• developing countries
• ELISA
• leptospirosis
• natural disasters
• poverty areas

Leptospirosis is a zoonotic disease of global significance.¹ In recent years, clinicians and epidemiologists have given increasing attention to this disease, with particular focus on two features: its epidemic potential; and severe manifestations, particularly pulmonary haemorrhage.^2,3 However, in leptospirosis endemic regions, one quarter of patients (or more) presenting with simple fever have serological results suggesting the diagnosis of acute leptospirosis. Severe leptospirosis seems to be the tip of the iceberg of leptospiral infection: most people infected by Leptospira seem to have either have simple, undifferentiated fever (fever without focus) or subclinical illness.⁴

Fever is a cardinal manifestation of illness and is a common clinical complaint. In industrialised countries, an undifferentiated febrile illness is often referred to a “viral syndrome” or a “flu-like illness”, with the expectation that it will resolve itself. In the developing world, depending on locale, an undifferentiated fever may be called “dengue” or “malaria”, …