Background: Leptospirosis is one of the most common bacterial zoonoses in the world. However, there is scarce available literature on public awareness of the infection and the main clinical symptoms of leptospirosis. Objective: The aim of this study was to assess the level of leptospirosis awareness among the general population and individuals with occupational risk of the disease in Lviv Region, Ukraine. Material and methods: A leptospirosis questionnaire on potential risk factors, routes of transmission and ways of protection along with the demographic data was prepared, posted on Facebook and distributed as a printed version. The statistical analysis was performed using Fisher's two-sided test. Results: A total of 446 individuals completed the questionnaire. Of these, 364 persons had no occupational risk of acquiring leptospirosis, while 82 of them had it. The study showed the following levels of leptospirosis awareness among the participants: 193 out of 446 (43.3%) individuals knew what leptospirosis was, with 158/364 (43.4%) representing general population (Group 1) and 35/82 (42.7%) representing individuals with an occupational risk of acquiring leptospirosis (Group 2), p>0.05. Furthermore, a total of 55.8% of all the participants knew how they could contract leptospirosis: 194/364 (53.3%) in Group 1 and 55/82 (67.1%) in Group 2, p<0.05. The most common risk factors of acquiring leptospirosis observed in both groups were as follows: swimming in ponds and lakes with stagnant water (57.69% in Group 1and 79.26% in Group 2, p<0.01), and the presence of rodents in houses, basements and utility rooms as well as periodic visits to these premises by respondents (45.6% of the respondents in Group 1 and 58.53% of the respondents in Group 2, p<0.01). Conclusions: Outreach campaigns should be implemented to raise the awareness of leptospirosis, both among the general population and among the individuals at increased risk of exposure.

Background. Over last five years, 20 cases of Hemorrhagic Fever with Renal syndrome (HFRS) have been officially registered in Ukraine. We believe that the real incidence rates of HFRS are significantly higher. This underdiagnosis is partially due to the rarity of HFRS cases in Ukraine and the limited number of patients that are referred to specialists for laboratory examinations.

Case description. Patient D., 34 years old, became acutely ill with a fever of 39°C, back pain, nausea, and weakness. He was hospitalized with suspicion of leptospirosis. The biochemical panel revealed increasing levels of creatinine and urea, and the level of ALAT was slightly elevated.  Other biochemical data were normal. A complete blood cell count (CBC) revealed thrombocytopenia. Tests for viral hepatitis and leptospirosis were negative. HFRS was not suspected at this stage and symptomatic treatment was prescribed. The patient was discharged from the hospital on the 17th day of the disease. However, the patient's condition was not satisfactory, and the patient was hospitalized again on the 20th day of the disease. CBC, urine test, and coagulation test were unchanged. Only an elevated level of ALT(120.6 U/l) was identified.  An epidemiological review of the patient’s history revealed that he worked in a fish farm, feeding fish with dry food that was stored where rodents were possibly present. During the second hospitalization, the doctor again did not suspect HFRS. Only on the 25th day of the illness, during a multi-disciplinary meeting on the basis of the epidemiological history and after familiarization with the initial clinical signs and symptoms, was HFRS suspected. On the 25th day of the disease, Hantavirus IgM (IFA titer 1:640) and IgG (titer 1:10240) were detected in the blood of the patient. The patient received symptomatic therapy and was discharged on the 32nd day of disease.

Discussion. This case demonstrates a low vigilance of Ukrainian doctors to Hantavirus infection. To improve diagnosis and detect more cases of HFRS, it is necessary to introduce a mandatory examination of all patients with fever and kidney damage, as well as with suspicion of leptospirosis for Hantaviruses. 

Наведено клінічний приклад, який ілюструє тяжкий перебіг септицемії спричиненої Micrococcus luteus із залученням у патологічний процес внутрішніх органів, а саме нашаруванням негоспітальної лівобічної пневмонії, ексудативного плевриту, перикардиту, менінгіту. 

Сепсис визначається як загрозлива для життя органна дисфункція у результаті порушення регуляції реакції організму пацієнта на інфекцію. Серед етіологічних чинників сепсису S. aureus займає домінуюче місце (20,5%). Метою роботи є представити клінічний випадок сепсису, спричиненого S.aureus.