The prevention and control of human leptospirosis.

Human leptospirosis is prevalent in several states in India, sporadically or as outbreaks, especially during rainy seasons. It affects predominantly male adults who work in agriculture, causing severe morbidity and unnecessary mortality. Yet, there is no systematic leptospirosis prevention and control programme in the country, as it is not identified as priority under the national health policy. Therefore states with leptospirosis ought to establish public health programme for its prevention and control, as part of building a comprehensive initiative for the control of all-important infectious diseases. After establishing disease surveillance and laboratory support service, the disease burden must be monitored before and during interventions for control. The District is the ideal unit of activity, with full participation of the State Government and Local Panchayati raj. The public health staff must give technical leadership and the risk factors of human leptospirosis must be identified and specific interventions targeted against them. Action must be local-area-specific and coordinated between the Departments of Health, Agriculture, Animal Husbandry, Environment and Forestry. A model leptospirosis control programme has been formulated in Kerala State and is awaiting implementation. A state level Diagnostic and Epidemiology centre has been established to provide technical leadership. This model must be implemented and also replicated in other states. The most important ingredient for the control of infectious diseases is the 'political will'.