Fatal case of leptospirosis in Honduras in a patient…

In Honduras, a Venezuelan migrant, originally from Caracas, died on 27 July 2022 from leptospirosis with respiratory complications in the internal department of Gabriela Alvarado Hospital, where he was hospitalized on 21 July. for liver and kidney failure. He went to Honduras in the Trojes region.

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, wastewater workers, garbage collectors, farmers, land work, etc.) including boots, gloves, wading suits , protective clothing, even splash-proof goggles in case of exposure 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 risky operation 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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