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This epidemiological bulletin aims to provide the situation of key infectious diseases in the WHO South-East Asia Region to inform risk assessments and responses. The bulletin uses information from publicly available sources and will be published every two weeks. For feedback or suggestions, please write to seoutbreak@who.int.
Key events and updates
Sri Lanka: Leptospirosi
Situation as of 27 December 2024
- Cyclonic Storm Fengal caused significant flooding and damage across Sri Lanka in late November 2024; this was the most severe flooding in Jaffna district (Northern Sri Lanka) in over a decade.
- As of 27 December 2024, for this event, 185 patients have been admitted to Base Hospital Point Pedro, Teaching Hospital Jaffna, and District General Hospital Mullaitivu with fever, myalgia, and shortness of breath.
- Following a thorough investigation, an outbreak of leptospirosis was confirmed in Jaffna district, which had previously been considered non-endemic. o Of total patients admitted, 75 were clinically confirmed as leptospirosis.
- Laboratory testing identified six Polymerase Chain Reaction (PCR)-positive and four Microscopic Agglutination Test (MAT)-positive samples, confirming the presence of leptospira as the etiological agent (a positive MAT result suggests that the patient has antibodies to the leptospira serovars).
- Eight deaths were reported; all deceased patients presented with severe respiratory failure, progressing rapidly within 24 hours of hospital admission. o Laboratory analyses confirmed leptospirosis infection in three of the deceased.
- Autopsy findings revealed pulmonary pneumonia and leptospirosis-related pulmonary hemorrhage as the primary causes of death for the five other deaths.
Response
- A national-level response was promptly initiated, including the establishment of an Incident Management Support Cell at the regional level.
- Teams from the central Epidemiology Unit provided on-site technical assistance and organized a symposium on leptospirosis for clinicians and public health staff in the Jaffna District.
- Chemoprophylaxis with doxycycline was administered to at-risk communities to control disease transmission.
- Primary care clinicians were equipped with a working case definition to facilitate timely referral and diagnosis.
- Hospitals adhered to national leptospirosis management guidelines to ensure optimal patient care.
- Environmental and animal-related factors contributing to the outbreak were addressed through coordinated efforts involving multiple sectors.
- The response highlighted the importance of a multisectoral approach in managing such outbreaks effectively.
- Sri Lanka aims to review the surveillance case definition in light of the observed atypical clinical presentation, marked by predominant respiratory manifestations and rapid clinical progression.