• Medical Research Institute - Sri Lanka

  • Medical Research Institute - Sri Lanka

  • Medical Research Institute - Sri Lanka

Leptospira

Head of Laboratory

Dr. Lilani Karunanayake

Consultant Clinical Microbiologist

HISTORY

Eight new reference Leptospira serovars from human and animals have been added from Sri Lanka to the world literature (gem, alice, weerasinghe, ratnapura, ceylonica, jeyaweera, lanka and animal spp.)  In 1971, Dr. Nityananda identified many different serotypes and their reservoir hosts in Sri Lanka. The findings suggested the existence of a diversity of serotypes maintained by different maintenance hosts such as rodents, domestic farm animals and dogs [K. Nithyananda et.al.,‘Leptospirosis in Ceylon]. In 1962, a serological survey of occupational groups showed rice field workers, sewer workers, workers in coconut plantations and desiccated coconut mills, sugar cane workers, abattoir workers, fish market workers and river bathers were as at risk of leptospirosis.

Heads of National Reference Laboratory for Leptospirosis
1953 – Dr. K. Nityananda, Consultant Bacteriologist
1970’s – Dr. M. Atapattu, Consultant Microbiologist
2000 – Dr. Philomina Chandrasiri, Consultant Clinical Microbiologist
2003 – Dr. Praneetha Somarathne, Consultant Clinical Microbiologist
2011 to date – Dr. Lilani Karunanayake, Consultant Clinical Microbiologist

Administrative Structure

Presently available tests:

  • Microscopic Agglutination Test (MAT) Pathogenic Panel
  • Leptospira detection by qPCR from blood and urine
  • Blood culture
  • Urine / CSF Microscopy

HUMAN LEPTOSPIROSIS IN SRILANKA

Leptospirosis is a zoonotic bacterial infection caused by pathogenic spirochetes of Leptospira interrogans. It is maintained by chronic renal infection in carrier animals, which excrete leptospira in their urine and contaminate the environment.
Leptospirosis is a notifiable disease in Sri Lanka. It is highly endemic, with an annual incidence rate of >10/100,000 population. The Case Fatality Rate (CFR) ranges from 1.5-2.9%.
Human leptospirosis is an acute febrile illness with a wide spectrum of clinical manifestations, ranging from mild to severe disease.
The common circulating serogroup is Tarassovi. The important maintenance hosts in Sri Lanka are cattle and buffalo according to the available data.
High risk occupations include farmers, labourers, manual workers and men in armed forces.
Common severe diseases include Acute Kidney Injury (AKI), Leptospira Pulmonary haemorrhage (LPH), liver involvement, myocarditis and pancreatitis.  Other complications noted in our patients are hemiplegia, hepatic encephalopathy, acute quadriplegia, cerebellar signs, Guillain-Barre syndrome, and skin rash. LPH is now commonly seen in Southern Province.

Source: Karunanayake et.al., Demographic, Clinical and Bacteriological Characteristics of Human Leptospirosis in Sri Lanka: A Retrospective Study. J Bacteriol Mycol – Volume 3 Issue 2 – 2016 ISSN : 2471-0172
The common circulating serogroup is Tarassovi. The important maintenance hosts in Sri Lanka are cattle and buffalo according to available data.
Other complications noted in our patients are hemiplegia, hepatic encephalopathy, acute quadriplegia, cerebellar signs, Guillain-Barre syndrome, and skin rash. Pulmonary hemorrhage is now commonly seen in Southern Province.
High risk occupations include farmers, labourers, manual workers and men in armed forces.


Leptospira Diagnostic time-line at NRL
1959 – Complement fixation test and Guinea pig inoculation
1962 -Macro-agglutination test
1970’s – Sapropytic Microscopic Agglutination Test, blood culture
2014 – Pathogenic Microscopic Agglutination Panel
2016 – Leptospira detection by qPCR
2018 – ELISA