Michael is an infectious disease and respiratory physician based at the University of Otago Christchurch and Canterbury District Health Board. His active research interests include clinical and epidemiologic research into zoonotic diseases in New Zealand and low- and middle-income countries. He is a member of the Otago Global Health Institute, and One Health Aotearoa, which is an inter-disciplinary research group focusing on a holistic approach to infectious disease prevention and control.
Leptospirosis: A Re-Emerging Threat In New Zealand
Leptospirosis is a zoonosis which is of particular importance among rural New Zealanders, agricultural workers, and travellers to the tropics. It is an important disease for general physicians as leptospirosis is one of the most commonly notified zoonoses in New Zealand with 174 notified cases during 2018, and New Zealand has one of the highest incidences in high income countries. Recent notifications suggest the epidemiology of leptospirosis is changing, and new population groups are at risk – meaning clinicians need to remain alert. In addition leptospirosis is challenging to recognise, and diagnose and as such is often missed. It has been estimated that there are between sixteen and fifty-six unreported cases for every notified case. Diagnosis of leptospirosis is challenging due to protean manifestations and an array of imperfect tests. Among patients diagnosed with leptospirosis, challenges include uncertainty as to optimal specific and supportive care, as well as a prolonged recovery with emerging evidence of persistent symptoms.
This talk will cover the changing epidemiology of leptospirosis in people and animals in New Zealand, and the under-recognised threat of leptospirosis in the Pacific. We will review the diagnostic tests for leptospirosis, current understanding of the accuracy of leptospirosis tests and when to employ each test, and recent diagnostic advances. We also review controversies in the management of patients with leptospirosis, occupational aspects of leptospirosis, and emerging evidence on persistent symptoms following leptospirosis.