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Leptospirosis in Malaya

I. Sporadic Cases among Military and Civilian Personnel¹

A study of 852 patients with acute febrile illnesses revealed that leptospirosis was a common disease in Malaya, having been the cause of 35 per cent of fevers among foreign military personnel and 13 per cent among adult male non-European civilians. The diagnosis of leptospirosis was accomplished by a combination of procedures including cultural, complement-fixation and agglutination-lysis techniques. Under the conditions of this study, approximately 60 per cent of those patients whose blood was cultured had demonstrable leptospiremia, 90 per cent developed complement-fixing antibodies and all had demonstrable agglutination-lysis antibodies during convalescence.

Leptospirosis in this series of patients was characterized by headache, gastro-intestinal disturbances, conjunctival injection and a febrile course of about 8 days' duration. Varying degrees of renal dysfunction as manifested by the excretion of albumin, cells and casts occurred in about 80 per cent of these patients. Clinical jaundice was uncommon but laboratory evidence of hepatic dysfunction was encountered in half the patients.

Patients acquired leptospirosis in a variety of environments in Malaya but contracted it most frequently in primary forest in which there appeared to be hyperendemic foci of infection.

¹ This study was carried out under the sponsorship of the Commission on Immunisation of The Armed Forces Epidemiological Board and was supported in part by a contract between The Office of the Surgeon General, Department of the Army and The Institute for Medical Research, Kuala Lumpur, Federation of Malaya.

² Present address: University of Maryland, School of Medicine, Baltimore, Md.

³ Present address: National Institutes of Health, Bethesda, Md.

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