A Waterborne Outbreak of Leptospirosis

Cacciapuoti, B; Ciceroni, Lorenzo; Maffei, C.; Stanislao, Francesco Di; Strusi, Patrizia; Calegari, L; Lupidi, Remo; Scalise, Giorgio; Cagnoni, G.; Renga, Giovanni

doi:10.1093/oxfordjournals.aje.a114686

Cited by 72 publications

(35 citation statements)

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“…[17][18][19] Serogroup Australis has been described in cattle, sheep, rats, donkeys, dogs, and hedgehogs. [20][21][22][23][24][25][26][27] Serogroup Autumnalis has been described in cattle, rats, mice, sheep, pigs, goats, and dogs. 3,17,20,22 On the basis of the most common reactive serogroups in the study population, likely local reservoirs include livestock, rodents, dogs, and potentially hedgehogs.…”

Section: Discussionmentioning

confidence: 99%

Leptospirosis among Hospitalized Febrile Patients in Northern Tanzania

Biggs

Bui²,

Galloway³

et al. 2011

The American Society of Tropical Medicine and Hygiene

107

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Abstract. We enrolled consecutive febrile admissions to two hospitals in Moshi, Tanzania. Confirmed leptospirosis was defined as a ≥ 4-fold increase in microscopic agglutination test (MAT) titer; probable leptospirosis as reciprocal MAT titer ≥ 800; and exposure to pathogenic leptospires as titer ≥ 100. Among 870 patients enrolled in the study, 453 (52.1%) had paired sera available, and 40 (8.8%) of these met the definition for confirmed leptospirosis. Of 832 patients with ≥ 1 serum sample available, 30 (3.6%) had probable leptospirosis and an additional 277 (33.3%) had evidence of exposure to pathogenic leptospires. Among those with leptospirosis the most common clinical diagnoses were malaria in 31 (44.3%) and pneumonia in 18 (25.7%). Leptospirosis was associated with living in a rural area (odds ratio [OR] 3.4, P < 0.001). Among those with confirmed leptospirosis, the predominant reactive serogroups were Mini and Australis. Leptospirosis is a major yet underdiagnosed cause of febrile illness in northern Tanzania, where it appears to be endemic. Laboratory methods. Leptospirosis laboratory diagnosis was made using the standard MAT performed at the CDC. 10 Live leptospiral cell suspensions representing 20 serovars and 17 serogroups were incubated with serially diluted serum specimens. Resulting agglutination titers were read using darkfield microscopy. The reported titer was the highest dilution of serum that agglutinated at least 50% of the cells for each serovar tested. 10 The serogroups (serovars) included in the antigen panel were Australis ( Leptospira interrogans serovar Australis, L. interrogans serovar Bratislava), Autumnalis ( L. interrogans serovar Autumnalis), Ballum ( Leptospira borgpetersenii serovar Ballum), Bataviae ( L. interrogans serovar Bataviae), Canicola ( L. interrogans serovar Canicola), Celledoni ( Leptospira weilii serovar Celledoni), Cynopteri ( Leptospira kirschneri sero-interrogans serovar Wolffi), and Tarassovi ( L. borgpetersenii serovar Tarassovi).Study definitions. Confirmed leptospirosis was defined as a ≥ 4-fold rise in the agglutination titer between acute and convalescent serum samples.11 Probable leptospirosis was defined as a single reciprocal MAT titer ≥ 800.3, 12, 13 Exposure to pathogenic leptospires was defined as any reciprocal MAT titer ≥ 100.3, 12 Predominant reactive serogroup was defined as the serogroup for the reacting serovar with the highest MAT titer. Rural or urban residence, based on the 2002 Tanzania Population and Housing Census, was determined on a village level for all those with complete residence demographics available.14 Statistical analysis. Data were entered using the Cardiff Teleform system (Cardiff, Inc ., Vista, CA) into an Access database (Microsoft Corp., Redmond, WA). Descriptive statistics are presented as proportions, medians, ranges and interquartile ranges (IQR). Pearson's χ 2 was used to compare categorical data; Fisher's exact test was used when any cell contained fewer than 10 observations. Wilcoxon rank sum was used to compare categor...

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Section: Discussionmentioning

confidence: 99%

Leptospirosis among Hospitalized Febrile Patients in Northern Tanzania

Biggs

Bui²,

Galloway³

et al. 2011

The American Society of Tropical Medicine and Hygiene

107

View full text Add to dashboard Cite

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“…21 As illustrated by the triathlon in Illinois, the multisport races in Malaysian Borneo and Florida, this current study in Martinique, and several other outbreaks of leptospirosis associated with water; the first steps of prevention in athletes should be to avoid swimming in rivers, swallowing lake or river water, and prevent dermal cuts. 3,4,7,8,22,23 In addition, several studies suggest that doxycycline could be used either as chemoprophylaxis or as post-exposure prophylaxis and post-exposure empirical treatment. 21,[24][25][26][27] Both a study of U.S. Army soldiers who participated in a 3-week training exercise in the jungles of Panama and another study in residents of a rural area of the Andaman Islands found preventive efficacy of doxycycline, administered 200 mg once weekly.…”

Section: Discussionmentioning

confidence: 99%

Outbreak of Leptospirosis after a Race in the Tropical Forest of Martinique

Hochedez¹,

Rosine²,

Théodose³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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Three athletes who participated in a race in the tropical forest of the Caribbean island of Martinique were subsequently diagnosed with leptospirosis using polymerase chain reaction (PCR). We investigated an outbreak to evaluate possible risk factors, and to determine the appropriate public health recommendations. Of 230 athletes, we contacted 148 (64%) and 20 (13.5%) met our case definition. Five were hospitalized and none were fatal. Ten (91%) of the 11 ill athletes who were tested were confirmed by PCR or serology. Serogroup Pyrogenes was commonly found. Cutaneous cuts, reported by 14 (73.7%), was the only potential risk factor using univariate analysis. Sporting event participants in tropical areas should be made aware of specific warnings and recommendations concerning the risk of leptospirosis, especially after periods of heavy rainfall or flooding. Rapid diagnostic assays such as PCR are particularly appropriate in this setting for early diagnosis and for formulating public health recommendations.

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“…Excepcionalmente, se ha comunicado ocurrencia de un brote asociado a la ingestión de agua procedente de una fuente contaminada 12 . Publicaciones recientes 1,4 destacan una disminución del riesgo ocupacional y aumento relativo del riesgo recreacional relacionado, especialmente, a baño en aguas estancadas u otras actividades asociadas a turismo aventura durante el período estival.…”

Section: Epidemiologíaunclassified

“…La bacteria penetra, principalmente, por inoculación a través de piel erosionada, mucosas nasofaríngea, bucal, genital, o conjuntival 1,2,4,20,21,24 . Excepcionalmente, se ha documentado transmisión sexual y transplacentaria 3 y la infestación por ingestión de agua contaminada 12 . Para ello, las leptospiras cuentan con propiedades agresivas, como su motilidad y, probablemente, el efecto de toxinas y/o enzimas del tipo fosfolipasas, que no han sido claramente definidas.…”

Section: Patogeniaunclassified

Leptospirosis: Puesta al día

M¹,

P²

2007

Rev. chil. infectol.

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A Waterborne Outbreak of Leptospirosis

Cited by 72 publications

References 0 publications

Leptospirosis among Hospitalized Febrile Patients in Northern Tanzania

Leptospirosis among Hospitalized Febrile Patients in Northern Tanzania

Outbreak of Leptospirosis after a Race in the Tropical Forest of Martinique

Leptospirosis: Puesta al día

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