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Final Issue: Volume 16 Number 51
Published on: 21 December 2006
Final Issue in PDF
Last updated: 19 October 2006 Volume 16, No.42 (PDF file, 207 KB)
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Leptospirosis has been diagnosed clinically in two men recently returned from a fishing holiday at a resort in the Picardie région of north-east France. One case has since been serologically confirmed. Both patients were at the same resort at the same time (mid-September), and became unwell about one week after their return to the United Kingdom.
We wish to alert clinicians and laboratory staff to the possibility of leptospirosis in other people who have been on similar activity holidays.
Leptospires infect a variety of wild and domestic animals, including rodents, cattle and pigs, which then excrete organisms in their urine. Leptospires are naturally aquatic organisms and are found in fresh water, damp soil, vegetation, and mud. Human leptospirosis thus usually occurs following exposure to water or environments contaminated by infected animal urine, and is associated with a variety of occupations and activities in which this contact occurs; farming, agricultural work and sewer maintenance. Recreational activities with possible exposure include canoeing, windsurfing, swimming in lakes and rivers, pot holing, and fishing.
Typically, symptoms develop seven to 14 days after infection, though, on rare occasions the incubation period may be short as two to three days or as long as 30 days. Symptoms vary, and are usually biphasic. There is an abrupt onset of a ‘flu-like’ illness with high fever, severe headache, chills, muscle aches, and vomiting. Jaundice, red eyes, abdominal pain, diarrhoea, or a rash may follow.
Diagnostic serological tests, which include a screening IgM ELISA and a confirmatory Microscopic Agglutination Test, are done at the Leptospirosis Reference Laboratory, County Hospital, Hereford, HR1 2ER (tel: 01432 277117).
Please notify CfI via the duty doctor service on (tel: 020 8200 4400) if you become aware of any related cases. The relevant authorities in France are being informed.
The Health Protection Agency has launched a consultation to look at the social and ethical implications of a blood test for variant (vCJD), should a test become available. There is currently no blood test to detect vCJD infection in people who appear to be well. Such tests may soon be developed, and this consultation aims to seek views about how these tests for vCJD could be used once they become available.
A vCJD test could be used to screen blood donors, allowing the blood services to prevent blood from people with positive tests being given to patients. This is important as there have now been three probable cases of vCJD infection being transmitted through blood transfusions and a measure such as this could further ensure the safety of blood supplies.
The consultation will explore some questions and concerns about introducing a blood test, including:
1. Should a test for vCJD be introduced when it is not known whether people with positive test results would ever develop symptoms of vCJD, and if they would, how long this would take?
2. Should the UK blood services always tell donors if their vCJD tests are positive? And how should donors’ GPs be involved?
3. If donors knew that they would be tested for vCJD, and that they would be told if they tested positive for vCJD, would they be put off giving blood?
Together with an opinion research company, the HPA is asking experts, health professionals, interest groups and members of the public for views on the possible impact and implications of a blood test for vCJD. A stakeholder audit is being complemented by an on-line questionnaire. The answers will be completely confidential and anonymous.
If you would like to join in this consultation, please take part in the online poll at http://www.hpa.org.uk/infections/topics_az/cjd/consultation.htm