Leptospirosis in Israel: a report of 14 cases caused by icterohaemorrhagiae serogroup (1968-82).

Fourteen cases of leptospirosis due to the Leptospira interrogans serogroup Icterohaemorrhagiae (Weil's disease) were serologically confirmed in the last 15 years. In two cases, Icterohaemorrhagiae was also isolated from the patients' blood. Both positive cultures were obtained in Korthof's medium by indirect passage through brain-heart infusion medium. One of the isolates was identified as serovar budapest, which has never been reported in Israel. In most of the cases, paradoxical cross-reactions with serovars of the Autumnalis, Hebdomadis and Canicola serogroups were observed in the early stages of the illness. In all cases, we suspected that the source of the infection was serovars of the Icterohaemorrhagiae serogroup shed in the urine of Rattus norvegicus rats. Thirteen of the affected persons were working and living in the Tel Aviv area, all in places not known to be Icterohaemorrhagiae endemic before 1968. One patient was working and living in the Hadera region. All patients were jaundiced, and one died. The illness was usually accompanied by pronounced and long-lasting elevation of blood bilirubin and urea levels.