Environment Communicable diseases Prevention Notifiable disease

The annual incidence of leptospirosis in France is estimated at around 1 case/100,000, i.e. around 600-700 cases, with a probable underestimation of the number of cases. Its incidence in the DOM-COM is 10 to 70 times higher than in mainland France.

Current surveillance of leptospirosis is based on the CNR (national reference centre) and its partner laboratories. This surveillance system has never been evaluated and the completeness of the data collected by this network is not known.

This disease, caused by a bacterium of the genus Leptospira, is most often transmitted to humans indirectly through contact with injured skin or mucous membranes with water or soil contaminated by rodent urine.

The clinical features of this infection are not very specific (flu-like syndrome), but leptospirosis can be responsible for serious forms of the disease with myocardial, pulmonary or renal damage and a significant mortality rate.

Diagnosis is based on gene amplification, serology (Elisa IgM) and MAT (microagglutination test).

Prevention of infection includes personal and environmental protection measures, and vaccination of at-risk populations.

With regard to the criteria for inclusion of a disease on the list of notifiable diseases (MDO), the Haut Conseil de la santé publique recommends that leptospirosis be reinstated on the list of MDO throughout France in order to

• improve knowledge of the epidemiology, weight and incidence of the disease ;
• identify clustered cases and implement appropriate management measures;
• re-evaluate prevention measures in the workplace as well as in the general population and routine diagnostic tools.