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Leptospirosis in Malaysia: “The Great Mimicker”

Leptospirosis contributes to over 1.03 million cases annually with 58,900 reported deaths globally. As a matter of fact, Southeast Asia has the second highest cases of Leptospirosis.

This figure may be understated due to a lack of updated and reliable data on leptospirosis infection in many countries.

What is Leptospirosis?

Leptospirosis is an animal-borne disease. It is caused by a bacterium called Leptospira interrogans, a highly motile and aerobic spirochete.

Typically, wild and domestic animals such as rodents, cattle and wild animals may carry the bacterium in their kidneys.

Cause of Prevalence in Malaysia

The first ever human case of severe Leptospirosis in Malaysia was in 1927.

Since Malaysia is located near the equator, Malaysia harbors a suitable environment for the progression of this bacterium.

Moreover, factors such as occupation, animal contact, adventure travel, and lack of sanitation contributes to the spread Leptospirosis.

How do you get Leptosprosis?

Leptospirosis may be spread through the urine of infected animals, which can get into water or soil. Leptospira interrogans can even survive there for weeks to months.

Contact with urine from infected animals can infect humans. This includes indirect contact, such as from soil, food and, also water infected with the urine.

The bacterium enters into the body through the breaks of skin, such as scratches as well as open wounds.

Additionally, it can also get into a person through the nose, mouth or genitals.

Signs & Symptoms

Leptospirosis is also known as “The Great Mimicker” because patients infected with this disease may mimic symptoms of other unrelated infections, such as hepatitis as well as dengue.

Symptoms includes:

  • High fever
  • Headache
  • Chills
  • Muscle aches
  • Jaundice (yellow skin and eyes)
  • Red eyes
  • Abdominal pain
  • Diarrhea
  • Rash


According to National Antibiotic Guideline Malaysia (2019), leptospirosis can be treated with oral antibiotics such as doxycycline and penicillin.

It is advisable to give an early treatment of antibiotics in the course of the disease. Patients with severe symptoms may require intravenous antibiotics.

Pain management medications such as Paracetamol or Ibuprofen can treat fever and pain.

Ways to prevent and control

In Malaysia, the main cause of leptospirosis are environmental, occupational and, also behavioural factors. Thus, several actions may help in combating this infection.

1. Health education

Organizing public awareness campaign can help in creating awareness. Moreover, this approach also helps to deliver important messages as well as motivate them to take preventive actions.

2. Risk assessment of possible contaminated water sources/bodies

Authority should assess possibly contaminated areas. Additionally, posting warning signage can help to notify public of the hazard of the contaminated area.

3.  Public behavioural prevention

Persons with occupational and recreational exposure to potentially contaminated water or soil should also wear protective clothing. Additionally, protecting open wounds with a waterproof dressing and immediately washing the exposed area with clean water can help to reduce the chances of infection from leptospirosis.

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