulsions, coma) and profuse bleeding (pulmonary, gastrointestinal).

The initial nonspecific clinical signs (headache, fever, myalgia) can lead to delays in diagnosis and treatment due to confusion with differential diagnoses such as influenza, chikungunya, or dengue.

Precautions and personal protection against leptospirosis:

  • Avoid swimming in fresh water, especially when you have an injury, and when the water is cloudy or muddy;
  • Avoid contact with water, nose, mouth and eyes;
  • Avoid walking barefoot or wearing open sandals on muddy ground, standing puddles, ravines (especially in surgical departments);
  • Protect the wound from contact with water with a waterproof dressing;
  • Wear protective equipment during high-risk occupational activities (livestock, drainage workers, garbage collectors, farmers, working on the ground, etc.) including boots, gloves, amphibious suits, protective clothing or even splash-proof goggles in case of a projection hazard; practice white water sports such as canyoning, kayaking, including protective suits, boots and gloves.
  • Control rodents, which are reservoirs of disease.

After taking the risk:

  • Wash with drinking water and disinfect the wound;
  • Consult a doctor immediately in the event of the appearance of symptoms, informing him of the dangerous activity carried out in the previous two weeks.

These measures will be strengthened during the rainy season.

There is a vaccine against leptospirosis. Its effectiveness is limited to certain strains of leptospira, it is rarely done in practice, mainly involving specialists.

Source: ProMED.

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