Leptospirosis - a significant but often overlooked disease

March 16, 2025 - 12:30
Leptospirosis, though often overlooked, is a significant public health concern in tropical and subtropical regions. 
Dr Mattias Larsson. Photo courtesy of Family Medical Practice

Dr Mattias Larsson*

Minh is an energetic eight-year-old boy who loved to visit his grandparents in the countryside. The freedom to run around was a welcome escape from the bustling city.

 It was the beginning of the rainy season, and the fields near his grandparents’ home were becoming submerged in water. Like any curious child, Minh couldn’t resist playing in the floodwaters with his cousins. They splashed around, laughing and chasing each other. 

After a few days, Minh developed a high fever, headache and muscle pain. His parents took him to the local clinic where the doctor diagnosed as a common flu and prescribed a short course of antibiotics and steroids. For a while, Minh seemed to improve, but his relief was short-lived. 

A week later, Minh’s fever returned, this time accompanied by chills, vomiting, and a yellowish colouring of his skin and eyes, jaundice. Alarmed, his parents decided to seek better care. They had heard that Family Medical Practice (FMP) was known for its excellent paediatric care, and made the decision to bring Minh there.   

Leptospirosis, though often overlooked, is a significant public health concern in tropical and subtropical regions. Photo canva.com

At FMP, Minh was seen by a paediatrician with extensive experience in infectious diseases. The doctor listened carefully to Minh’s history, including his exposure to floodwaters, conducted a thorough physical examination, and ordered tests. The results showed that Minh was infected with Leptospirosis. 

The paediatrician explained that leptospirosis is often misdiagnosed because its early symptoms mimic those of the flu. However, Minh’s worsening of symptoms, including jaundice and exposure to floodwaters indicated this bacterial infection.

Leptospirosis is caused by bacteria found in water contaminated by animal urine. It can enter the body through cuts or mucous membranes. If not treated promptly, it can lead to severe complications like kidney or liver failure. Minh’s parents worried about his condition but were relieved to finally have a clear diagnosis.  

Given the severity of Minh’s symptoms, he was initially treated with intravenous (IV) antibiotics to quickly combat the infection, as Minh’s condition improved, the treatment was de-escalated to oral antibiotics. 

The parents who wanted to know more about the disease and how to prevent it asked more questions to the doctor who explained: Leptospirosis, though often overlooked, is a significant public health concern in tropical and subtropical regions. Việt Nam is one of the countries where it is common, particularly in rural and flood-prone areas. The disease is underreported due to its nonspecific symptoms and limited diagnostic capabilities in some regions. 

It is estimated that there are over one million cases of leptospirosis worldwide each year, with nearly 60,000 deaths. The exact incidence in Việt Nam is difficult to determine due to underdiagnosis and underreporting. Outbreaks are frequently reported during the rainy season, especially in the Mekong Delta and central regions, where flooding is common. Farmers, fishermen, and children who play in floodwaters are particularly vulnerable.

Poor sanitation and overcrowding in urban areas can lead to rodent infestations, which are a major reservoir for the bacteria. 

Preventing leptospirosis requires a combination of public health measures and individual precautions: Improved sanitation, rodent control and public awareness campaigns are essential. Avoiding contact with contaminated water, wearing protective clothing, and practicing good hygiene can reduce the risk of infection. Parents are advised to educate their children about the risks of playing in floodwaters. If a child develops flu-like symptoms after such exposure, seek medical attention immediately. Early diagnosis and treatment can make all the difference. 

Leptospirosis remains a significant but often overlooked disease. With climate change increasing the frequency of floods and extreme weather events, the risk of outbreaks is likely to grow. Raising awareness, improving diagnostic capabilities, and implementing preventive measures are crucial to reducing the burden of this disease. 

After a week of treatment, Minh’s fever subsided, his jaundice faded, and his energy returned. Minh’s parents were happy to see their son healthy again. Family Medical Practice

*Dr Mattias Larsson is a paediatrican at FMP Hanoi and associate professor at Karolinska Institutet and has a long experience in research on infectious diseases. He has worked with the Oxford University Clinical Research Unit and the Ministry of Health of Việt Nam. He is fluent in English, Swedish, Vietnamese, German, and some Spanish.

FMP Healthcare Group operates medical centres in major cities including HCM City, Hà Nội, and Đà Nẵng, offering consultations with international doctors, check-up centres, and emergency ambulance services.

Visit FMP Hanoi 24/7 at 298I Kim Mã Street, Kim Mã Ward, Ba Đình District. 

To book an appointment, please call (024).3843.0748, chat via Whatsapp, Viber or Zalo on +84.944.43.1919 or email hanoi@vietnammedicalpractice.com.

 

 

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