Epidemiological Characteristics and Trends in the Incidence of Leptospirosis in Japan: A Nationwide, Observational Study from 2006 to 2021

Hideharu Hagiya Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Kitaku, Okayama, Japan;

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Toshihiro Koyama Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan

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Fumio Otsuka Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Kitaku, Okayama, Japan;

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ABSTRACT.

During this age of climate change, the incidence of tropical diseases may change. This study compared the epidemiological characteristics and trends of leptospirosis in Japan between the endemic region, Okinawa, and the rest of the country. Infectious Diseases Weekly Reports were used to determine the numbers and crude incidence rates of leptospirosis. Data were stratified by sex, age, the estimated location of the infection, the notified regions, and the reporting month. A joinpoint regression analysis was performed to estimate the annual percentage change (APC). During the 16-year study period (2006–2021), 543 leptospirosis cases were reported, with male dominance (86.2%). Approximately half of these cases were reported from Okinawa (47.1%). The patients were relatively younger in Okinawa (20–29 years, 23.4%; 30–39 years, 20.7%) than outside Okinawa. The frequency of imported cases was significantly higher outside Okinawa (0.4% versus 14.3%). The incidences of leptospirosis in and outside Okinawa were apparently higher during the summer and typhoon seasons. The annual crude incidence ratios were 20–200 times higher in Okinawa than in the rest of the country. The average APCs for the entire study period in Okinawa and the rest of Japan were 1.6% (95% CI: −5.9 to 9.6) and −1.8% (95% CI: −7.8 to 4.6), respectively, without any particular trends. Collectively, the patient profile of leptospirosis differed between Okinawa (younger men) and outside Okinawa (middle- or older-aged men with a history of traveling abroad). The disease remains a neglected tropical disease; continuous surveillance with close monitoring is required.

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Author Notes

Address correspondence to Hideharu Hagiya, Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kitaku, Okayama 700-8556, Japan. E-mail: hagiya@okayama-u.ac.jp

Author’s addresses: Hideharu Hagiya and Fumio Otsuka, Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Kitaku, Okayama, Japan, E-mails: hagiya@okayama-u.ac.jp and fumiotsu@md.okayama-u.ac.jp. Toshihiro Koyama, Department of Health Data Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan, E-mail: koyam-t@cc.okayama-u.ac.jp.

  • 1.

    Costa F, Hagan JE, Calcagno J, Kane M, Torgerson P, Martinez-Silveira MS, Stein C, Abela-Ridder B, Ko AI, 2015. Global morbidity and mortality of leptospirosis: a systematic review. PLoS Negl Trop Dis 9: e0003898.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Boey K, Shiokawa K, Rajeev S, 2019. Leptospira infection in rats: a literature review of global prevalence and distribution. PLoS Negl Trop Dis 13: e0007499.

  • 3.

    Yamaguchi T, Higa N, Okura N, Matsumoto A, Hermawan I, Yamashiro T, Suzuki T, Toma C, 2018. Characterizing interactions of Leptospira interrogans with proximal renal tubule epithelial cells. BMC Microbiol 18: 64.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Guglielmini J, Bourhy P, Schiettekatte O, Zinini F, Brisse S, Picardeau M, 2019. Genus-wide Leptospira core genome multilocus sequence typing for strain taxonomy and global surveillance. PLoS Negl Trop Dis 13: e0007374.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Levett PN, 2001. Leptospirosis. Clin Microbiol Rev 14: 296326.

  • 6.

    Kakita T, Okano S, Kyan H, Miyahira M, Taira K, Kitashoji E, Koizumi N, 2021. Laboratory diagnostic, epidemiological, and clinical characteristics of human leptospirosis in Okinawa Prefecture, Japan, 2003-2020. PLoS Negl Trop Dis 15: e0009993.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Sato Y, Hermawan I, Kakita T, Okano S, Imai H, Nagai H, Kimura R, Yamashiro T, Kajita T, Toma C, 2022. Analysis of human clinical and environmental Leptospira to elucidate the eco-epidemiology of leptospirosis in Yaeyama, subtropical Japan. PLoS Negl Trop Dis 16: e0010234.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Narita M, Fujitani S, Haake DA, Paterson DL, 2005. Leptospirosis after recreational exposure to water in the Yaeyama Islands, Japan. Am J Trop Med Hyg 73: 652656.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Chen H-W, Zhang Z, Belinskaya T, Williams M, Ching W-M, 2020. Leptospirosis seroconversion surveillance among US marines assigned to Japan, 2011-2015. Mil Med 185: 624627.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Rossati A, 2017. Global warming and its health impact. Int J Occup Environ Med 8: 720.

  • 11.

    Bandara M, Ananda M, Wickramage K, Berger E, Agampodi S, 2014. Globalization of leptospirosis through travel and migration. Global Health 10: 61.

  • 12.

    Suzuki R, Terayama M, Tanda M, 2021. Severe leptospirosis infection in a non-epidemic area. IDCases 26: e01345.

  • 13.

    Saitoh H et al., 2015. Leptospirosis in the Tohoku region: re-emerging infectious disease. Tohoku J Exp Med 236: 3337.

  • 14.

    Mutoh Y, Koizumi N, Morino E, Hayakawa K, Kato Y, Ohmagari N, 2017. Leptospirosis cases in the Tokyo metropolitan area, Japan. Jpn J Infect Dis 70: 669671.

  • 15.

    Suzuki T, Morioka S, Kikuchi T, Sato L, Nomoto H, Yamamoto K, Koizumi N, Hayakawa K, Kutsuna S, Ohmagari N, 2022. Case report: leptospirosis by wild rat bite in winter in Tokyo metropolitan area, Japan. Am J Trop Med Hyg 107: 100101.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    National Institute of Infectious Diseases , 2023. Infectious Diseases Weekly Report. Available at: https://www.niid.go.jp/niid/ja/idwr.html. Accessed February 21, 2023.

    • PubMed
    • Export Citation
  • 17.

    Japanese Ministry of Health, Labor, and Welfare , 2023. Vital Statistics. Available at: https://www.e-stat.go.jp/dbview?sid=0003411884. Accessed February 21, 2023.

    • PubMed
    • Export Citation
  • 18.

    Kanda Y, 2013. Investigation of the freely available easy-to-use software “EZR” for medical statistics. Bone Marrow Transplant 48: 452458.

  • 19.

    National Cancer Institute , 2023. Annual Percent Change (APC) and Confidence Interval. Available at: https://surveillance.cancer.gov/help/joinpoint/setting-parameters/method-and-parameters-tab/apc-aapc-tau-confidence-intervals/estimate-average-percent-change-apc-and-confidence-interval. Accessed February 21, 2023.

    • PubMed
    • Export Citation
  • 20.

    Katz AR, Ansdell VE, Effler PV, Middleton CR, Sasaki DM, 2001. Assessment of the clinical presentation and treatment of 353 cases of laboratory-confirmed leptospirosis in Hawaii, 1974-1998. Clin Infect Dis 33: 18341841.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Tubiana S, Mikulski M, Becam J, Lacassin F, Lefèvre P, Gourinat A-C, Goarant C, D’Ortenzio E, 2013. Risk factors and predictors of severe leptospirosis in New Caledonia. PLoS Negl Trop Dis 7: e1991.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Philip N et al., 2020. Leptospira interrogans and Leptospira kirschneri are the dominant Leptospira species causing human leptospirosis in central Malaysia. PLoS Negl Trop Dis 14: e0008197.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Kamath R, Swain S, Pattanshetty S, Nair NS, 2014. Studying risk factors associated with human leptospirosis. J Glob Infect Dis 6: 39.

  • 24.

    Daher EF, Lima RS, Júnior GB, Silva EC, Karbage NN, Kataoka RS, Júnior PC, Magalhães MM, Mota RM, Libório AB, 2010. Clinical presentation of leptospirosis: a retrospective study of 201 patients in a metropolitan city of Brazil. Braz J Infect Dis 14: 310.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Klement-Frutos E, Tarantola A, Gourinat A-C, Floury L, Goarant C, 2020. Age-specific epidemiology of human leptospirosis in New Caledonia, 2006-2016. PLoS One 15: e0242886.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Tique V, Mattar S, Miranda J, Oviedo M, Noda A, Montes E, Rodriguez V, 2018. Clinical and epidemiological status of leptospirosis in a tropical Caribbean area of Colombia. BioMed Res Int 2018: 6473851.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Le Turnier P et al., 2018. Epidemiology of human leptospirosis in French Guiana (2007-2014): a retrospective study. Am J Trop Med Hyg 99: 590596.

  • 28.

    Jauréguiberry S, Roussel M, Brinchault-Rabin G, Gacouin A, Le Meur A, Arvieux C, Michelet C, Tattevin P, 2005. Clinical presentation of leptospirosis: a retrospective study of 34 patients admitted to a single institution in metropolitan France. Clin Microbiol Infect 11: 391394.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Haake DA & Adler B Leptospirosis in humans. Berlin, Germany: Springer, 6597.

  • 30.

    Ministry of Education, Culture, Sports, Science and Technology, Japan Meteorological Agency , 2020. Climate Change in Japan. Available at: https://www.data.jma.go.jp/cpdinfo/ccj/2020/pdf/cc2020_gaiyo_en.pdf. Accessed February 21, 2023.

    • PubMed
    • Export Citation
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