Guidance

National leptospirosis service

The National Leptospirosis Service (NLS) is the national laboratory reference centre for the diagnosis of leptospira infections.

• From: Public Health England
• Published: 5 July 2012
• Last updated: 1 June 2018 — See all updates

Introduction

From 1 April 2015, a new combined clinical diagnostic and reference leptospirosis service is being provided by the National Leptospirosis Service (NLS).

This replaces the service previously provided by the Leptospira Reference Unit (LRU), Hereford, which was discontinued on 31 March 2015.

Service overview

The NLS offers a coordinated approach to patient centred diagnostics across 2 sites:

• the Rare and Imported Pathogens Laboratory (RIPL), PHE Porton is providing the PCR and IgM diagnostic service
• the Bacteriology Reference Department (BRD), PHE Colindale is providing serology and confirmatory testing, on referral from RIPL only

The single port of entry for testing and clinical information will be at RIPL.

Clinical advice

RIPL clinical staff are available to discuss cases with medical professionals during working hours.

Where clinically appropriate, clinical advice is available out of normal working hours by contacting either the on-call RIPL consultant or the Imported Fever Service (IFS).

There is no clinic at Public Health England Porton, and we are unable to see patients or give phone advice direct to members of the public.

Diagnostic tests

The leptospirosis clinical diagnostic service is provided by the Rare and Imported Pathogens Laboratory (RIPL) at PHE Porton.

Leptospirosis is diagnosed by either:

• PCR in the acute stage of infection (within 5 days of symptoms onset)
• serological assays (ELISA or MAT) later in illness

A full diagnostic service consisting of PCR and ELISA testing is provided 5 days a week during normal working hours (Monday to Friday, 9am to 5pm). In addition the PCR service may be available at weekends, if deemed urgent following discussion with a RIPL Consultant.

Confirmatory tests

Upon referral of samples from RIPL Porton, the BRD unit (Colindale) will perform the microscopic agglutination test (MAT). The MAT is the current international gold standard serology test for the detection of agglutinating antibodies that may be present from 5 days after the onset of disease. It is necessary to examine at least 2 serum specimens taken at least 7 days apart. The majority of leptospirosis cases are identified through MAT serology.

Multilocus sequence typing (MLST) will be performed on clinical samples that have tested PCR positive.

Send all diagnostic and confirmatory samples to RIPL with a completed leptospirosis request form.

User manuals

See the Rare and Imported Pathogens Laboratory (RIPL) user manual.

See the Bacteriology Reference Department (BRD) user manual.

Contact

Rare and imported pathogens laboratory (RIPL)

UK Health Security Agency
Manor Farm Road
Porton Down
Wiltshire
SP4 0JG

Email ripl@ukhsa.gov.uk

Telephone 01980 612348 (available 9am to 5pm, Monday to Friday)

DX address DX 6930400, Salisbury 92 SP

Bacteriology reference department (BRD)

UK Health Security Agency
61 Colindale Avenue
London
NW9 5EQ

Telephone 020 8327 7887 (staffed from 9am to 5.30pm, Monday to Friday)

DX address UKHSA Colindale Bacteriology, DX 6530002

Published 5 July 2012
Last updated 1 June 2018 + show all updates

1. 1 June 2018

   Process changed for confirmatory tests for PCR positive.

2. 1 April 2015

   Updated guidance.

3. 5 July 2012

   First published.