1921
Volume 85, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Global leptospirosis disease burden estimates are hampered by the lack of scientifically sound data from countries with probable high endemicity and limited diagnostic capacities. We describe the seroepidemiologic and clinical characteristics of the leptospirosis outbreak in 2008 in Sri Lanka. Definitive/presumptive case definitions proposed by the World Health Organization Leptospirosis Epidemiology Reference Group were used for case confirmation. Of the 404 possible cases, 155 were confirmed to have leptospirosis. Highest titers of patient seum samples reacted with serovars Pyrogenes (28.7%), Hardjo (18.8%), Javanica (11.5%), and Hebdomadis (11.5%). Sequencing of the 16S ribosomal DNA gene identified six infections: five with and one with . In this patient population, acute renal failure was the main complication (14.8%), followed by myocarditis (7.1%) and heart failure (3.9%). The case-fatality rate was 1.3%. This report strengthens the urgent need for increasing laboratory diagnostic capabilities to determine the causes of epidemic and endemic infectious diseases in Sri Lanka, a finding relevant to other tropical regions.

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2011-09-01
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References

  1. 1999. Leptospirosis worldwide, 1999. Wkly Epidemiol Rec 74: 237242.
  2. Cachay ER, Vinetz JM, , 2005. A global research agenda for leptospirosis. J Postgrad Med 51: 174178.
  3. Brooks GF, Butel JF, Morse SA, , 2004. Leptospira and Leptospirosis. Medical Microbiology. Singapore: McGraw Hill Education (Asia), 338340.
  4. World Health Organization, 2010. Report of the First Meeting of Leptospirosis Burden Epidemiology Reference Group. Geneva: World Health Organization 134.
  5. Agampodi S, Peacock SJ, Thevanesam V, , 2009. The potential emergence of leptospirosis in Sri Lanka. Lancet Infect Dis 9: 524526.[Crossref]
  6. Unit E, 2009. Selected notifiable diseases reported by Medical Officers of Health. Wkly Epidemiol Rec 36: 4.
  7. Unit E, 2010. Selected notifiable diseases reported by Medical Officers of Health. Wkly Epidemiol Rec 37: 4.
  8. Unit E, 2011. Selected notifiable diseases reported by Medical Officers of Health. Wkly Epidemiol Rec 38: 4.
  9. Pappas G, Papadimitriou P, Siozopoulou V, Christou L, Akritidis N, , 2008. The globalization of leptospirosis: worldwide incidence trends. Int J Infect Dis 12: 351357.[Crossref]
  10. Koizumi N, Gamage CD, Muto M, Kularatne SA, Budagoda BD, Rajapakse RP, Tamashiro H, Watanabe H, , 2009. Serological and genetic analysis of leptospirosis in patients with acute febrile illness in Kandy, Sri Lanka. Jpn J Infect Dis 62: 474475.
  11. Gamage CD, Yasuda SP, Nishio S, Kularatne SA, Weerakoon K, Rajapakse J, Nwafor-Okoli C, Lee RB, Obayashi Y, Yoshimatsu K, Arikawa J, Tamashiro H, , 2011. Serological evidence of Thailand virus-related hantavirus infection among suspected leptospirosis patients in Kandy, Sri Lanka. Jpn J Infect Dis 64: 7275.
  12. Thaipadungpanit J, Wuthiekanun V, Chierakul W, Smythe LD, Petkanchanapong W, Limpaiboon R, Apiwatanaporn A, Slack AT, Suputtamongkol Y, White NJ, Feil EJ, Day NP, Peacock SJ, , 2007. A dominant clone of Leptospira interrogans associated with an outbreak of human leptospirosis in Thailand. PLoS Negl Trop Dis 1: e56.[Crossref]
  13. Levett PN, Branch SL, , 2002. Evaluation of two enzyme-linked immunosorbent assay methods for detection of immunoglobulin M antibodies in acute leptospirosis. Am J Trop Med Hyg 66: 745748.
  14. World Health Organization, 2010. Leptospirosis. Communicable Disease Epidemiological Profile. Geneva: World Health Organization, 102108.
  15. Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P, , 2004. Acute renal failure—definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 8: R204R212.[Crossref]
  16. Sanders EJ, Rigau-Perez JG, Smits HL, Deseda CC, Vorndam VA, Aye T, Spiegel RA, Weyant RS, Bragg SL, , 1999. Increase of leptospirosis in dengue-negative patients after a hurricane in Puerto Rico in 1996. Am J Trop Med Hyg 61: 399404.
  17. Cruz LS, Vargas R, Lopes AA, , 2009. Leptosoirosis: a worldwide resurent zoonoses and important cause of acute renal failure and death in developing nations. Eth Dis 19 (Suppl 1): S137S141.
  18. Deepak NA, Patel ND, , 2006. Differential diagnosis of acute liver failure in India. Ann Hepatol 5: 150156.
  19. Santos VM, Rocha de Sa DA, Turra TZ, Ferreira Borges NM, Nascimento UM, Damasceno EA, , 2009. Hantavirus pulmonary syndrome in Brasilia periphery: a diagnostic challenge. J Infect Dev Ctries 3: 639643.
  20. Akritidis N, Boboyianni C, Pappas G, , 2010. Reappearance of viral hemorrhagic fever with renal syndrome in northwestern Greece. Int J Infect Dis 14: e13e15.[Crossref]
  21. Nachega JB, Bottieau E, Zech F, Van Gompel A, , 2007. Travel-acquired scrub typhus: emphasis on the differential diagnosis, treatment, and prevention strategies. J Travel Med 14: 352355.[Crossref]
  22. Leelarasamee A, Chupaprawan C, Chenchittikul M, Udompanthurat S, , 2004. Etiologies of acute undifferentiated febrile illness in Thailand. J Med Assoc Thai 87: 464472.
  23. Murav'Ev NV, , 1956. Problem of differential diagnosis of malaria from leptospirosis [in German]. Zh Mikrobiol Epidemiol Immunobiol 27: 97101.
  24. Sunil-Chandra NP, Premaratne R, Somasiri DA, de Silva HJ, , 2003. Evidence of leptospira and hanta virus co-infections amongst pateints hospitalized for leptospirosis-like illness. Bulletin of the Sri Lankan Colleage of Microbiology 1: 3233.
  25. Smythe LD, Wuthiekanun V, Chierakul W, Suputtamongkol Y, Tiengrim S, Dohnt MF, Symonds ML, Slack AT, Apiwattanaporn A, Chueasuwanchai S, Day NP, Peacock SJ, , 2009. The microscopic agglutination test (MAT) is an unreliable predictor of infecting Leptospira serovar in Thailand. Am J Trop Med Hyg 81: 695697.[Crossref]
  26. Levett PN, , 2003. Usefulness of serologic analysis as a predictor of the infecting serovar in patients with severe leptospirosis. Clin Infect Dis 36: 447452.[Crossref]
  27. Hurst FP, Neff RT, Katz AR, Buchholz AE, Sasaki DM, Berg BW, Abbott KC, , 2009. Acute kidney injury requiring hemodialysis in patients with anicteric leptospirosis. Clin Nephrol 72: 186192.[Crossref]
  28. Merien F, Perolat P, , 1996. Public health importance of human leptospirosis in the South Pacific: a five-year study in New Caledonia. Am J Trop Med Hyg 55: 174178.
  29. Yersin C, Bovet P, Merien F, Wong T, Panowsky J, Perolat P, , 1998. Human leptospirosis in the Seychelles (Indian Ocean): a population-based study. Am J Trop Med Hyg 59: 933940.
  30. Gunawardhana SA, Sellahewa KH, , 2008. Clinical features of leptospirosis: a prospective descriptive study at the National Hospital of Sri Lanka (NHSL) in 2007. Ceylon Med J 53: 155156.
  31. Rajasuriya K, Munasinghe DR, Vitarne UT, Ratnaike VT, Peiris OA, , 1964. Leptospirosis in Ceylon: a Clinical Study. Ceylon Med J 93: 136153.
  32. Kularatne SA, , 2008. Human leptospirosis: case studies. Zoonotic and Emerging Zoonotic Diseases and their Prevention in the SAARC Region. Faculty of Veterinary Medicine and Animal Science. Peradeniya, Sri Lanka: University of Peradeniya.
  33. Faine S, , 1994. Leptospira and Leptospirosis. Boca Raton, FL: CRC Press.
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Supplementary Data

Errata

  • Received : 28 Apr 2011
  • Accepted : 01 Jun 2011

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