La Leptospirose: Une Zoonose Sous Surveillance En Nouvelle-Calédonie Et Dans Le Pacifique

Leptospirosis is caused by the Leptospira bacteria belonging to the order Spirochaetales. According to shared antigens, Leptospira is divided into serogroups and serovars, usually associated with a natural host. Leptospirosis is an important emerging disease and is at present recognised as a major endemic environmental disease in many tropical and wet countries, including some of the Pacific region. Peaks are usually seen during rainy seasons in tropical areas. Human contamination is due to direct or indirect contact with urine of infected animals. Contamination usually occurs through cuts in the skin. It may also happen through intact skin after prolonged contact with contaminated water. Following a 2- to 20-day incubation, the symptoms are variable, ranging from a classical flu syndrome to Weil disease (hepatic and renal failure), often leading to death. Leptospirosis is sometimes severe and the associated mortality may be high. Clinical as well as biological diagnosis of leptospirosis is difficult. Specific biological tests, including bacteria isolation, DNA testing (PCR, real time PCR) and serology using the microagglutination test (MAT), still remain limited to highly specialised laboratories. Classical treatment is based on antibiotics such as ampicillin or doxycyclin.