HUMAN LEPTOSPIROSIS IN FRANCE FROM 1986 TO 1992

Drought has settled on continental France since 1988. After increasing in 1987-88, the incidence rate of leptospirosis has decreased. In French overseas areas, during the same period, the incidence rate (20 to 100 times higher than in continental France) has stabilized after an increase probably due a better access to serology. The main serogroups involved in leptospirosis were diversified in areas specialized in farming (continental France, New Caledonia) in contrast to other overseas territories where Icterohaemorrhagiae is prevailing. A greater diversity in serogroups is noticed when leisure rather than occupational activities are involved in disease transmission. In continental France, two main regions are foci for leptospirosis (Southwestern and Eastern ones) but the Loire valley is also endemic. Biological confirmation is hampered by the delay required by both culture and serology. Recently, polymerase chain reaction was described and could give a result within 2 days which will lead to a real benefit for the patient.