French West Indies Leptospirosis Study
French West Indies Leptospirosis Study
Leptospirosis is a zoonosis of worldwide distribution whose incidence is higher in the
 tropics, where conditions for transmissions are favorable. The disease is endemic in
 Martinique and Guadeloupe, two Caribbean islands of the French West Indies. In tropical
 areas, many wild and domestic animals serve as reservoirs for pathogenic Leptospira strains
 and contaminate the environment by shedding the organisms in their urine. Humans are usually
 infected through abraded skin or mucous membrane contact with water contaminated by the urine
 of animal reservoirs, and less frequently by direct contact with animals or their urine. The
 mean incubation period is 10 days, with a usual range of 2-20 days. Clinical manifestations
 are protean and the spectrum of symptoms range from subclinical or mild anicteric febrile
 illness to acute renal failure and respiratory distress syndrome which are associated with
 high mortality rates.

 The microscopic agglutination test (MAT) and culture are the reference standard test for
 diagnosis of leptospirosis, but they are only available in reference laboratories and their
 conclusive results requires convalescent sample or prolonged incubation. At present, only
 direct detection methods using PCR might provide rapid diagnosis during the early acute stage
 of the illness, when treatment is likely to have the greatest benefit.

 Quantitative PCR also offers the ability to measure level of leptospiremia in clinical
 samples. Using qPCR based diagnosis, the investigators have the opportunity to study the
 association of level of leptospiremia and clinical manifestations in French West Indies. All
 qPCR-positive samples will be used for molecular typing.
Principal objective

 To determine if leptospiral bacterial load is associated with severe evolution of the disease
 (organ failure, internal bleeding, death) in French West Indies.

 Secondary objective

 1. To identify demographic, clinical, biological, bacteriological, and genetic factors
 (HLA) associated with severe complications of leptospirosis (organ failure, internal
 bleeding, death).

 2. To identify demographic, clinical, biological, bacteriological, and genetic factors
 (HLA) associated with an altered quality of life after the acute phase of leptospirosis.

 3. To collect human biological samples to allow studies of the individual susceptibility to
 the infection (genetic polymorphisms, HLA).
Inclusion Criteria:

 -  Adults (more than 18 years)

 -  Consulting a participating hospital center (emergency room, full hospitalization, day
 hospitalization, or outpatient visit).

 -  Diagnosis of leptospirosis confirmed by qPCR

 -  Possibility of follow-up throughout the 12-week study period.

 -  Patient registered in the French medical social security national program

 -  Acceptance to participate in the study and in follow-up; informed consent of the
 patient or a legal representative (patients unable to sign the consent form).

 Exclusion Criteria:

 -  Negativity of leptospirosis qPCR based diagnosis

 -  Children under 18 years old

 -  No possible follow-up after the first visit

 -  Refusal to participate in the study

 -  Patient not registered in the French medical social security national program