Instructor

Darvin Scott Smith, MD
Infectious Disease Specialist, San Mateo Medical Center

Description

The course addresses Leptospirosis as a global threat that frequently mimics diseases like Lyme disease. It is designed to improve healthcare providers’ ability to identify the often non-specific symptoms of Leptospirosis, a challenge in its early detection.

A key component of the course is the One Health approach, which melds human, animal, and environmental health considerations. This is crucial for the comprehensive understanding and management of Leptospirosis.

Participants will delve into the diagnostic challenges of Leptospirosis and explore the limitations of current testing methods. Treatment protocols, focusing on antibiotics such as doxycycline and penicillin, will be extensively covered.

Moreover, the course includes a section on preventive measures. Strategies for avoiding exposure to contaminated environments and the use of appropriate protective gear are emphasized as key to controlling the spread of Leptospirosis.

Learning objectives

  1. Identify the epidemiologic risks for acquiring leptospirosis
  2. Describe the transmission of leptospirosis
  3. Consider, recognize, and diagnose leptospirosis
  4. Cite the limitations of current diagnostics

Accreditation Statement

This session, Leptospirosis: A Clinical Perspective,, is approved for 0.5 enduring AAFP Prescribed credits.

The AAFP has reviewed One Health Medical Education for a Changing Climate, and deemed it acceptable for AAFP credit. Term of approval is from 01/01/2025 to 12/31/2025. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AAFP Prescribed credit is accepted by the American Medical Association as equivalent to AMA PRA Category 1 credit(s)™ toward the AMA Physician’s Recognition Award. When applying for the AMA PRA, Prescribed credit earned must be reported as Prescribed, not as Category 1.

Evidence-based bibliography for further study

  1. https://www.ecdc.europa.eu/en/leptospirosis/factsheet#
  2. Centers for Disease Control and Prevention. Leptospirosis: Fact sheet for clinicians. https://www.cdc.gov/leptospirosis/pdf/fs-leptospirosis-clinicians-eng-508.pdf (accessed 11-26-23)
  3. Brito Monteiro M, Egídio de Sousa I, Piteira M, Coelho S, Freitas P. Leptospirosis, a Re-emerging Threat. Cureus. 2021 Apr 5;13(4):e14295. doi: 10.7759/cureus.14295. PMID: 33968509; PMCID: PMC8098779
  4. Costa F, Hagan JE, Calcagno J, et al. Global Morbidity and Mortality of Leptospirosis: A Systematic Review. PLoS Negl Trop Dis 2015; 9:e0003898.
  5. Torgerson PR, Hagan JE, Costa F, et al. Global Burden of Leptospirosis: Estimated in Terms of Disability Adjusted Life Years. PLoS Negl Trop Dis 2015; 9:e0004122.
  6. Guernier V, Goarant C, Benschop J, Lau CL (2018) A systematic review of human and animal leptospirosis in the Pacific Islands reveals pathogen and reservoir diversity. PLoS Negl Trop Dis 12(5): e0006503. https://doi.org/10.1371/journal.pntd.0006503
  7. Haake DA, Levett PN. Leptospirosis in humans. Curr Top Microbiol Immunol. 2015;387:65-97. doi: 10.1007/978-3-662-45059-8_5. PMID: 25388133; PMCID: PMC4442676.
  8. Grennan D. Leptospirosis. JAMA. 2019;321(8):812. doi:10.1001/jama.2019.0697
  9. Bierque E, Thibeaux R, Girault D, Soupé-Gilbert M-E, Goarant C (2020) A systematic review of Leptospira in water and soil environments. PLoS ONE 15(1): e0227055. https://doi.org/10.1371/journal.pone.0227055
  10. Rajapakse S. Leptospirosis: clinical aspects. Clin Med (Lond). 2022 Jan;22(1):14-17. doi: 10.7861/clinmed.2021-0784. PMID: 35078790; PMCID: PMC8813018
  11. Covic A, Goldsmith DJ, Gusbeth-Tatomir P, Seica A, Covic M. A retrospective 5-year study in Moldova of acute renal failure due to leptospirosis: 58 cases and a review of the literature. Nephrol Dial Transplant 18: 1128-1134, 2003. 
  12. Premarathne SS, Gamage C, Chandrajith R, Ratnatunge NV, Wijetunge S, Wazil A, Chou LF, Ko YC, Huang CT, Yang HY, Fonseka A, Sonnadara T, Herath D, Hewavitharane P, Yang CW, Nanayakkara N. Leptospirosis: A Potential Culprit for Chronic Kidney Disease of Uncertain Etiology. Nephron. 2023;147(8):510-520. doi: 10.1159/000528703. Epub 2023 Feb 21. PMID: 36809758; PMCID: PMC10568603
  13. Rathi H, Patel A, Beblawy R, et al. (August 17, 2023) A Rare Complication of Leptospirosis: Weil’s Disease Diagnosed in the United States. Cureus 15(8): e43620. doi:10.7759/cureus.43620
  14. Jayathilaka, P.G.N.S., Mendis, A.S.V., Perera, M.H.M.T.S. et al. An outbreak of leptospirosis with predominant cardiac involvement: a case series. BMC Infect Dis 19, 265 (2019). https://doi.org/10.1186/s12879-019-3905-7
  15. Guzmán Pérez M, Blanch Sancho JJ, Segura Luque JC, Mateos Rodriguez F, Martínez Alfaro E, Solís García Del Pozo J. Current Evidence on the Antimicrobial Treatment and Chemoprophylaxis of Human Leptospirosis: A Meta-Analysis. Pathogens. 2021 Sep 2;10(9):1125. doi: 10.3390/pathogens10091125. PMID: 34578157; PMCID: PMC8467609.
  16. Haake DA, Levett PN. Leptospirosis in humans. Curr Top Microbiol Immunol. 2015;387:65-97. doi: 10.1007/978-3-662-45059-8_5. PMID: 25388133; PMCID: PMC4442676.
  17. Levett, P. N. (2020). Leptospirosis. Clinical Microbiology Reviews, 33(4), e00023-20
  18. Picardeau, M. (2017). Virulence of the zoonotic agent of leptospirosis: Still terra incognita? Nature Reviews Microbiology, 15(5), 297-307.
  19. World Health Organization (WHO). (2022). Leptospirosis: A global public health problem of high mortality. https://www.who.int/publications/i/item/B4221
  20. Guernier V, Goarant C, Benschop J, Lau CL (2018) A systematic review of human and animal leptospirosis in the Pacific Islands reveals pathogen and reservoir diversity. PLoS Negl Trop Dis 12(5): e0006503. https://doi.org/10.1371/journal.pntd.0006503
  21. Guzmán Pérez M, Blanch Sancho JJ, Segura Luque JC, Mateos Rodriguez F, Martínez Alfaro E, Solís García Del Pozo J. Current Evidence on the Antimicrobial Treatment and 
  22. Chemoprophylaxis of Human Leptospirosis: A Meta-Analysis. Pathogens. 2021 Sep 2;10(9):1125. doi: 10.3390/pathogens10091125. PMID: 34578157; PMCID: PMC8467609.

Darwin (Scott) Smith

About the Instructor

Darvin (Scott) Smith, MD, MSc, DTM&H, FIDSA

Infectious Disease Specialist, San Mateo Medical Center

Scott grew up in Boulder Colorado and attended medical school at the University of Colorado.

He went to public health school at Harvard University where an interest in Tropical Public Health was further developed, leading to a yearlong study as a Fulbright Scholar in Cali Colombia, where he studied improved diagnostic technologies to understand the epidemiology of leishmaniasis, and onchocerciasis (River Blindness), a leading infectious cause of blindness worldwide.

He completed residency then a Fellowship at Stanford University in Medicine then Infectious Disease & Geographic Medicine.

He taught at Stanford Medical School and directed a course in Human Biology entitled “Parasites & Pestilence” for over 20 years.  He was presented the Bloomfield award in recognition of excellence in teaching of clinical medicine at Stanford School of Medicine.

Since 1999 he has organized local then regional then Kaiser Nationally sponsored Travel Medicine Conferences to prepare travelers for safe international trips.  He served as Chief of Infectious Disease & Geographic Medicine at Kaiser Redwood City before retiring in 2023 after the COVID pandemic.  He concluded his tenure on a high note, serving as a subject matter expert and on the regional task force for COVID and Influenza vaccination.

He has served locally on the San Mateo County Mosquito Abatement District Board as trustee and board member since 2012 for his town of Hillsborough.   He currently serves on the Professional Education Committee as Co-Chair in the ISTM (International Society of Travel Medicine), organizing webinars and Update Courses.   He continues working in the clinical sector for the International non-profit organization since the tsunami in 2004 with MENTOR-Initiative leading training workshops about Malaria and Vector-borne diseases as well as Emergency Responses, in Indonesia, Uganda, Kenya, Tanzania, Haiti, and Myanmar.

He has appeared on The Doctors Show (CBS), Animal Planet, Discovery Channel and National Geographic (and even the Tyra Bank’s Show in New York!) about several unusual parasitic diseases in humans including leishmaniasis, tapeworm, leprosy and hookworm.