Leptospirosis, a neglected zoonotic disease caused by Leptospira spirochetes, poses a significant health burden, particularly in the tropical climate of most states of India. This study examines the occurrence and epidemiological distribution of leptospirosis in the eastern region of Northern India, specifically Eastern Uttar Pradesh. Out of the total 2430 suspected cases, 550 samples (22.6%) tested positive using the Leptospira-specific IgM ELISA.

Demographic analysis revealed a similar distribution of leptospirosis cases between males (49.4%) and females (50.5%), with age-specific prevalence in the 11–20 years age group among males and 21–40 years in females. Seasonal trends revealed a peak for males in October and for females in November. The highest infection rates occurred in the 11–30 age group, due to more outdoor exposure. Housewives, farmers, and students had high positivity rates, highlighting both domestic and agricultural risk factors. A strong correlation with the monsoon and post-monsoon seasons indicates the need for targeted surveillance and prevention strategies. Epidemiologically, cases were distributed across 16 districts, with the highest positivity reported in Deoria (33.3%), Prayagraj (31.2%), and Azamgarh (23.6%). It is intriguing to note that in Varanasi city, the subjects with the highest prevalence of leptospira antibodies were residing along the bank of the River Ganga.

This study highlights the endemic nature of leptospirosis in eastern UP and calls for enhanced suspicion index, diagnostic facilities, and preventive strategies in this region of a subtropical climate.