PostHeaderIcon Leptospira

This page last updated on 28.06.2018                                      

Head / National Reference Laboratory for Leptospirosis    

Dr. Lilani Karunanayake, Consultant Clinical Microbiologist

HISTORY

 

Guideline for Collection and Transport of Specimens to MRI

Guideline for Collection and Transport of Blood for leptospira culture

Presently available tests:

Pathogenic Microscopic Agglutination Panel

Leptospira detection by qPCR

Blood culture

Urine Microscopy

HUMAN LEPTOSPIROSIS IN SRILANKA

Leptospirosis is a zoonotic bacterial infection caused by pathogenic spirochetes of Leptospira interrogans. It is maintained by chronic renal infection in carrier animals, which excrete leptospira in their urine and contaminate the environment.

Leptospirosis is a notifiable disease in Sri Lanka. It is highly endemic, with an annual incidence rate of >10/100,000 population. The Case Fatality Rate (CFR) ranges from 1.5-2.9%.

Human leptospirosis is an acute febrile illness with a wide spectrum of clinical manifestations, ranging from mild to severe disease.       

The common circulating serogroup is Tarassovi. The important maintenance hosts in Sri Lanka are cattle and buffalo according to the available data.

High risk occupations include farmers, labourers, manual workers and men in armed forces.

Common severe diseases include Acute Kidney Injury (AKI), Leptospira Pulmonary haemorrhage (LPH), liver involvement, myocarditis and pancreatitis.  Other complications noted in our patients are hemiplegia, hepatic encephalopathy, acute quadriplegia, cerebellar signs, Guillain-Barre syndrome, and skin rash. LPH is now commonly seen in Southern Province

 

Leptospirosis 

Source: Karunanayake et.al., Demographic, Clinical and Bacteriological Characteristics of Human Leptospirosis in Sri Lanka: A Retrospective Study. J Bacteriol Mycol - Volume 3 Issue 2 - 2016 ISSN : 2471-0172

The common circulating serogroup is Tarassovi. The important maintenance hosts in Sri Lanka are cattle and buffalo according to available data.

Other complications noted in our patients are hemiplegia, hepatic encephalopathy, acute quadriplegia, cerebellar signs, Guillain-Barre syndrome, and skin rash. Pulmonary hemorrhage is now commonly seen in Southern Province.

High risk occupations include farmers, labourers, manual workers and men in armed forces.

History

Eight new reference leptospira serovars from humans and animals have been added from Sri Lanka to the world literature (gem, alice, weerasinghe, ratnapura, ceylonica, jeyaweera, lanka and animal spp.)

In 1971, Dr. Nityananda identified many different serotypes and their reservoir hosts in Sri Lanka. The findings suggested the existence of a diversity of serotypes maintained by different maintenance hosts such as rodents, domestic farm animals and dogs [K. Nithyananda et.al.,‘Leptospirosis in Ceylon]. In 1962, a serological survey of occupational groups showed rice field workers, sewer workers, workers in coconut plantations and desiccated coconut mills, sugar cane workers, abattoir workers, fish market workers and river bathers were as at risk of leptospirosis.

Leptospira Diagnostic time-line at NRL

1959 - Complement fixation test and Guinea pig inoculation

1962 -Macro-agglutination test

1970’s - Sapropytic Microscopic Agglutination Test, blood culture

2014 - Pathogenic Microscopic Agglutination Panel

2016 – Leptospira detection by qPCR

2018 - ELISA

 

Previous Heads at the National Reference Laboratory for Leptospirosis

1953 - Dr. K. Nityananda, Consultant Bacteriologist

1970’s - Dr. M. Atapattu, Consultant Microbiologist

2000 - Dr. Philomina Chandrasiri, Consultant Clinical Microbiologist

2003 - Dr. Praneetha Somarathne, Consultant Clinical Microbiologist