[The clinico-epidemiological characteristics of leptospirosis].
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Biomedical subjects
Publications and source records attributed to N A Stoianova.
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The comparative study of 16 Leptospira cultures, serogroup Canicola, isolated from humans and animals in different years in the North-West of the RSFSR and 2 reference strains of the Canicola serovar, Hond Utrecht IV and Kashirsky, was carried out in the agglutinin cross-adsorption tests. The absence of the antigenic homogeneity of the cultures under test was established: 9 of them proved to be identical to strain Kashirsky and 7, to strain Hond Utrecht IV.
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Observations in 5 patients dying with leptospirosis (at 6-30 days after the onset) caused by leptospira of the Hebdomadis serogroup are described. Bright jaundice developed due to severe serous liver centrilobular edema with pronounced dissociation of the liver cell bands, cholestasis, and cloudy swelling of hepatocytes. Albuminuria, oliguria, and uraemia were caused by acute tubular and interstitial nephritis. Hemorrhagic diathesis with small bleedings in the skin, mucous and serous membranes was associated with the impairment of permeability of microcirculatory vessels. Focal necroses of skeletal muscles, myocardiodystrophy, and focal myocarditis, serous leptomeningitis were also seen. Few leptospirae could be detected extracellularly (often attached to the outer host cell membranes) by Warthin-Starry's method of silver impregnation of paraffin sections and by indirect immunofluorescence, much more rarely could they be demonstrated by Levaditi's method of silver impregnation of pieces of the viscera. Most leptospirae were present in the liver in the case of death on the 6th day when no antibodies were yet present in the blood. Since the 9th day when the antibodies did appear, leptospirae gradually disappeared from the liver and were found in the kidneys. It is suggested that some leptospiral cytotoxic products play a role in the pathogenesis of leptospirosis.
The results obtained in the study of the intensity and character of immunity in persons immunized with commercial leptospirosis vaccine are presented. These results indicate that antibody formation occurs only in 12.5% of the vaccinees; antibodies are not formed to all Leptospira strains contained in the vaccine, and in 6 months all antibodies completely disappear. In persons immunized with a single vaccine dose the agglutinating activity of blood sera was linked only with IgM. In persons subjected to multiple immunizations for a number of years IgG could also be detected. Cases of leptospirosis among vaccinees have been registered.
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The existence of valent natural foci of leptospirosis, stable and polyhostal, under the conditions of urban agglomerations has been established. In an intensively urbanized landscape, the foci of mixed (natural and anthropic) type can be found. Depending on the character of microlandscape in a given zone, the main hosts of leptospires are different species of small mammals in whose populations, as a rule, the circulation of at least three Leptospira species is observed. Introduction of the 'carriership index' will help determine the role of different species of small mammals as the potential source of leptospires in the foci, as well as the proportion of different circulating Leptospira species and their zonal distribution.
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